Mercury Free Dentistry Seminar & Curriculum Update Workshop, July 24th 2019, Abuja, Nigeria
This session (preconference seminar and curriculum update workshop) was chaired by the Registrar of the Medical and Dental Council of Nigeria Dr. T.A.B. Sanusi. The Seminar/workshop was organized in partnership with the World Alliance for Mercury Free Dentistry, SHRAdeV, Association of Nigerian Dental School Deans and the Nigerian Dental Association. The morning session (Mercury Free Dentistry Seminar) was for both General Dental Practitioners (GDPs) and lecturers in faculties of Dentistry. For GDPs it serves as an introduction to Minimum Intervention Dentistry (MID). For lecturers of Faculties of Dentistry it served as both an introduction to MID and a foundation for the curriculum update workshop in the afternoon session.
International facilitator, Prof. Jo E. Frencken, the inventor of Atraumatic Restorative Dentistry (ART) from Netherlands, Europe presented two seminars: The use of glass hybrid materials for restorations and Integrating Minimum Intervention Dentistry in Dental Curriculum. Both presentations generated interesting questions from the participants.
Prof Jo Frencken advised that Nigeria should first ensure the wide availability of mercury free restorative materials before the restriction of the use of Dental Amalgam in vulnerable groups by January 2020.
In his presentation on “Phase down of dental amalgam: The Training of 21st century Dentists”, Coordinator, Mercury free dentistry in Nigeria, Prof. Godwin Arotiba said there is no more scientific backing for the continued use of dental amalgam as a tooth filling material in the 21st century. He emphasized that ‘Mercury Dental Amalgam’ belonged to the 19th and 20th century Dentistry and has no place in 21st century dentistry.”
Prof. Arotiba highlighted the definitions, principles and clinical strategies of Minimum Intervention Dentistry (MID) and informed the gathering that MID is focused on early caries diagnosis, caries risk and activity assessments/classifications, targeted preventive treatments based on CRA classification, frequent recall visits to evaluate compliance with counselling, caries control and oral health outcome, minimally invasive restorations and repair rather than replacement of defective restorations. He submitted that the goal of MID is to keep oral tissues healthy and functional for life. In addition, he pointed out that MID has applications in periodontology, oral surgery and oral rehabilitation and that all branches of dentistry will soon embrace it.
In his presentation on “Dental Amalgam phase-down: The imperative of curriculum review and update in dental schools in Nigeria” Dr. Adolphus Loto said curriculum update is a necessity in the ever-changing world owing emerging new knowledge and techniques through research and technological development/advances. Dr. Loto, who urged dental practitioners to embrace change, stressed that curriculum update will involve update of courses at almost every level of a typical 6 years Bachelor of Dental Surgery programme.
Other presentations include Curriculum development, review, update and evaluation by Dr. O.A Loto; The European Core Cariology curriculum by Prof. M.A Sede; The Association of Nigerian Dental School Deans (ANDD) Cariology curriculum by Prof. M. Ukpong;
Prof G T Arotiba also presented a modified color-coded GC Corporation Minimum Intervention Treatment Plan (MITP) framework for implementing MID in General Dental Practice and in Dental Education. This modified MITP framework was adapted for student’s clinical assessment in MID (see Fig. X)
Fig. X: The Modified color-coded GC Corp. MITP framework
Godwin Toyin Arotiba Seminar / Workshop Director & Coordinator of Mercury Free Dentistry in Nigeria.
Presented on 8th July, 2019 Abuja, Nigeria.
Goodwill Message from Attorney Charlie Brown,
President, World Alliance for Mercury-Free Dentistry
To Professor Arotiba, Professor Frencken, the Deans and Professors of the Colleges of Dentistry, the Dentists of Nigeria, Government Officials federal and state, NGO leaders Adogame, Bally, and Aneni, and all other stakeholders:
Congratulations for your work to implement the Minamata Convention on Mercury.
Congratulations for the far-sighted decision to end amalgam use for children under 15 and for pregnant and breastfeeding women as of 1 January 2020, in less than six months! You are saving an entire generation of Nigerians from exposure to toxic mercury. Arise, O Compatriots!
Nigeria is the leader for Africa – what you do will affect the entire continent. It is the reason I have been to your great nation for each of the past three years, four times in all, to work for mercury-free dentistry.
We attribute the enormous progress at the federal level to the excellent quality of men and women at the environmental and health ministries, especially my friends Dr. B.O. Alonge, Chief Dental Officer of Nigeria and Director Charles Ikeah, Pollution Control and Environmental Health, Federal Ministry of Environment, who leads your government’s delegation at the Minamata Convention negotiations.
The World Alliance for Mercury-Free Dentistry is proud to work with the esteemed Professor and former Dean Godwin Aritoba, and we salute his leadership to bring 21st century dentistry to Nigeria. I am pleased that you are joined by Professor Jo Francken, whose well-known work as a pioneer of A.R.T. I have been reading about for at least a decade.
Progress toward mercury-free dentistry is succeeding in Nigeria, Africa’s colossus state, because of the work of our excellent NGO team, led by Leslie Adogame in Lagos and including Tom Aneni in Benin and Joy Eziallor in Enugu. I am most pleased that Monsieur Dominique, the founder of the African Center for Environmental Health and the vice president for Africa of the World Alliance, came over to Abuju from Abidjan to speak.
The World Alliance works at the federal level for mercury-free dentistry, plus has “model state” campaigns in Edo State and Lagos State. Having done a regional conference in the South-South Region in 2017, later this year we will a regional conference in Enugu for the South East Region.
My warmest wishes to the people of Nigeria and to today’s visitors to Nigeria:
23 July 2019
Activities completed in 2019
The following activities were completed in 2019 in partnership with the Nigerian Dental Association:
- National Policy on phase down of dental amalgam steering committee meeting organized by dentistry division, federal Ministry of Health, Abuja, Nigeria.
- Mercury free dentistry seminar for general dental practitioners and faculties of dentistry in Nigeria (organized by the Nigerian Dental Association and the Association of Nigerian Dental School Deans).
- Curriculum update workshop for faculties of Dentistry in Nigeria. (organized by the Nigerian Dental Association and the Association of Nigerian Dental School Deans).
- Minimata convention on mercury – phasing out dental amalgam in Nigeria (organized by the Nigerian Dental Association).
Nigeria sets to get National Policy on phase down of dental amalgam
Photo Caption: Participants in a group photograph during the Steering Committee on development of National Policy on phase down of dental amalgam held in Abuja on Tuesday July 23, 2019.
In continuation of her efforts to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds, Nigeria will soon get a National Policy on phase down of dental amalgam in line with the objective of the Minamata Convention on Mercury.
Essentially, the goal of the document tagged “National Policy on Phase- Down of Dental Amalgam in Nigeria” is to phase down the use of dental amalgam in vulnerable groups by June 2020 and phase out in all age groups by 2022 on a consensus-based timetable.
Dental amalgam is a mercury-added product containing about 50 per cent of mercury, forming a metallic alloy with silver and tin. It is widely used in the restoration of teeth affected by dental caries which about the most common dental disease worldwide and it has been available for over 150 years.
At a-day long Steering Committee meeting on development of the National Policy held at the nation’s capital, Abuja on Tuesday July 23, 2019 facilitated by the Federal Ministry of Health in conjunction with Federal Ministry of Environment in partnership with Sustainable Research and Action for Environmental Development (SRADev Nigeria) and World Alliance for Mercury Free Dentistry, USA, stakeholders reviewed and made recommendations to the draft document.
In her welcome address at the meeting, Director, Dental Services, Federal Ministry of Health, Dr. B.O. Alonge, provided an overview of mercury as a toxic substance posing a global threat, noting the damaging effects on health and environment. She noted that the Minamata convention calls for a phase down and subsequently a phase out of the use of Dental amalgam which Nigeria is taking step in that direction.
She added that Nigeria is a Party to the Convention and the Ministry initiated the process of developing a National Policy on dental amalgam phase down in line with the Convention objective.
Representative of the Federal Ministry of Environment and a Deputy Director, Mr. Olubunmi Olusanya, said dental amalgam phase down is a cross-cutting issue which the ministry has carried along all the parastatals under it along in ensuring that they are all well informed including the private sector.
He explained that the Ministry has been fully involved in the process right from the onset leading to the signing in 2013 and ratification of the Convention in 2018.
Olusanya added that Nigeria was the first country to conduct the Mininamata Initial Assessment (MIA) report in the world, which was completed in 2018 and received commendation from the international community on it.
He listed several other efforts that the Ministry has made as the Secretariat of the Minamata Convention since the country ratified the Convention last year.
Regional Environment Expert, United Nations Industrial Development Organization (UNIDO) Mr. Oluyomi Banjo, in his goodwill message commended the cooperation between the Federal Ministry of Health and Environment on the Minamata Convention on Mercury, adding that the cooperation led to Nigeria been the first to successful complete the Minamata Initial Assessment (MIA).
“This would not have been possible without the cooperation of the two ministries”, Banjo stated.
Banjo urged the two ministries to ensure that the cooperation continues in the implementation stage of the Minamata Convention, stressing that the MIA had earned Nigeria recognition in the international community which others are now following.
He added that Nigeria has made a lot of progress in the phase down of dental amalgam and in the mining sector to eliminate mercury pollution.
President, Nigeria Dental Association (NDA), Dr. Omoshibo Eshikena said the association has being part of the process for implementation on the phase down of dental amalgam in the country.
Dr. Eshikena who expressed her delight on the development of the policy hope that Nigeria will soon be mercury free.
In his goodwill message, Vice President Africa for World Alliance for Mercury-Free Dentistry (WAMFD), Mr. Dominique Bally, an Ivorian, commended Nigeria for the efforts towards making dental amalgam history in the country.
He explained that like all the countries that participated in the negotiations of the Minamata Convention on Mercury and even those who have not ratified it, is clear that the question of dental amalgam elimination remained one of the priorities for Africa region.
Bally, who extended the greetings of the WAMFD president, Charlie Brown to the meeting said, “Nigeria has not been left out of this whole process. Indeed, it is since here that in 2014, African civil society organizations have enacted the Abuja Declaration calling on Africa to be the first continent to eliminate mercury amalgam in dentistry. Since then, how many activities have not been carried out to achieve this noble goal that protects the health of our valiant populations who are longing to live in a healthy environment, which is a mercury-free one.
“Today’s meeting is intended primarily to bring to the table the finalization of the policy documents leading Nigeria to achieve the dental mercury elimination in a very short time, starting with children under 15 years old and women of childbearing age”, he said.
The WAMFD Africa Vice President said the Africa region has rightly submitted, through the governments of Gabon, Guinea, Senegal, Niger, Madagascar and South Africa, a proposal for an amendment of Annex A, Part II, of the Minamata Convention with a view to reaching a precise date for the banning of dental amalgam in children and women of childbearing age at COP 3.
“In my turn, I, would like too, to call on the Government of Nigeria to take ownership of this proposed amendment so that Africa speaks with one voice, as it has always been, and whose palpable example goes back to this vibrant echo calling for consideration of pollution questions and public health ones generated by dental amalgam at COP 2 in 2018”, Bally added.
Erudite scholar and Professor of Chemistry, Babajide Alo, said Nigeria is leading globally in the process of eliminating dental amalgam through the submission of MIA in 2018.
He stressed that the “Abuja Declaration” in 2014 is widely recognized and that the country is making progress in the phase down of dental amalgam. He urged the dental practitioners to change to the alternatives to amalgam, which he said it will take time but “it is achievable because there are alternatives to amalgam”.
In a communiqué, the committee unanimously agreed that in alignment with global standard documents, the national policy should be further updated to drive the phase down of amalgam use in Nigeria as a road map and implementation plan.
The National Policy draft was developed by former Dean, Faculty of Dental Sciences, College of Medicine of the University of Lagos, Prof. Godwin Arotiba.
In his vote of thanks to the committee members, Executive Director of SRADev Nigeria, Dr. Leslie Adogame, commended them for their commitment towards the project as well as the support of WAMFD for making the meeting possible.
NDA backs dental amalgam phase down, seeks partners on implementation
Photo Caption: Cross section of participants at the 52nd AGM/SC of Nigerian Dental Association (NDA) held in Abuja from 24-26 July 2019.
Members of the Nigerian Dental Association (NDA) have put their weight behind dental amalgam phase down in Nigeria. Besides, they have called on all stakeholders to partner with them towards its implementation in dentistry practice in Nigeria in line with the objective of the Minamata Convention on Mercury.
President of the association, Dr. Eshikena Evelyn stated this in Abuja on Thursday during the 52nd Annual General Meeting /Scientific Conference themed “The Minamata Convention on Mercury-Phasing Down of mercury Dental Amalgam in Nigeria” held from 24th-26th of July in Abuja.
According to her, the federal Ministry of Environment and Health need to develop the country’s national action plan around the convention to set realistic targets around dental amalgam phase down, adding that the Ministry of Science and Technology need to direct the research institutes/parastatals to collaborate with NDA, Faculties of Dentistry and Universities to conduct research into mercury free dental restorative materials with a view to explore the possibility of local manufacture.
Besides, the NDA President also request that the necessary legislation be put in place to restrict the importation of dental amalgam into the country, proscribe the use of dental amalgam in the vulnerable group by January 2020, and obtain duty free concession/reduction on mercury free restorative materials.
Dr. Eshikena, in her welcome speech at the conference said, “NDA calls on all stakeholders here present and those we have invited to partner with us. Our dental schools need equipment and an upgrade of the simulation laboratories of the 13 Dental Schools in Nigeria with ICT, Interactive smart boards and e-learning facilities”.
She added that through the Scientific Conference, the NDA would promote update of dental schools curricula, retrain general dental practitioners in Minimum Intervention Dentistry and increase public awareness of the harmful effects of mercury in dental amalgam.
Nigeria is a signatory and 88th Party to the Minamata Convention on Mercury. The Convention which came into force on 16 August 2017 aimed at protecting human health and the environment from anthropogenic emissions and releases of mercury compounds. The Convention focused on the entire life cycle of mercury, including controls and reduction across a range of products, processes and industries where mercury is used, released or emitted.
Approximately 50% of dental amalgam is elemental mercury by weight. Mercury can damage the child’s brain even before they are born. The World Health Organization considers it one of the top ten chemicals of major public health concern.
Already, the Federal Ministry of Health has commissioned a consultant to develop a National policy on phase down of dental amalgam in Nigeria, a document that will guide towards the implementation of the Convention.
In his good will message, Vice- President Africa of the World Alliance for Mercury-Free Dentistry (WAFMD) Mr. Dominique Bally, congratulated Nigeria for the work done to implement the Convention and the far-sighted decision to end amalgam use for children under 15 and for pregnant and breastfeeding women by January 1, 2020. “Doing that, you are saving an entire generation of Nigerians from exposure to toxic mercury”, he said.
“Nigeria is the leader for Africa – what you do will affect the entire continent. It is why World Alliance for Mercury-Free Dentistry has been present in this great nation for each of the past three years, four times in all, to work for mercury-free dentistry.
“like all the countries that participated in the negotiations of the Minamata Convention on Mercury and even those who have ratified it, it is clear that the question of dental amalgam phase down remained one of the priorities for Africa region. So many progresses have been made in Africa on this question and Nigeria as well.
“These enormous progress at the federal level are attributed to the excellent quality of men and women at the environmental and health ministries, at this point, allow me please to nominate Dr. B.O. ALONGE, Chief Dental Officer of Nigeria and Director Charles IKEAH, Pollution Control and Environmental Health, Federal Ministry of Environment, who leads your government’s delegation at the Minamata Convention negotiations.
“The World Alliance for Mercury-Free Dentistry is proud to work with the National Dental Association these past five years led at this day by Dr Eshikena OMOSHIBO. We are most proud to closely work with the esteemed Professor and former Dean Godwin ARITOBA, and we want once again to salute his leadership to bring 21st century dentistry to Nigeria. I am pleased that you are joined by Professor Jo Frencken, whose well-known work as a pioneer of A.R.T. I have been reading about and promoting in African continent for at least a decade”, Bally said.
Bally, who expressed greeting from the President of WAFMD, Charlie Brown, said Progress toward mercury-free dentistry is succeeding in Nigeria, Africa’s colossus state, because of the work of her excellent NGO team, led by Dr Leslie Adogame in Lagos and including Dr Thomas Aneni in Benin City and Mrs. Joy Eziallor in Enugu.
In her goodwill message, Director, Family health, Federal Ministry of Health, Dr Adebimpe Adebiyi, who congratulated NDA on the occasion of her 52nd AGM/SC, urged participants to probe into the wisdom of phase down of dental amalgam.
International facilitator, Prof. Jo E. Frencken, said Nigeria should not be fast in phasing down of dental amalgam but should consider national economy in the area of availability of alternatives to dental amalgam.
He went further “you don’t destroy your old house, when you have not built a new one”.