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CED ÁLLÁSFOGLALÁSA AZ AMALGAM HASZNÁLATÁRÓL
Az FDI állásfoglalása szerint az amalgám használata biztonságos, és nincs olyan tudományos bizonyíték, amely alátámasztaná az amalgám toxicitását. A CED is elfogadja az FDI ezen állásfoglalását. Az amalgám ma is a legmegbízhatóbb tömőanyag bizonyos kavitások ellátására. Amennyiben az amalgám használatát betiltanánk, a legtöbb ország biztosított betegeinek ellátása veszélybe kerülne. Az EU 27 országából 25-ben az amalgám használata engedélyezett. A környezeti hatások miatt az amalgám felhasználását és az amalgám hulladék kezelését, szállítását és megsemmísítését vagy újra hasznosítását (recycling) minden ország saját környezetvédelmi rendeletei szabályozzák. A legtöbb országban fogászati egység készülékekben az amalgám szeparátor használata előírt. A CED felhívja minden ország kormányának és fogorvos társadalmának figyelmét a környezetvédelmi és veszélyes hulladékkal kapcsolatos EU rendszabályok betartására.

 

DRAFT CED RESOLUTION
DENTAL AMALGAM
CED-DOC-2010-085-E 19 November 2010

// HEALTH CONSIDERATIONS
The safety and importance of the continued use of amalgam is supported by the World Dental Federation (FDI) (Resolution on the use of dental amalgam adopted 2010) and by the report from 1998 of the ad hoc dental amalgam working group mandated by the European Commission. The effectiveness and safety of dental amalgam in the restoration of decayed teeth has been demonstrated through long usage. Research over many decades has failed to show any significant health risk posed by dental amalgam either to patients, dental staff or the public.
The CED welcomed the adoption, in May 2008 after public consultation, of the report of the EU Scientific Committee on "Safety of amalgam and alternative dental restorative materials". The reports confirmed the stance of the CED in regard to dental amalgam and its alternatives concluding that, "dental health can be adequately ensured by both types of material. All the materials are considered safe to use and they are all associated with very low rates of local adverse effects with no evidence of systemic disease."
// ENVIRONMENTAL CONSIDERATIONS
The CED also welcomed the adoption, in November 2007, of the report of the EU Scientific Committee on, "Environmental risks and indirect health effects of mercury in dental amalgam" and but also noted that report stated that, "the information presently available does not allow to comprehensively assessing the environmental risks and indirect health effects from use of dental amalgam in the Member States of the EU 25/27."
The dental profession takes seriously the environmental impact of its activities and the CED emphasises that the dental professional has an obligation to work within the legal framework governing mercury containing products. The CED calls on Member States to ensure the full implementation and enforcement of EU waste laws, and fully supports examination into whether this is happening. In most Member States amalgam separators are used and in many they are obligatory. Amalgam separators are an effective way of reducing harmful waste and remove a further 95% from the dental units' existing filtration systems resulting in a total capture of 99%, so preventing waste amalgam entering the waste stream. The CED also encourages national dental associations to share best practice on waste management and to support their members regarding compliance with waste management obligations.


// USE OF AMALGAM
The worldwide consensus of the dental profession is that amalgam should remain part of the dentist's armoury in order to best meet the needs of patients. It is important that patients must not be denied freedom of choice in respect of how to be treated. Dental amalgam continues to be the most appropriate filling material for many restorations, due to its ease of use, durability and cost-effectiveness. Dentists are best placed to identify patients' oral health needs. Restrictions on the use of amalgam would damage the financial stability of health systems as well as impact on individual patients' ability to afford dental care.
// IMPORTANCE OF PREVENTION
CED, as the authoritative and independent voice of dental profession in Europe, calls on governments to foster and ensure the phase up of effective prevention of dental caries and associated health promotion programs. This should be linked to preventive disease management, which will result in the phase down of use of current restorative materials, including dental amalgam. It is predicted that the pace of improvement of oral health will vary from country to country depending on such factors as the level of existing disease, particularly in disadvantaged communities, and the investment of national governments in supporting health promotion. Amalgam is a safe and highly effective restorative material. To maintain and protect public health, a phase down of amalgam will be only appropriate when an alternative and suitable restorative material is available.