• Print

Details

Published: Monday, 25 March 2024 10:32

Written by Guy Tuggle

Hits: 636

As has been widely reported, Northern Ireland faces a ban on the use of dental amalgam from January 2025.

Northern Ireland, under the terms of the Protocol agreed as part of the Brexit negotiations, will likely be obliged to follow the amended EU Mercury Regulation. This will ban the use and, from June 2026, the manufacture, import and export of amalgam within the EU.

The measures have been provisionally approved by the European Parliament and European Council, however, they are still awaiting ’formal adoption’.

For NHS practices it’s a worry. Amalgam is a proven restorative material.  It’s resilient and invariably easier and speedier to place than alternatives.  And whilst it’s only Northern Ireland that is currently contemplating an ’all change’ situation next year, NHS practices across the UK have genuine concerns regarding the ongoing supply and affordability of amalgam.

Northern Ireland governmental processes, under the terms of the ’Windsor Framework’  provide for objections and Inquiries that can trigger delay where EU proposals ’are deemed to affect everyday  life in an ongoing way’. But could ’opt outs’ like the UK’s famous ’opt out’ from the Single Currency and Social Chapter come to amalgam’s rescue?

"This is completely uncharted constitutional territory, with more unknowns than knowns at this stage" according to Tristan Kelso, the British Dental Association’s Northern Ireland Director.

"We find ourselves at the centre of a process which could have massive implications for the dental profession and the future of dental services in Northern Ireland" said Kelso.  

Quoting the UK Chief Dental Officers (CDOs) he added "it is extremely important that dental amalgam remains within our treatment armamentarium for the foreseeable future".  For this reason, ’maintaining a phase-down approach’ to the use of the material was favoured’.

Amalgam has faced an uncertain future for many years.  From the World Health Organisation to national governments  , there is agreement that mercury use should be phased out.  It’s a passionate debate, with strong advocates on either side. 

Northern Ireland has a ’Plan to phase down the use of Dental Amalgam (2019)’ and this advocates a gradual reduction. A similar approach has been proposed in the other countries of the UK.

Northern Ireland’s Plan to reduce amalgam use is predicated on ’improving oral health by prevention’, promoting the ’development of alternatives’ beyond existing composite solutions, and changines the delivery of dental services via new General Dental Services Contract.

The BDA supports the phase-down approach but ominously for the provision of services Tristan Kelso, in his BDA briefing notes that "Northern Ireland is nowhere near being ready to move to a phase-out position, least of all to a date arbitrarily set as 1 January 2025".

For its part, the BDA is lobbying all relevant Northern Ireland ministers and institutions including Stormont. "We are clear that the strongest possible case must be put forward to Stormont for phase-down, and against this replacement EU act from having direct application". the BDA states.

’There is no way to predict where we will land on the dental amalgam issue.  But we will commit to highlighting loud and clear the concerns of the profession on this issue, and the potential impact on dental services over the coming weeks’ the BDA says.  

The BDA was commenting on Northern Ireland.  As the other countries that make up the UK  confront the consequences of the EU’s ban phase-down and contemplate their own inevitable phase-down, the arguments the BDA is currently advocating are likely to enjoy a long shelf life.

---

You need to be logged in to leave comments.

×

Report

ReportClose