PubMed · 16224884
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Kathryn Kell. Forging our future.. https://pubmed.ncbi.nlm.nih.gov/16224884/
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OBJECTIVES: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the U.S. dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. METHODS: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. RESULTS: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of 1 million dollars or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 U.S. members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. CONCLUSIONS: Findings suggest the U.S. dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the U.S. dental public health infrastructure will require substantial collaboration among many diverse partners.
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Dental amalgam has been extensively used as a tooth filling material for many decades and has beyond doubt saved millions of teeth that otherwise would have needed to be extracted. The release of amalgam particles into dental office wastewater is a matter of particular concern as amalgam particles could then be discharged into the environment. Amalgam waste discharges contribute to mercury in the environment through direct wastewater discharge, incineration, land-filling and sewage sludge incineration, although the discharge from dentistry is probably responsible for less than 1% of the total mercury discharged annually into the environment as a result of human activities. Nevertheless, dentists, by being producers of amalgam waste, have a responsibility and a duty of care for the proper management of this waste within their practices. Appropriate measures should be taken to minimise the amount of waste where possible or take action to ensure that all generated waste is disposed of in accordance with environmental legislation.