The filling of teeth is one of the most routine and common tasks undertaken by dentists.

Because of fluoridation and improved dental care, Irish adults have fewer missing teeth; however, they have more teeth with fillings as a result.

Most Irish adults have been affected by dental caries (decay) and have fillings: 82% of Irish adults with teeth have at least one filling, with each adult having, on average, 7.8 filled teeth each.

When filling teeth, dentists rely on two main materials: amalgam (a metallic compound containing mercury) and resin composite (a plastic, tooth-coloured material).

Identifying Pressures

From an environmental perspective and in an attempt to introduce international controls on the use of mercury, a recent international agreement has included a commitment that there should be a phase down in the use of dental amalgam (United Nations Environmental Programme 2013).

More recently, European Union Regulation 2017/852 and the European Union (Mercury) Regulations 2018 will give further impetus and drive to a reduction in the use of amalgam filling materials.

What is perhaps more subtle, but environmentally significant, is the waste management systems used by dentists in relation to the safe disposal of amalgam and composite materials, with the Dental Council having published codes of practice regarding dental amalgam in 2015 and 2018.

Research undertaken by Martina Hayes, Aileen Callanan, Mairead Harding, Christopher Lynch and Francis Burke titled ‘Study on Usage and Waste Management of Amalgam Dental Fillings and Mercury-free Alternatives’, aims to quantify the usage of amalgam and mercury-free alternatives in the dental service in Ireland, describe current waste management policies and practices, and identify operational variation between dental practitioners in this area.

The information garnered will determine if further research is needed in this area and if there is a need for more formal guidance for dental practitioners around waste management for mercury-free alternatives to amalgam fillings.

The full report can be accessed from the Environmental Protection Agency’s website