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news 6 IDEM Singapore 2016—9 April nWith the Minamata Convention on Mercury signed in 2013 and its proposed phase-out of mercury- containing products, including dental fillings, dentistry has en- tered a new era in which new and less harmful filling materials than amalgam are increasingly gaining importance. This year at IDEM, an entire symposium will be dedi- cated to that topic. Scientific pro- gramme director Dr David Alexan- der spoke with presenter Prof. Hien Ngo from the University of Queensland in Australia about the post-amalgameraanditsimpacton dental practice. Dr David Alexander: Why is now the time to be organising such a detailed symposium on dental restorative materials? Prof.HienNgo:Thescopeofthe Minamata Convention is much wider than dentistry. Its main ob- jective is to “protect human health and the environment from anthro- pogenic emissions and releases of mercury and mercury com- pounds”. In 2014, the FDI World Dental Federation issued a policy statement on dental amalgam sup- porting the recommendations of the Minamata Convention, which include the phase-down of amal- gam. As this material has been one of the mainstays of dentistry for over 150 years, this move has huge impact on the way dentistry is practised every day. We need to start preparing today. Surely with all the various tooth-coloured restorative ma- terials available we are already in the post-amalgam era? You are right, with the wide choice of tooth-coloured restora- tive materials and their improved performance, we are well equipped to enter the post-amal- gameraindentistry.However,the call by the FDI and United Nations Environment Programme (UNEP) for the phase-down, rather than the removal of amalgam from our profession, indicated that these authoritiesrealisedthatamalgam is still an important tool in many parts of the world. This is mainly because of its perceived low cost, long track record and high tech- nique tolerance. There are bil- lions of amalgam restorations still in service and the search for the ideal tooth replacement material is still ongoing. In preparation for the eventual removal of amalgam, the FDI policy statement stresses that authorities should work with thedentalprofessiononacompre- hensive global dental materials research agenda together with ef- fective preventive strategies. In the post-amalgam era, the profes- sion has to focus on both restora- tive and preventive approaches to the management of dental dis- eases. Briefly, how did the United Na- tions treaty on limiting the use of mercury come about? It started with the realisation of the negative impacts of mercury on the environment. The UNEP first looked into this issue in 2001. By 2003, it had concluded that there was enough evidence to rec- ommend reducing the use of mer- cury globally. However, by 2009 UNEP realised that there was in- sufficient voluntary action, so it was decided to step up the pres- sure with the introduction of a legally binding instrument. This wasthebirthoftheMinamataCon- vention, which was finally signed in 2013. Today, over 128 nations have signed it. Asfarasdentistryisconcerned, what will be the main changes in everyday practice? The main changes include fo- cusing on managing dental dis- eases, early detection and empow- ering patients in effective preven- tive regimes. When repair is re- quired, the focus should be on maximum preservation of tooth structure. This can be achieved only with the use of adhesive den- tistry and not amalgam. In order to gain public confi- dence, dental practitioners should demonstrate and communicate their commitment to safe handling practices, effective waste manage- ment and safe disposal of dental restorative materials. The public should be educated on the implica- tions of the Minamata Convention and the choice of restorative mate- rials should be based on a sound cost–benefit analysis of each par- ticular case. In this new era, den- tistry will be both challenging and fun, and the symposium will pre- pare participants for this new phase. As you already stated, dental amalgam has been one of the mainstays of dentistry for over 150 years. How can dental pro- fessionals acquire the knowl- edge, learn the skills and train their supporting staff to adopt the necessary procedures so thatpatientsmayenjoytheben- efitsofthesemodernmaterials, in most cases, in place of amal- gam? The alternative restorative ma- terials to dental amalgam are not that new; thus, most dental profes- sionals and their supporting staff will already be familiar with these materials, even if they may not be in widespread use in their clinics. New are the features and benefits that the most recently developed materials offer. The symposium will place much emphasis on this aspect, especially regarding the clinical techniques. Therefore, the adoptionofnewtechniques,under- standingthestrengthsandthelim- itations of various materials, and then the training of the wider den- talteamshouldnotbetoochalleng- ing. A benefit for every member of the dental team will be seen in pa- tient satisfaction, as the aesthetics and longevity are so much greater now. The symposium will address restoring a single tooth, as well as the entire dentition, and re-estab- lishing a healthy oral environ- ment. What are the major learning outcomesofthewhole-daysym- posium? Thissymposiumwillenablepar- ticipants to understand the ration- ale behind the need to phase down the use of dental amalgam and to gain a detailed and complete up- date on the latest advances in den- tal materials and the optimal tech- niques for clinical success. By the end of the symposium, participants will have gained prac- ticalknow-howtodelivereffective, evidence-based and patient-cen- tred preventive and restorative so- lutions in the everyday practice of dentistry. We have assembled a panel of internationally prominent scien- tists and clinicians to share their knowledgeandclinicalexperience in order to enable a greater under- standing of the opportunities for oral health and dental practice in the shift towards the post-amal- gam era of dentistry. By attending the symposium, will dentists be able to gain suf- ficient knowledge and skills to initiate the changes required in their practices? Thesecrettosuccessinrespond- ing to this call to action is to focus on preparing for the new era. This symposium is intended to provide participants with an understand- ing of the rationale behind the phase-down of amalgam, and par- ticipants will gain detailed knowl- edge on tooth-coloured materials, learn new skills on the selection and application of these, and most importantly be able to communi- cate the significance of the changes to members of the dental teamandpatients.Attheendofthe day, participants will feel ready and empowered to embark on this new and exciting phase of den- tistry. Clearly, the environment is at the heart of the treaty and the consequentchangesintheprac- tice of dentistry, but what do youseeasotherbenefitstoboth the dentist and, of course, the patient? The risk associated with free mercury has been well acknowl- edged by the dental profession. Waste management and safe han- dling of amalgam have been ob- served, and they are well regu- lated. One can argue that, for the majority of dental practitioners, the transition to tooth-coloured restorative materials happened a while back. These materials have much improved performance and they are now very popular. The main objective of this symposium istobringtogetheragroupofexcel- lent speakers to provide the latest information to the participants, as well as to share experiences and skills. The list of speakers includes eminent dental leaders, scientists and clinicians to ensure that each participant will benefit. Thank you very much for the interview.7 “The focus should be on maximum preservation of tooth structure” An interview with Prof.Hien Ngo,Australia 5 Prof. Hien Ngo, University of Queensland, Australia. 5 (From left to right) Nobuteru Ishihara, Minister of Environment, Japan, Achim Steiner, UNEP Executive Director, Ikuo Kabashima, Governor of Kumamoto Prefecture, and Katsuaki Miyamoto, Mayor of Minamata, posing with a plaquette commemorating the signing of the historic treaty. © ENB TDI0716_06_News 01.04.16 13:15 Seite 6 TDI0716_06_News 01.04.1613:15 Seite 6