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Vital UK dentistry avoids a rapid ‘phase-out’ of dental amalgam

We continue to lobby for a phase-down of dental amalgam in dentistry in the EU, rather than the proposed phase out by 2030.

We continue to lobby for a phase-down of dental amalgam in dentistry in the EU, rather than the proposed phase out by 2030, arguing that it is vital UK dentists can continue to use the full range of materials appropriate to different clinical situations. A phase-out in the EU would affect dental amalgam supply chains and prices in the UK despite Brexit.

We are particularly concerned about the impact for dentistry in Northern Ireland, as under the terms of the Northern Ireland Protocol, it will have to continue to follow EU legislation. We’ve said that a phase out date of 2030 - or earlier - could potentially destabilise health systems that are already under considerable strain in the wake of the Covid pandemic, and increase oral health inequalities.

We continue to support the Council of European Dentists (CED) in arguing for a phase-down of the use of dental amalgam, rather than a phase out, and have said that each country must be able to implement its own timetables, based on domestic circumstances. Dentists throughout the UK and EU are already taking their environmental responsibilities seriously and making good progress on reducing dental amalgam use.

We have helped to develop a new CED fact sheet and template letter to make the case for the ‘phase down’ to help other EU member states (and other nations), lobby their national health and environmental ministries.

Following the European Commission (EC) report in June 2020, which concluded a phase-out of dental amalgam was technically and economically feasible before 2030, the EC has published its roadmap. We, and the CED, argued that there were inaccuracies, assumptions and misinformation contained in this report, and submitted commentaries to the EC detailing the problems with its approach.

The EC is now assessing the phasing-out of the use of dental amalgam in the EU and on the measures to prohibit the manufacture and export of mercury-added products (MAPs), like dental amalgam. For dental amalgam, an impact assessment is planned to consider a phase-out over different timeframes and include the possibility of certain exceptions, relating to specific categories of patients or medical needs.

We argue that dental amalgam continues to be a well-established and needed filling material and make clear:

  • There is a lack of alternative materials with equivalent advantages
  • Other restorative materials could also have adverse environmental impacts; more research is needed on this
  • The need for dentists to make individual assessments based on the clinical situation and best interests of each individual patient
  • The impact on national health reimbursement systems and potential destabilization; and
  • The need for real investment in prevention, to reduce the requirement for restorative treatments.

The EC is planning a public consultation in the autumn of 2021.

The COVID pandemic has already threatened the financial sustainability of the sector, and the business models on which practices operate. We continue to make the case to the Department of Health and the Department for Environmental, Food and Rural Affairs (DEFRA), and other stakeholders on behalf of dentists across the UK.

We are also working closely with international partners to advocate a pragmatic phase-down approach globally, in the run-up to the fourth Conference of Parties to the Minamata Convention, which begins its discussions in November.