Practices and attitudes of dentists regarding the use and phase-out of dental amalgam fillings: compliance with EU regulations and the Minamata Convention

Background: This study examines the responses of 171 dentists to a comprehensive questionnaire to understand the current practice regarding the use and phase-out of dental amalgam. It assesses compliance with EU Regulation 2017/852 and the Minamata Convention, exploring factors associated with material choice, dentists’ awareness of regulations, and the use of amalgam separators. The study also identifies challenges and proposes support mechanisms to facilitate a smoother transition to mercury-free dentistry. Methods: The research was conducted as a cross-sectional study with 171 dentists who collected data on amalgam use, alternative materials, legislation, and separators through a questionnaire. Results: The study revealed regional and sector-specific variations in amalgam use, emphasizing the role of education, financial incentives, and safety standards on professional practices and the environmental impact. Amalgam use varied the most in adult clinics, influenced by clinical needs, patient preferences, and systemic barriers related to reimbursing costs for alternative materials not covered by health insurance until recently. Paediatric clinics demonstrated higher compliance with phase-out guidelines, highlighting the effectiveness of targeted training and policy interventions. Conclusions: The results of this study provide valuable insights for policymakers and other stakeholders to enhance and improve the planning and implementation of measures (primarily regulative) and support mechanisms to mitigate health risks associated with the use of mercury and encourage transition to safer dental practices. Since the level of compliance with regulatory requirements varies across regions, targeted measures, particularly in adult clinics, can improve the transition process. Targeted educational programs and financial incentives are crucial for the successful gradual phase-out of dental amalgam. Limitations: Potential response bias may arise due to voluntary participation and reliance on self-reported data, which could have influenced the comprehensiveness of responses.