EU ban on dental fillings ‘could break UK dentistry’
European Union ban on dental fillings made from amalgam could “break NHS dentistry”, top dentists have warned, as UK supply chains are set to be disrupted by the move.
The European Parliament has voted to ban dental amalgam from January 1, 2025, “sending shockwaves across the UK’S already struggling dental services”, according to the British Dental Association.
Silver amalgam is the most common material for NHS permanent fillings across the UK. It is made from an amalgamation of different metals, including mercury. Any mercury released into the environment can re-enter the food chain, with residues having been found in soils, fish and seafood.
High mercury exposure can damage the brain, lungs, kidneys and the human immune system.
However, according to the NHS: “Although amalgam fillings can release low levels of mercury vapour, particularly when they are put in or removed, there is no evidence that exposure to mercury from amalgam fillings has any harmful effects on health.”
The BDA estimates fillings represent around a quarter of all courses of NHS treatment, with amalgam used in around a third of procedures. The treatment times and costs of alternative materials are as much as 50 per cent higher than those of amalgam.
On July 14, the European Commission adopted a proposal to revise the Mercua ry Regulation, to introduce a total phase-out of the use of dental amalgam and prohibit the manufacture and export of dental amalgam from the EU from January 5, 2025 – five years earlier than expected.
According to the BDA, the vote will hit all four UK nations, but will have a disproportionate impact on services in Northern Ireland, which has the highest proportion of filled teeth of any UK nation.
Under post-brexit arrangements, Northern Ireland will be expected to phase out dental amalgam on the same basis as EU member states. Divergence means the rest of the UK faces disruption and higher costs given the impact on supply chains, but not a formal ban.
BDA chair Eddie Crouch said: “When we are set to lose a key weapon in the treatment of tooth decay, all four UK governments appear asleep at the wheel. When alternative materials can’t compete, this will add new costs and new uncertainties to practices already on the brink.
“Without decisive action, this could be the straw that breaks the back of NHS dentistry.”
The decision follows an EU directive handed down in 2018, which banned stopped silver fillings in baby teeth and children under the age of 15, unless dentists felt it necessary. The fillings are also not given to pregnant or breastfeeding women.
In an open letter to all four UK chief dental officers, the BDA said there were no alternative restorative materials “that compete with amalgam on speed of placement or longevity, meaning the ban will eat into clinical time and resource that are in short supply”, creating further access barriers.