Has the implementation of the Minamata convention had an impact on the practice of operative dentistry in Jordan?

Objective: To assess Jordanian dentists' current perception and attitudes towards amalgam and composite restorations four years after the Minamata treaty was endorsed and suggest decision making factors that may influence the type of restoration requested by patients.

Methods: The cross-sectional study was conducted through structured questionnaires distributed to dentists in Amman, Jordan from June 2017 to February 2018.

Results: Of the 1686 dentists who were contacted 758 dentists (response rate 45%) responded to the questionnaire either by email or via field visits. Jordanian dentists used more composite restorations than amalgam. Recurrent caries followed by fracture of the restoration were the main reasons for replacement of both fillings by dentists. However, dentists suggested that the main reason patients requested replacement of amalgam was for 'staining'. In addition, a large proportion of the dentists had experienced patients who had asked either for replacement of amalgam (77%) or refused an amalgam filling (99%) for aesthetic reasons. In the opinion of the dentists, only 20% patients requested replacement of amalgam because of the mercury content.

Conclusion: The findings of this survey suggest that a 'phase-down' of dental amalgam is being implemented in Jordan's dental clinics but it is not associated with commitment to the Minamata Convention, rather to current dental practice trends and patients' aesthetic demands.