All GDC Dental Registrants in England – Notice on the restrictions of use and disposal of dental amalgam

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To: All GDC Dental Registrants in England

Dear Colleague,

For action: Notice on the restrictions of use and disposal of dental amalgam

You will recall that I wrote to you on 12th April to alert you to the new European Union Regulation 2017/852 regarding the use and disposal of mercury. Specifically, Article 10 of the regulation which introduces provisions that will need to be implemented by all dental professionals in the UK:

Article 10[1])- With effect from 01 January 2019, dental amalgam must only be used in pre-dosed encapsulated form.

Article 10[2]- From 1 July 2018, dental amalgam shall not be used for dental treatment of:

 Pregnant or breastfeeding women
 Children under 15 years
 Deciduous teeth

except when deemed strictly necessary by the dental practitioner based on the specific medical needs of the patient. Article 10[4]- With effect from 01 January 2019 dental facilities must be equipped with an amalgam separator, and by 01 January 2021, all separators must retain at least 95% of amalgam particles. (This latter requirement applies to any new separators installed from January 2018 onwards). Article 10[6]- With effect from 01 January 2018 – Dental practitioners shall ensure that their amalgam waste, including amalgam residues, particles and fillings, and teeth, or parts thereof, contaminated by dental amalgam, is handled and collected by an authorised waste management establishment or undertaking.

I noted that the vast majority of dental practices already comply with Articles 10 (1), (4) and (6), and that UK Chief Dental officers were working on guidance in respect of Article 10(2). We have commissioned the Scottish Dental Clinical Effectiveness Programme to produce Health and high quality care for all, now and for future generations Implementation Advice on behalf of the UK. This Advice is now published and can be accessed here. You are advised to read this carefully and share it with your dental team. In particular, I would draw your attention to Section 1.6 which reads “The aim of this advice document is to support dental professionals in interpreting and implementing the restrictions on dental amalgam use. As with all SDCEP publications, the information presented does not override the healthcare professional’s right, and duty, to make decisions appropriate to each patient, with their valid consent. It is advised that significant departures from this implementation advice, and the reasons for this, are documented in the patient’s clinical record.”

We are working closely with NHS Choices to ensure that information is available online to answer questions from the public, should these arise. Patient information leaflets can be downloaded from the SDCEP website:
 Information for Patients Under 15 Years Old.
 Information for Parents or Carers of Patients Under 15 Years Old.
 Information for Pregnant or Breastfeeding Patients.

These can be used within your practice, should you receive any queries.

Yours sincerely,
Sara J Hurley, Chief Dental Officer England

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