Newly qualified dentists’ perceptions of amalgam restorations

Objectives: This study explores United Kingdom (UK) based newly qualified dentists’ perceptions of amalgam as a clinical restorative material and investigates whether the perceived level of confidence on the use of amalgam is matched by knowledge and understanding of this subject.

Methods: A non-incentivised mixed qualitative/quantitative questionnaire was distributed to all the newly qualified dental foundation dentists (DF1) attending a postgraduate teaching day to elicit their perceptions. Results were collated and analysed.

Results: The response rate was 88% (87/99). Respondents qualified from 18 dental schools including 14 of the 17 UK undergraduate dental schools. 97% were qualified for less than a year and 66% were female.

One school did not teach amalgam at all and there were wide variations of experience on qualification, ranging from 2 to over 50 amalgam restorations.
18% of the respondents currently placed less than 11 whilst 11% placed over 41, amalgam restorations per month. Clinical factors were the main influence on the choice of restorative materials.

Although 94% expressed confidence in using amalgam, this was not matched by their understanding and knowledge of amalgam as a restorative material. Only 27% correctly selected more than two key facts (out of a total of four) on the indications and limitations of amalgam and 45% selected one or none.Conclusions: There was a wide variation of clinical experience and knowledge of amalgam for these newly qualified dentists. Although most of them felt very confident on its use and limitations, this was not reflected in the demonstrated level of knowledge. This is a potential cause for concern for the dental profession.

There is a significant shift away from the undergraduate teaching of amalgam as the main restorative material with the main reasons being the availability of alternative materials, potential environmental issues and perceived health concerns surrounding amalgam.