Northern Ireland exempt from EU dental amalgam ban

Dental Tribune International

Tue. 6 August 2024

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BELFAST, Northern Ireland: Earlier this year, the European Parliament voted in favour of a total phase-out of dental amalgam from 1 January 2025. This decision led to serious concerns regarding dental care provision in the UK and especially in Northern Ireland. At the end of July, the European Commission extended the period of use of amalgam in Northern Ireland in order to give health services and dental practices more time for an orderly transition.

Even though the UK has left the EU, Northern Ireland remains subject to some EU rules as a result of the post-Brexit agreement, the Windsor Framework. Therefore, the amalgam ban would have applied in Northern Ireland.

For this reason, the Department of Health has secured a ten-year derogation specifically for Northern Ireland, allowing dentists to continue using amalgam until 31 December 2034. This date of extension will apply unless a different date is agreed upon by the global Minamata Convention on Mercury, to which the UK is a signatory.

“I am very pleased that this has been secured and that the phasing down of mercury can be taken forward in a much more planned way over the coming years,” Minister of Health Mike Nesbitt told the BBC.

BDA raised concerns about dental care provision in Northern Ireland

As reported by Dental Tribune International in January, the EU ban on amalgam led to concerns about supply chain issues in the UK. Amalgam is the material most commonly used for permanent fillings by the National Health Service (NHS), according to the British Dental Association (BDA). Since Northern Ireland has the most filled teeth proportionally, the country would have been the most affected UK nation. Although the BDA generally supports amalgam reduction, it has called the rapid phase-out of amalgam in dental practices unfeasible and unjustifiable.

A survey by BDA’s Northern Ireland branch in March revealed that an amalgam ban starting from 2025 would have a significant impact on dental practices. According to the survey, 88% of dentists reported that such a ban would lead them to reduce or end their NHS commitment altogether, 92% expected increased costs for NHS services and 91% of respondents indicated that higher-need patients would be affected.

In a press release, BDA Northern Ireland expressed its relief that these concerns have been addressed. “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,” commented Dr Ciara Gallagher, chair of the BDA’s Northern Ireland Dental Practice Committee.

Fundamental reforms and measures needed

Even though the derogation provides more time for a seamless transition to amalgam-free dentistry, health bodies have stressed the need for reform and thorough investment into dental care by the government. “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 ten-year derogation is a mere stay of execution for NHS dentistry,” said Dr Gallagher.