Ministry of environment, water and natural resources state department of natural resources report of the kenya implementation of the



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3. INCEPTION WORKSHOP


An inception meeting was held aimed at gaining a better understanding and role clarification on the EADAP project objectives, methodology, outputs and outcome. The objective of this project is to explore essential conditions for a phase down in the use of dental amalgam.UNEP, WHO, iLima, World Dental Federation (FDI) and the International Association of Dental Manufacturers (IDM) will present their respective contributions to the project. National project coordinators (Kenya, Tanzania, and Uganda) will present their respective project workplans.


    • Representatives came from the governments (environment, health, other relevant agencies) , national dental associations, NGOs, industry and other relevant stakeholders in Kenya, Tanzania, Uganda





3.1 Validation of the Dental Amalgam Waste Practices and Trade and Supply of Restorative Dental Materials


The need for restorative materials is a reality as the oral health promotion has not attained a caries free global population. As illustrated by results of the completed 2012 Desk top survey on Kenya, Uganda and Tanzania, dental amalgam is used in majority of the dental facilities. Moreover, the use of bothresin composites and glass ionomer cements is equally high among the dentists. In general, management of waste dental amalgam was poor though the dentists were concerned about contributing to the overall mercury released to the environment by anthropogenic activities.

After execution of the desk top study, it was evident that on-line data collection is not feasible in most of the parts of the three countries.

Hence the validation of the Kenyan data was executed via both soft and hard copy questionnaire modes.

3.2 Aim


The aim of the study was to validate results of the East African Desk top study on dental amalgam waste practices and amalgam trade and supply completed in 2012.

3.3 Materials and Methods


A descriptive cross-sectional study was carried out. The questionnaire was reformatted from the existing EADAP desk top survey questionnaire to be shorter and anonymous. The project team held several meetings to discuss study process as well as participated in data collection. Self administered questionnaires were sent by email to the dentals public hospitals by the Ministry of Medical Services Dental Department. In addition hard copies were delivered to dental facilities in Nairobi . The returned and collected questionnaires were analysed and data summarised.

4 RESULTS

4.1 Dental Restorative Waste Management Practices


A sample of 25 dentists and 9 dental material suppliers completed the questionnaire. Majority of the respondents were anonymous and those who opted to give contacts hailed from Nairobi, Kiambu, Vihiga and Siaya.

4.1.1 Type of Restorative Materials in use


Out of the targeted dental facilities, twenty five completed the questionnaire, four (16%) on-line and 21 (84%) off-line. All the dentists 25 (100%) reported using resin composites, where as 52% use dental amalgam. Table1.

Material used

Number

Percentage

Dental amalgam

13

52

Resin Composite

25

100

Glass ionomer cements

24

96

Compomers

7

28

Ceramics

7

28

Table 1: Types of restorative materials used

On the type of dental amalgam used by the dentists, 23 (92%) reported using capsulated amalgam whereas 4 (16%) reported using Mercury liquid and alloy powder. One (4%) did not use dental amalgam. The capsule sizes available in the facilities were from the most to the least F2 23 (92%), F1 14 (56%) and F3 8 (32%).


4.1.2 Protective equipment and dental clinic set up


Majority of the respondents reported the use of gloves 23 (92%) and masks 23 (92%) while handling amalgam and non-amalgam restoratives as shown in Table 2.

Protective Equipment

Number

Percentage

Gloves

23

92

Masks

23

92

Eye wear

16

64

No response

2

8

Table 2: Personal Protective equipments used

More than half 16 (64%) reported that they have adequate ventilation in the dental clinics, 1 (4%) did not have adequate ventilation and 8 (52%) did not respond to the question. No dentist used carpets in their clinics and 22 (88%) stated that they do not have floor carpets. However, 3 (12%) did not respond to this question.


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