# Community social responsibility of continued and appropriate use of silver amalgam as dental restorative material in southern India: A cross-sectional study

## TL;DR

This study explores why many dentists in southern India are choosing to stop using silver amalgam despite its effectiveness and low cost.

## Contribution

The study provides new insights into dentists' perspectives on mercury toxicity and environmental concerns in South India.

## Key findings

- Most dentists were satisfied with dental amalgam's performance and found it economical.
- Over half of the dentists would stop using amalgam due to mercury toxicity and environmental concerns.
- Older and more experienced dentists were more likely to continue using amalgam.

## Abstract

Background: For more than 150 years, dental amalgam (DA) has been popular as a dental restorative material. Yet, many organisations oppose its use due to perceived toxicity and environmental concerns. Hence, this study aimed to explore the continued use of DA from a South Indian dental practitioners’ perspective.

Methods: This cross-sectional study was conducted among fifty-two private and public dental practitioners of Udupi district in Southern India. A self‑administered questionnaire was distributed, that involved assessment of their preferences, continuation of use and concerns of using DA as a restorative material. Percentage contribution of each variable was calculated. Preferences for continuation of use of silver amalgam based upon the age, experience and mercury toxicity as a risk factor were analysed using Students-t test and Chi-square test.

Results: The majority of dentists were satisfied (87%) with the results of the DA, found minimal failures (96%) and found DA more economical (89%). More than half (54%) of the participants reported that they would not continue the use of DA owing to mercury toxicity and environmental concerns. Dentists with higher age and longer clinical experience preferred continuation of DA.

Conclusions: In spite of satisfaction with DA for its minimal failure, longevity and affordability, the authors found that a majority of practitioners did not prefer its continued usage. This highlights their concerns over mercury toxicity and soft tissue lesions and accentuates their community social responsibility. There is also an urgent need to educate dentists on mercury hygiene, mercury waste management and disposal.