Stakeholders call for urgent action to end dental amalgam use in Nigeria

Ahead of the fast approaching September 28, 2023 date that Children’s Amendment under the Minamata Convention on mercury will enter into force, stakeholders in the environment and health sectors have called for urgent action to end  dental amalgam use in children under 15, pregnant and breast feeding women in Nigeria.

At a tripartite Stakeholders’ meeting organized by Sustainable Research and Action for Environmental Development (SRADev Nigeria) under the auspices of World Alliance for Mercury-Free Dentistry towards the Implementation of the Children’s Amendment to the Minamata Convention on Mercury in Nigeria held in Abuja on 17 May 2023, participants resolved that the Federal Ministry of Environment (FMEnv) as the National Designated Authority (NDA) on the Minamata Convention should formally notify the Nigeria Dental Association (NDA) and the Federal Ministry of Health (FMoH) on the Children’s Amendment, requesting their positions considering local capacities and priorities.

Other resolution passed at the end of the daylong meeting include:

• Federal Ministry of Health dental division to put machinery in place to notify state units to implement the phase out of dental amalgam use in children, pregnant and lactating women by 28 September 2023.
• Establish state structures that will enable policy statement to be sent to local levels for its implementation.
• Conduct technical dental training to community dental officers, nurses and technicians using the WHO training manual.
• The consultant works with selected stakeholders particularly NDA president and the Vice President of the WAMFD Nigerian group to update the relevant sections on National Policy on Dental Amalgam Phase-down.
• The FMoH makes a recommendation to the National Health Insurance Authority on the need to include oral health, replacement of safer alternatives with dental filling in dental practice
• The FMoH and FMEnv work collaboratively to request from the appropriate MDA of government, the removal of tariff for alternatives to dental amalgam to reduce the overall cost of purchase for ease of implementation of the Convention.
• Request local and international assistance to mop up the current available (legacy) dental amalgam from dental clinics to dispose in an environmentally sound manner.
• The Federal Ministry of Health through its dental division must work with relevant stakeholders to develop strategic plans to implement the steps to phase down dental amalgam use as enshrined in the National Policy to Phase down Dental Amalgam.

Other recommendations include the need for government to initiate a coordinated multi-sectoral approach for an effective phase out of amalgam in children under 15, pregnant and breastfeeding women; the need to come up with action plan towards implementation of the Children’s Amendment in Nigeria and implementation of a phase out work plan.

They also recommended promotion of alternatives/transition to alternatives by a concession for imported alternative restorative materials, engagement of public and media as well as other stakeholders in awareness creation on the health impacts of mercury in dental amalgam and the need for prevention of caries.

They also called for continuous awareness raising among the policy makers and practitioners in the country.

Executive Director, SRADev Nigeria, Dr. Leslie Adogame, in his welcome remarks said dentists have accepted that amalgam is toxic most especially for the vulnerable group. He disclosed that the effort to end dental amalgam started 10 years with the Abuja declaration to phase down dental amalgam.

Adogame stressed that the civil society in collaboration with government and other stakeholders are ready to do every possible to ensure that Nigeria join the global community to phase out dental amalgam as stipulated in the Minamata Convention.

President of the Nigeria Dental Association (NDA) Dr. Tope Adeyemi, stressed the need to ban use of dental amalgam in the dental profession. He listed activities of the association to promote amalgam phase down including: checking the availability of amalgam in dental clinics, awareness raising among practitioners and setting phase out dates for vulnerable population and the general citizenry.

Adeyemi explained that the NDA current position to phase out dental amalgam use in vulnerable groups -Children, pregnant and lactating women- is December 31, 2025 while for the entire population is December 31, 2030. “NDA has commenced a nationwide phase down/phase out activities towards these dates.

“Many members of the NDA has stopped the use of dental amalgam in various dental clinic and monitoring team engaged to access information of amalgam stock available in the some of the clinics,” he added.

Dr. Tom Aneni and Mrs Joy Mamah, WAMFD national members in the South South and South Eastern Nigeria respectively reflected on the activities of the regions in promoting dental amalgam phase down. The duo disclosed that as a pilot states, they have embarked on awareness raising and advocacy on phase down of dental amalgam in the regions, adding that with the lessons learnt, they would be able to implement in other part of the country.

Representative of Federal Ministry of Environment, Mr. Ahmed Ibrahim, presented a paper on ‘Minamata Convention Implementation in Nigeria- Dental Amalgam Phasedown/Phase out and Africa Amendment’, while Prof. Arotiba presented a brief overview of the National Policy on Dental Amlagam Phase down and Strategies to implement the Children’s amendment to the Minamata Convention on Mercury.

Participants at the meeting commended the president of the World Alliance for Mercury-Free Dentistry, Charlie Brown, for the continuous support to Nigeria to end dental amalgam in dentistry.

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