Dental amalgam extension: a ‘glimmer of hope’ for Northern Ireland dental services

22 July 2024

The British Dental Association (BDA) Northern Ireland (NI) has expressed relief that the European Commission has approved a derogation from the EU’s mercury regulations.

The move has averted an expected ban on the use of mercury fillings in dentistry from January 1, 2025, a move the BDA stressed in March 2024 would have broken NHS dentistry in NI.

Under the ‘Windsor Framework’, NI remains subject to some EU rules. According to the arrangements, dental amalgam can be used in NI until December 31, 2034, or until the date agreed under the Minamata Convention on mercury, whichever is sooner.

Ciara Gallagher, chair of the British Dental Association's Northern Ireland Dental Practice Committee, said, “A ban on dental amalgam in 2025 could have spelled the end for NHS dentistry in Northern Ireland.

“We sounded the alarm and fought tooth and nail for a workable solution. This delay is a glimmer of hope for a service that’s on its knees and could not have shouldered any further financial pressure.”

In survey evidence presented to Stormont’s Windsor Framework Democratic Scrutiny Committee in March 2024, the professional body warned that 92 per cent of dentists were on track to reduce the amount of NHS activity at their practice in the event of a ban.

In addition, 92 per cent said it would increase costs for NHS activity at their practice, with 91 per cent reporting this would impact higher needs patients seen at their practice. A further 88 per cent said it would lead their practice to reduce or end its NHS commitment.

The BDA has recognised the considerable efforts to secure this major result - not only from the dental profession itself - but on the part of Department of Health officials working extensively with the UK Cabinet Office, and in their engagement with the European Union, underpinned by political advocacy.

However, it has stressed that concerted action is needed from both the Stormont and UK governments to ensure a seamless transition to an amalgam-free service.

Provision for a 10-year derogation is subject to specific conditions being met, including the UK taking the necessary measures to make regular and consistent progress towards phasing down amalgam.

Ciara added, “We have some breathing space, but Stormont and Westminster cannot take their feet off the pedal to affect a seamless transition to amalgam-free dentistry.

“Any progress will require reform, investment, and concerted action on deep oral health inequalities.

“When the plug is finally pulled on amalgam, Northern Ireland will need to have a healthier population and a more sustainable service. Otherwise, this 10-year derogation is a mere stay of execution for NHS dentistry.”