Concerns have been raised about the future availability of silver dental fillings in Northern Ireland due to an upcoming phase-out of amalgam across the EU.
The plan to phase out amalgams by January 1 next year will apply in Northern Ireland due to Brexit trading arrangements and will also impact dental care in other parts of the UK, dental representatives say.
This is because the ban also includes a ban on the export of the product from the EU, and with much of the amalgam’s supply coming from Germany, there are fears that supply to the NHS will dry up.
The British Dental Association (BDA) says Northern Ireland will be “disproportionately” affected not only because of Brexit but also because of the state of the region’s healthcare system, the weakest in Britain with the longest waiting lists and the highest use of healthcare. the filler. The BDA says amalgam is an affordable and efficient treatment for dental restoration.
In an open letter from the BDA to Britain’s four chief dentists, they said: “This recent development in the EU is crucial for Northern Ireland. We do not believe that the phase-out by January 1, 2025 is feasible given the significant degree of unpreparedness in oral health prevention and mitigation strategies currently in place. Urgent action must be taken.”
Under the Windsor framework and the Northern Ireland Protocol that previously governed the special Brexit arrangements for Northern Ireland, a number of previous EU rules must be complied with, including those on dental amalgam.
“We are extremely concerned about the impact this EU phase-out will have on services in the UK, both directly under the post-Brexit arrangements and indirectly as a result of the collapse of the supply chain in Europe,” the BDA said .
A spokesperson said data from Northern Ireland shows the amalgam was used in 46% of fillings, the highest use of amalgam in Britain, reflecting poorer health outcomes in the region. In contrast, England used amalgam in only about 33% of fillings.
Regulations in the UK and EU restricted the use of the partially mercury fillings in 2018 as part of the Minamata Treaty on the Mercury Treaty reducing global environmental pollution caused by mercury, including the release of the heavy metal during the production of dental amalgam.
Although there is no evidence of any harm caused by amalgam according to the NHS Education for Scotland literature, the use of amalgam fillings in children under 15 years of age and pregnant or breastfeeding women was prohibited under the 2018 regulations unless instructed to do so by the dentist deemed necessary.
The BDA says amalgam is around 50% cheaper than the white filling material and also lasts longer, raising fears of higher costs for NHS dental services, which they say are already in a “precarious” state.
“The loss of a vital restorative material and its replacement with more expensive and time-consuming alternatives is just a further blow to the financial viability of NHS dentistry. It is a particular loss in the context of patients with high needs for whom amalgam remains the best treatment option,” said the report to UK dental officials.
MEPs have supported an amendment to limit the socio-economic impact of the measure.
The Scottish Government has adopted an amendment to existing dental benefits legislation to mitigate the additional costs resulting from the phasing out of amalgam. However, with the continued suspension of power-sharing government in Stormont, such legislation cannot be implemented in Northern Ireland.