The future of dental amalgam

This paper is a comment on 'The enigma of dental amalgam' by Carl Leinfelder published in 2004 in the Journal of Esthetic and Restorative Dentistry. In that paper a warning is stated against a too abrupt change from amalgam towards resin composite, because this will bring a lot of clinical problems due to the limited skills of todays' dentists in placing posterior composite resin restorations. However, the situation in The Netherlands is different since a gradual changeover from amalgam towards resin composites has taken place during the last decades and dental schools have skipped training in placing amalgam restorations out of the curriculum. Clinical studies on the longevity of amalgam and resin composite restorations placed by dental students and dentists who are experienced in both composite resin and amalgam placement show a comparable and acceptable annual failure rate for those restorations. It is concluded that a gradual changeover from amalgam towards composite resin is preferred to avoid clinical problems.