The Department of Health today published a plan to phase down the use of dental amalgam fillings as part of a UK wide approach in line with EU regulations introduced in 2018.
EU Regulation 2017/852 on mercury was introduced for environmental reasons rather than any relating to the patient safety of amalgam (‘silver’) fillings used in dentistry. Factors to minimise the environmental discharge of mercury and amalgam in dentistry are already in place such as the use of pre-dosed amalgam capsules; the use of amalgam separators on discharge from dental surgeries; and the collection of amalgam waste.
Restrictions were also introduced last year on the use of amalgam fillings in children under 15, and pregnant or breastfeeding women, except when deemed strictly necessary by the dental practitioner on specific medical, including dental, needs.
Changes over the years in population needs and the delivery of dental care have already contributed to a gradual background reduction in the use of amalgam fillings. The plan outlines the measures intended to continue to phase down the use of amalgam. The greatest opportunities will be through three broad means; by improving oral health to reduce the need to use amalgam; the use of new treatment techniques and materials instead of amalgam; and continuing changes in service delivery to better enable the first two means.
Chief Dental Officer, Simon Reid said: “Your dental professional will be able to offer patients the best advice for their situation and explain what filling material is most appropriate for their needs. This may still be amalgam. It is still an effective filling material for particular situations, and the EU and UK Regulations allow exemptions when amalgam can be safely used in the same way that it has for many years.
“The ideal scenario is, of course, that fillings are not required at all,” the CDO added.
“By following three top tooth tips people help avoid tooth decay. Firstly, reduce the consumption of food and drinks that contain sugars, particularly at bedtime. Secondly, brush at least last thing at night, and at least one other time during the day, with a fluoride toothpaste. (Your dental team can advise on toothpaste strength and quantity.) Thirdly, visit your dentist regularly, taking your children from a very early age.”
Notes to editors:
- A copy of the plan is available to download on the Department's website at: www.health-ni.gov.uk/publications/dental-amalgam-plan
- EU Regulation 2017/852 on Mercury has applied since 1 January 2018 and Article 10 on Dental Amalgam has a phased approach until 1 January 2021.
- Changes in the delivery of dental services were introduced last year under Article 10(2) which placed restrictions on the use of amalgam in children under 15 years and pregnant and breastfeeding women from 1 July 2018.
- Article 10(3) requires a plan of measures to phase-down the use of amalgam in dentistry EU Member States. They are to “…make their national plans publicly available on the internet…” by 1 July 2019, and “…shall transmit them to the Commission within one month of their adoption.”
- Article 19 requires a subsequent European Commission review assessment by 30 June 2020 of “…the feasibility of a phase out of the use of dental amalgam in the long term, and preferably by 2030…” taking account of the Article 10(3) national plans, but importantly notes “…whilst fully respecting Member States' competence for the organisation and delivery of health services and medical care…”
- The plan outlines the principles for the phasing down which are broadly similar across all the UK regions.
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