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Amalgam derogation offers glimmer of hope for struggling service

The British Dental Association Northern Ireland has expressed its relief that the European Commission has approved a derogation from the EU’s new mercury regulations.

The move has averted an expected ban on the use of mercury fillings in dentistry from 1 January 2025, a move the BDA stressed in March would have broken NHS dentistry in Northern Ireland.

Under the Windsor Framework, Northern Ireland remains subject to some EU rules. Under new arrangements dental amalgam can be used in NI until 31 December 2034, or until the date agreed under the Minamata Convention on Mercury, whichever is sooner.

In survey evidence presented to Stormont’s Windsor Framework Democratic Scrutiny Committee in March, the professional body warned 92% of dentists were on track to reduce the amount of NHS activity at their practice in the event of a ban. 92% said it would increase costs for NHS activity at their practice, with 91% reporting this would impact on higher needs patients seen at their practice. 88% said it would lead their practice to reduce or end its NHS commitment.

The BDA has recognised the considerable efforts to secure this major result - not only from the dental profession itself - but on the part of Department of Health officials working extensively with the UK Cabinet Office, and in their engagement with the European Union, underpinned by political advocacy. However, it has stressed that concerted action is needed from both the Stormont and UK Governments to ensure a seamless transition to an amalgam-free service.

Provision for a 10-year derogation is subject to specific conditions being met, including the UK taking the necessary measures to make regular and consistent progress towards phasing down amalgam.

Ciara Gallagher, Chair of the British Dental Association's Northern Ireland Dental Practice Committee, said:

“A ban on dental amalgam in 2025 could have spelled the end for NHS dentistry in Northern Ireland.

“We sounded the alarm and fought tooth and nail for a workable solution. This delay is a glimmer of hope for a service that’s on its knees and could not have shouldered any further financial pressure.

“We have some breathing space, but Stormont and Westminster cannot take their feet off the pedal to affect a seamless transition to amalgam-free dentistry.

“Any progress will require reform, investment, and concerted action on deep oral health inequalities.

“When the plug is finally pulled on amalgam, Northern Ireland will need to have a healthier population and a more sustainable service. Otherwise this 10 year derogation is a mere stay of execution for NHS dentistry.”