A European Parliament vote on 17 Jan 2024 to ban dental amalgam has been met with breaking concerns from the British Dental Association (BDA) over the strains it would put on an already precarious NHS dentistry.
On 14 Jul 2023, the European Commission adopted a proposal to revise the Mercury Regulation. This included introducing a total phase-out of the use of dental amalgam, and prohibiting the manufacture and export of dental amalgam from the EU from 1 Jan 2025 – five years earlier than expected.
Responding to the vote, chair of the BDA, Eddie Crouch wrote in an open letter to the UK Chief Dental Officers (CDO) seeking their commitment to address the development concluding that “without decisive action, the could be the straw that breaks NHS dentistry”.
Crouch wrote: “This has taken a new urgency now that the European Parliament has voted in favour of a proposal to phase-out amalgam by 1 Jan 2025. We are extremely concerned about the impact this EU phase-out will have on services across the UK, both directly under post-Brexit arrangements and indirectly as a result of supply chain collapse in Europe.”
“NHS dentistry is already in precarious situation across the UK, with the Nuffield Trust recently warning that the service has most likely ‘gone for good’. The loss of a vital restorative material and its replacement with more expensive and time-consuming alternatives is only a further blow to the financial viability of NHS dentistry. It is a particular loss in the context of high needs patients for whom amalgam remains the best treatment option.”
Believing that the phase-out by 1 Jan 2025 was not feasible, Crouch urged all four UK CDOs to take the following actions:
1) Urgently address the impact of the direct application of the EU regulation to Northern Ireland
2) Adopt a renewed focus on prevention to reduce the need for dental restorations
3) Work with industry to secure an ongoing supply of amalgam
4) Work with the BDA to ensure that there is no financial impact on dentists from the need to use alternative materials
Silver amalgam is currently the most common material for NHS permanent fillings across the UK. Fillings represent around a quarter of all courses of NHS treatment delivered in England, according to the BDA, with amalgam used in around one third of procedures.
Related: Mercury released from dental amalgam fillings in response to different physical stressors
