ArticleBMC health services research2019
Assessing the perceived impact of post Minamata amalgam phase down on oral health inequalities: a mixed-methods investigation.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Amalgam versus composite restorations: a cost-consequence analysis.British dental journal · 2026Article
- Amalgam restorations for primary molars in clinical practice and dental schools: current situation and required changes.BMC oral health · 2026Article
- The evaluation of dentists' stances concerning resin composite and amalgam as restorative materials.BMC oral health · 2026Article
- Article
- Oxidative genomic damage in pediatric patients exposed to mercury released by dental amalgam.BMC oral health · 2025Article
- The long-term oral health consequences of an amalgam phase-out.British dental journal · 2025Review
- Knowledge on the Minamata Convention on Mercury and dental amalgam phase down, availability and selection of mercury-free restorative materials among dentists in Kenya: a cross-sectional study.The Pan African medical journal · 2025Article
- Dental Amalgam Phase-Down-Status, Alternatives, Strategies and Preparedness for Implementation: A Review.International journal of dentistry · 2025Review
- Clinical Guide Adaptation for Amalgam Waste Management in Dental Settings in Iran.Frontiers in dentistry · 2024Article
- Teaching and placement of dental amalgam restorations at South African dental schools.Frontiers in oral health · 2023Article
- The effects of amalgam contamination and different surface modifications on microleakage of dentin bonded to bulk fill composite when using different adhesive protocols.BMC oral health · 2022Article
- [Amalgam and alternatives-discussions on mercury reduction in the environment].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundData from countries that have implemented a complete phase out of dental amalgam following the Minamata agreement suggest increased costs and time related to the placement of alternatives with consumers absorbing the additional costs. This aim of this study was to investigate the impact of a complete phase out of dental amalgam on oral health inequalities in particular for countries dependent on state run oral health services.
methodsA mixed methods component design quantitative and qualitative study in the United Kingdom. The quantitative study involved acquisition and analysis of datasets from NHS Scotland to compare trends in placement of dental amalgam and a survey of GDPs in Yorkshire, UK. The qualitative study involved analysis of the free text of the survey and a supplementary secondary analysis of semi-structured interviews and focus groups with GDPs (private and NHS), dental school teaching leads and NHS dental commissioners to understand the impact of amalgam phase down on oral health inequalities.
resultsTime-trends for amalgam placement showed that there was a significant (p < 0.05) reduction in amalgam use compared with composites and glass ionomers. However dental amalgam still represented a large proportion (42%) of the restorations (circa 1.8 million) placed in the 2016-2017 financial year. Survey respondents suggest that direct impacts of a phase down were related to increased costs and time to place alternative restorations and reduced quality of care. This in turn would lead to increased tooth extractions, reduced access to care and privatisation of dental services with the greatest impact on deprived populations.
conclusionAmalgam is still a widely placed material in state run oral health services. The complete phase down of dental amalgam poses a threat to such services and threatens to widen oral health inequalities. Our data suggest that a complete phase out is not currently feasible unless appropriate measures are in place to ensure cheaper, long-lasting and easy to use alternatives are available and can be readily adopted by primary care oral health providers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.