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Northern Ireland: Phase-out of dental amalgam by 2030 unworkable

31 March 2021


BDA Northern Ireland has urged the European Commission to reconsider their plan for a full phase-out of amalgam by 2030. We believe a phase-down, rather than a phase-out, is the only viable way forward that can avoid destabilising health systems already under considerable strain, and exacerbating health inequalities.


A report by the European Commission to the European Parliament and Council claims that the phase-out of dental amalgam - the largest remaining intentional use of mercury in the EU –"is technically and economically feasible before 2030". 


Despite the UK having left the EU, under the Northern Ireland Protocol, European proposals on amalgam would apply to Northern Ireland, but not to England, Scotland or Wales.

 

We, alongside our colleagues in the Council of European Dentists and the FDI World Dental Federation, support a phase-down approach to dental amalgam use. However, dentists must continue to have the full range of restorative materials at their disposal, and at present there is no direct replacement for amalgam for durability, cost-effectiveness and ease of use. 


Alternative materials are also much less extensively researched for their impact on the environment and direct effects on human health. 


COVID has dramatically altered the dental landscape, meaning that the feasibility study undertaken pre-pandemic must be reviewed in respect of the different context we find ourselves in. A phase-down, not phase-out of dental amalgam is the only viable way forward. This will avoid destabilising health systems already under considerable strain, and exacerbating health inequalities. We also want to see an increased focus on prevention, as well as additional research into mercury-free alternative materials.


We are concerned about many aspects of the feasibility study undertaken by Deloitte that underpins the basis of these phase-out proposals, not least the data being incomplete. Any move to phase out dental amalgam as a low-cost restorative material will have the greatest impact on those most disadvantaged patients, increasing inequalities. These issues go to the heart of the right to access affordable healthcare, and must be properly considered in a full impact assessment. 

   

Our response urges the EU to take a more considered phase-down approach to what is a largely environmental issue. 


Regardless of what happens, this serves as an important reminder of the need for governments closer to home to step up on prevention. We will continue to liaise with officials to mitigate any impact of these developments on the profession.