KNOWLEDGE, ATTITUDES AND ADOPTION OF AMALGAM PHASEDOWN AMONGST DENTISTS IN NAIROBI COUNTY: A CROSS-SECTIONAL STUDY

Abstract

Background: Dental amalgam has long been used as a durable restorative material; however, global efforts to phase it down have intensified due to concerns regarding mercury exposure and its environmental and health effects. This study aimed to assess the knowledge, attitudes, and adoption of amalgam phasedown among practicing dentists in Nairobi County, Kenya.
Methods: This descriptive cross-sectional study was conducted among 83 practicing dentists in Nairobi County. Participants were recruited using a non-probability sampling approach. Data was collected using a self-administered questionnaire assessing knowledge, attitudes, and practices related to amalgam phasedown. Data were analyzed using Microsoft Excel and SPSS. Descriptive statistics were presented as frequencies and percentages, and associations between variables were tested using the Chi-square test, with statistical significance set at p < 0.05.
Results: All 83 (100%) participants were aware of amalgam phasedown. Ministry of Health circulars 44 (53.0%) were the most common source of information, closely followed by Kenya Dental Association communications 38 (45.8%). Regarding attitudes, 37 (44.6%) participants opposed the complete phase-out of amalgam, 30 (36.1%) supported it, and 16 (19.3%) were neutral. In terms of adoption, 45 (54.2%) participants reported rarely using amalgam, 21 (25.3%) used it occasionally, and 17 (20.5%) no longer used it in practice. A statistically significant association was found between reduced amalgam use and continuous training on posterior composite placement (χ² = 9.351, p = 0.009).
Conclusion: Dentists in Nairobi County demonstrated good knowledge and a generally positive orientation toward amalgam phasedown, with a substantial shift toward reduced use of amalgam. However, financial constraints and concerns regarding alternative materials remain key barriers to the phasedown. Strengthening continuous professional training and improving affordability of alternative restorative materials through government sponsored initiatives are recommended strategies to support an effective and equitable transition away from dental amalgam.