Tooth decay remains one of the main reasons for visiting the dentist.

Evidence that the treatment and filling of cavities goes back a long way in human history has been found during archaeological excavations in the form of fillings, probably with natural resins, on fossilized teeth of prehistoric man.

Amalgam has long been the material of choice, despite its unattractive appearance. Its properties - high mechanical strength, ease of handling, cariostatic (because bacteriostatic) action and, above all, low cost - made it popular.

Although often referred to as "fillings", amalgams have long since been lead-free. They contain silver, copper and tin in varying proportions. But it's the highly controversial presence of mercury that has made it the subject of heated debate for several years now. In particular, the degree of toxicity of amalgams, the regulations governing their use and removal, and the treatment of mercury waste.

Regulations...

July 2018 French regulations prohibit amalgam fillings for children under 15 and pregnant or breastfeeding women. As of January 1, 2019, dental practices throughout Europe must be equipped with amalgam separators, enabling amalgam to be recovered during placement or removal. In France, this rule has been in force since 1998*.

In New Caledonia, despite the importance of preserving its lagoon, this system is not yet compulsory. As a result, they are disposed of along with wastewater and mercury in the lagoon.

Many practitioners have long since made the personal choice not to use amalgams. For at least the next 30 years, however, the problem of removing and treating them will remain.

Although mercury is not very volatile, it can release large quantities of toxic vapour. During disposal, the nursing staff are particularly concerned, due to their frequent exposure.

The professional market today offers special suction cannulas and high-filtering masks for amalgam removal. Some dental clinics even have dedicated rooms equipped with powerful air purifiers.

The International Academy of Oral Medicine and Toxicology IAOMT has developed a protocol for amalgam removal. Safe Mercury Amalgam Removal Technique, available here.

Their site is a mine of information on the toxicity of certain materials used in dentistry and the potential risks for practitioners and patients.

Closer to home IMNC (Intoxication Métaux Nouvelle Calédonie) - is an NGO working to raise (re)awareness of the dangers of heavy metals in the body and the very serious problems they can cause. It works in partnership with New Zealand (Dr. Wojick) and Australia (Dr. Siow) to train doctors who will be able to treat affected patients*.

You can check out their research on their facebook page

Intermed is committed...

INTERMED joins this commitment and has already stopped importing amalgams since 2018.

In collaboration with PROMED, we have also set up a system for collecting and processing amalgam waste. You can drop them off at the boutique DENTAIRE in hermetically sealed plastic containers (bottles, jars, etc.), where they will be weighed. The cost of treatment is calculated by weight. A treatment receipt is issued to the depositor.

Today, the wide choice of high-quality filling materials (glass ionomer cements, composites) means that amalgams are no longer needed.

Don't hesitate to contact us for more information about dental amalgam collection in New Caledonia.

*Source: INTERNET site of the Ordre National des chirurgiens-dentistes.

**Thanks to Dr. Marc Rohr for information on ONG IMNC, where he has worked for several years.

M.IGNEVA-PETIT