Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives

Area of Science:

• Dental materials science
• Clinical dentistry
• Public health policy

Background:

• Amalgam use is undergoing a phasedown, with potential for a complete phase-out under consideration.
• This shift necessitates understanding clinician perspectives on current and future dental restorative materials.

Purpose of the Study:

• To assess UK primary care clinicians' awareness of the amalgam phase-down.
• To gauge their opinions on a potential amalgam phase-out.
• To evaluate their confidence in using various restorative materials in different clinical scenarios.

Main Methods:

• A cross-sectional e-survey was distributed to 11,902 British dentists and therapists.
• The survey assessed knowledge, opinions, and confidence regarding amalgam and its alternatives.
• Data were analyzed using descriptive statistics and logistic regressions.

Main Results:

• Low knowledge of amalgam phase-down criteria was observed (3% correctly identified all avoidance groups).
• While postgraduate composite training is high (88%), clinicians expressed significant concerns about composite suitability and confidence in difficult situations compared to amalgam (P < 0.0001).
• High confidence in placing posterior composites was linked to being a private general dentist or primarily a composite user.

Conclusions:

• UK primary care clinicians possess limited knowledge of the amalgam phase-down and harbor significant concerns about its potential phase-out.
• A notable lack of confidence exists in using composite materials for posterior restorations in challenging clinical settings, contrasting with high confidence in amalgam.
• Effective clinician education, understanding patient values, and supportive policy changes are essential for a successful amalgam phase-down and potential phase-out.