[What efforts are being made by dentists in the Flemish region for the limiting of amalgam rejection? A study conducted on a representative sample of 373 Flemish dentists on the subject of amalgam waste: extent of the problem, waste management and foreseeable solutions].

The great Amalgam debate is also taking place in Flanders (Belgium). Mercury amalgam has been used for dental fillings since the last century. Over that time, questions have occasionally been raised with regard to its safety (mercury vapour given off by the amalgam fillings and the possible dangers that these could cause to the patient and the dentist) and with regard to the ecological impact of amalgam waste. Some materials used to treat dental patients endanger the environment. The most important polluting materials are the heavy metals, in particular mercury. This study investigated the answers to the following research questions: What is the total volume of amalgam that is used in Flemish dentistry and what part ended up in the household waste? How do Flemish dentists manage (store and dispose of) their dental amalgam waste? Are Flemish dentists using any alternatives (amalgam separators or alternative materials for dental fillings) for amalgam? A randomly selected group of 500 dentists working in the Flemish part of Belgium was invited to answer a mail questionnaire. A total of 373 dentists responded (response rate 74.6%), providing a representative sample. Of the 5000 kg amalgam being used in one year in Flemish dentistry, about 1.200 kg is discharged either into the sewage or into the household waste. Furthermore, a supplementary 1.900 kg amalgam (extracted teeth with amalgam fillings or bored out amalgam fillings) is also being discharged either into the sewage or into the household waste. Although dental amalgam is the restorative material most used in Flanders, composite materials are becoming more widely used. Only 5% of the respondents were using an amalgam separator.