EU ban on tooth filling material will lead to ‘collapse of NHS dental services’ in Northern Ireland

A proposed EU ban on dental amalgam fillings will be the “tipping point” which leads to the collapse of NHS dentistry in Northern Ireland, MLAs have been warned. Representatives from the British Dental Association (BDA) in Northern Ireland told Stormont’s Windsor Framework Democratic Scrutiny Committee that an arbitrary ban from January of next year would cause “irreparable and long-lasting damage” to services. The committee has begun preliminary investigations on the consequences for Northern Ireland of any amalgam prohibition.

The EU is set to prohibit the use of amalgam from January 2025 as part of a health drive to reduce public exposure to mercury. Under post-Brexit trading rules, aspects of EU law still apply in Northern Ireland. Some member states will be able to avail of an 18-month derogation if it can be demonstrated the law change would have a disproportionate socio-economic effect on low-income households. The amended Mercury Regulation will also introduce a ban on member states exporting dental amalgam. The Assembly committee has been established to scrutinise forthcoming EU law changes as part of the Stormont brake oversight element of the Windsor Framework. Tristen Kelso, director of the BDA in Northern Ireland, told MLAs that the proposal to ban amalgam had “sent shockwaves” across the entire dental profession in Northern Ireland. He said dentists had been working on the basis of a “managed, phase-down trajectory” of amalgam. He said: “Phase-down of dental amalgam at a rate appropriate for each country is the best and only option for public health. “Not least considering the immense strain already on dental services, it is also an environmentally responsible approach. “Reducing dental amalgam use requires the necessary supports to be put in place by Government to manage the move away from this material.”

Mr Kelso added: “Being bound under the amended regulation by an arbitrary date of January next year for phase out, when the required preparatory steps, which we are fully supportive of, have not been adequately addressed, is alarming. “Deviating away from the established phase-down policy, which applies at UK level and which continues to be advocated by all four chief dental officers, poses considerable risks in the form of irreparable and long-lasting damage to provision of dental services here.” He said: “Members of the public are already struggling to access NHS dental care because the service is so poorly remunerated. “On financial grounds alone, this regulation if applied here will be the tipping point for health service dentistry.” Reading from written evidence provided by a Northern Ireland dentist, Mr Kelso said: “Increase in expenses and the ban on amalgam are the perfect storm, I don’t know any dentist who will be able to deliver any NHS work next year under the circumstances. “NHS dentistry is about to collapse.”

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