title: The Changes in Dentists' Perception and Patient's Acceptance on Amalgam Restoration in Kurdistan-Iraq: A Questionnaire-based Cross-Sectional Study.
abstract: BACKGROUND
  There has been considerable controversy concerning the health risks and benefits of utilizing mercury-containing amalgam. Across the developing countries, a reduction in the use of dental amalgam in oral health care provision is expected.
  
  
  OBJECTIVE
  Assessment of dentists' and patient's attitude of dental amalgam regarding attractiveness, perceived health, and treatment preferences in Kurdistan, Iraq.
  
  
  METHODS
  A 4-page questionnaire comprised two parts, specific for dentist and patient were structured and delivered to each dentist oneself. Both open-ended and close-ended questions about the treatment needs of patients, uses of amalgam and its alternative, the properties and usefulness of different materials. Patient's acceptance was assessed by means of structured questionnaire prepared based on commonly asked questions from routinely daily practice. Questions on the type of filling material in their mouth, previous knowledge of mercury in dental amalgam and disappointment due to mercury hazard and toxicity. They were to indicate their acceptance with filling their cavities by dental amalgam with or without prior information about its mercury content. This part was also accomplished by the dentists participated in this survey.
  
  
  RESULTS
  Out of 185 dentists shared, only 39 (21.1%) indicated that amalgam presents no harm for the dentists and patients. While majority of dentists 85 (45.9%) were uncertain about this issue. Amalgam was selected most often 107 (57.8%) as the material of choice for restoring posterior teeth. About 94(50.8%) and 85(45.9%) of the practitioners primarily used glass ionomer/resin-reinforced glass ionomer and composite, respectively. Among 1850 patients received treatment, only 450 (24.32%) claimed to have heard about adverse reactions to dental amalgams. Those who believed it to be safe were 200 (10.82%).Acceptance towards amalgam was 62%.
  
  
  CONCLUSIONS
  While amalgam was the most common material used for posterior restorations, direct tooth-coloured restorative materials were also popular among dentists participated in this study. Awareness of toxicity of mercury in dental amalgam was slightly low among the respondents studied. This may be suggested to be a reflection of devoid of planetary amalgam controversy in Kurdistan. The level of acceptance toward amalgam appears to be related to economics, dental education, and aesthetic orientation of the residents.
authors.affiliation: Associated Professor, Senior Lecturer, Department of Conservative Department, School of Dentistry, Faculty of Medical Sciences, University of Sulaimani , Head of Conservative Department .
authors.forename: Bestoon Mohammad
authors.initials: BM
authors.lastname: Faraj
authors.affiliation: Lecturer, Department of Conservative Department, School of Dentistry, Faculty of Medical Sciences , University of Sulaimani .
authors.forename: Hawzhen Masoud
authors.initials: HM
authors.lastname: Mohammad
authors.affiliation: Lecturer, Department of Conservative Department, School of Dentistry, Faculty of Medical Sciences, University of Sulaimani .
authors.forename: Kale Masoud
authors.initials: KM
authors.lastname: Mohammad
keywords: Dental amalgam; Dental treatment