Dentists' restorative decision-making and implications for an 'amalgamless' profession. Part 1: a review

Area of Science:

• Dental materials science
• Public health policy
• Restorative dentistry

Background:

• The Minamata Convention mandates global reduction and elimination of mercury-containing products.
• This international agreement significantly impacts dental practices, particularly regarding the use of dental amalgam.
• Limited recent research exists on the Australian dental context concerning mercury reduction.

Purpose of the Study:

• To review the shift in direct restorative materials in dentistry, from amalgam to resin composite.
• To examine the reasons behind the increasing use of resin composite despite its disadvantages.
• To discuss evidence-based decision-making, minimally invasive techniques, and educational approaches in an 'amalgamless' dental profession.

Main Methods:

• Literature review of direct restorative materials in dentistry.
• Analysis of clinical evidence and trends in material selection.
• Commentary on evidence-based decision-making and minimally invasive dentistry.

Main Results:

• Resin composite has largely replaced amalgam as the preferred material for direct posterior restorations globally.
• The shift towards resin composite is driven by various factors, despite amalgam's well-established properties.
• Current evidence supports resin composite use, influencing minimally invasive approaches and dental education.

Conclusions:

• The dental profession is transitioning towards an 'amalgamless' future due to global mercury reduction initiatives.
• Evidence-based decision-making and minimally invasive practices are crucial in selecting direct restorative materials.
• Dental education must adapt to prepare practitioners for an amalgamless environment and evolving restorative techniques.