Dentists in NI exempt from EU mercury filling ban

The Department of Health (DoH) has secured a derogation from the EU's new mercury regulations.

Northern Ireland dentists can continue to use dental amalgam until 31 December 2034, or until the date agreed by the global Minamata Convention, to which the UK is a signatory, whichever is earlier.

The EU wanted to ban mercury metal-based fillings (dental amalgam) in dentistry on 1 January 2025.

The ban would have applied in Northern Ireland because it still follows some EU rules as a result of its post-Brexit deal, the Windsor Framework.

The DoH said there are a number of "achievable" conditions attached to the agreement with the EU, mainly around reporting and showing continued progress to reduce the use of amalgam.

The DoH said it was a priority which it conveyed urgently to the new UK government when they took office, given the impact on patients and practices throughout Northern Ireland.

"I am very pleased that this has been secured and that the phasing down of mercury can be taken forward in a much more planned way over the coming years," Health Minister Mike Nesbitt said.

"For many months, the department has been working closely with officials in the UK's Cabinet Office and Department for Health and Social Care, as well as the Department of Agriculture, Environment and Rural Affairs and The Executive Office to make a strong and compelling case for why Northern Ireland needed this derogation," he explained.

"I am very glad to see our efforts translate into tangible benefits for patients and practitioners in this way."

Dental amalgam is a mixture of metals including silver, tin, copper and mercury, and is the most common type of filling used to repair tooth cavities.

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", according to the NHS.

However, the European Commission describes mercury as a "very toxic substance".

Under post-Brexit trading rules, aspects of EU law still apply in Northern Ireland.

This ban means it will not just be illegal to import mercury fillings, but to use them at all (except in exceptional circumstances).

Dentists in Northern Ireland said they were critically unprepared to work without dental amalgam, and that patient care would be affected.

They said they are already at crisis point and lose money carrying out most routine surgeries and fillings etc, unless they are private.

Dentists argue that dental amalgam is safe and has been used for a century.

Democratic Unionist Party leader Gavin Robinson welcomed the derogation.

"I am glad that common sense has prevailed and that a durable and workable arrangement has been reached," he said.

"The safeguards we secured have played a significant role in bringing London and Brussels to this place."

The British Dental Association (BDA) says dental amalgam is safe and that it has been in use and extensively studied for 150 years as a restorative material.

“A ban on dental amalgam in 2025 could have spelled the end for NHS dentistry in Northern Ireland," said BDA's Northern Ireland committee chair, Ciara Gallagher.

“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."

There are two ways which the Stormont Assembly can try to prevent new EU laws applying in Northern Ireland if it believes they will have a disruptive impact on everyday life.

The Stormont Brake and applicability motions are both conditional, arms-length vetoes - it’s ultimately for the UK government to decide if the veto will be used.

Alternatively we could see what has happened in this case: the EU and UK reach some sort of compromise, the issue is resolved and the Assembly doesn’t need to get involved.

The hope is that in future as EU rules are being drafted the potential impacts on NI can be understood and mitigated at an early stage rather than needing a last minute fix.