This paper highlighted six pertinent issues that developing economies should focus on with regards to mercury dental amalgam phase down. The need to set up structures for monitoring and evaluation of materials and technologies used in clinics, laboratories and hospitals was discussed as well as the need to provide research data on mercury pollution that may be peculiar to developing economies. The urgent needs to update dental schools' curricula and update the training of general Dental practitioners were also discussed. A framework for curriculum development, review and update was proposed using the Minimum Intervention Treatment Plan (MITP). Two other caries management pathways-the International Caries Classification and Management System Caries Management Pathway (ICCMS-CaMP) and the Caries Management by Risk Assessment (CAMBRA-CaMP) were also highlighted. A "frog-leaping' phase down approach was proposed that took cognizance of the poor infrastructure for waste management in developing economies. Opportunities for new oral health policy initiatives with regards to integration of oral health into national and international health agenda were also discussed.
This paper highlighted the clinical strategies for implementing minimum intervention dentistry (MID) in dental practice and in dental education in resource challenged practice environments (developing economies). The objectives of each of the 4 phases of minimum intervention treatment plan (MI Identify, MI Prevent, MI Restore and MI Recall) were highlighted and three levels of caries risk (Low risk, High risk and Super high risk) were adopted with the appropriate targeted preventive non restorative treatments. Three evaluation rating scales were introduced (early recall evaluation rating scale, caries control evaluation rating scale and oral health outcome evaluation rating scale) for monitoring the success or failure of counselling, the targeted preventive (non-surgical) treatments and the oral health outcome. Practitioners and academics in resource challenged practice environments should embrace MID with open minds, its goal is maximum preservation of healthy oral tissues with oral health promotion and targeted preventive non- surgical treatments as its cornerstones. Furthermore, MID is mercury free and will safeguard our environment from mercury pollution for the benefit of future generations.
Keywords: Minimum intervention dentistry, mercury free dentistry, dental practice, dental education, resource challenged practice environments
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