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Supporting dental teams in the implementation of new regulations on dental amalgam use


Advice published today by the Scottish Dental Clinical Effectiveness Programme (SDCEP) supports dental teams in implementing new environmental restrictions on dental amalgam use in specific patient groups effective from 1 July 2018. After this date, the use of dental amalgam for treatment of patients under 15 years old, of pregnant or breastfeeding patients or of deciduous (primary) teeth in any patient, will only be allowed when deemed strictly necessary by the dental practitioner.

The restrictions, which are specified in EU regulations, have been introduced to fulfil the requirements of the global Minamata Convention. This aims to reduce the use of mercury and mercury containing products, including dental amalgam, on environmental grounds.

SDCEP’s advice aims to support dental professionals across the UK in interpreting and implementing the restrictions on dental amalgam use. The advice emphasises the importance of caries prevention and provides information about alternative caries management approaches and restorative materials to inform practitioners’ clinical decision making. Examples of situations where dental amalgam may be the only feasible treatment option are presented. Information leaflets for the patient groups to which the restrictions apply are provided to help practitioners explain the new regulation, support discussions with patients and parents or carers and provide reassurance about their care.

The advice was requested by the UK Chief Dental Officers and has been developed following a rapid process that draws on elements of SDCEP’s accredited guidance development methodology.This SDCEP advice is a departure from conventional clinical guidance in that it is based around a predefined legal provision rather than on independently developed evidence-based clinical recommendations.

The Chair of the group that developed the advice, Professor Paul Speight, said:

"There is no evidence that dental amalgam presents any risk to individual patients. However, the use of amalgam currently creates the largest demand for mercury in the EU and an estimated two thirds of this mercury ends up back in the environment, where it can pollute marine life and become concentrated in the human food chain. The new regulations restricting dental amalgam use aim to reduce this environmental burden.

"The advice was developed by a group that included experienced dental practitioners and experts in restorative and paediatric dentistry drawn from across the UK and aims to be practical and to help the dental community support these environmentally-driven changes to practice.”

SDCEP is a National Dental Advisory Committee (NDAC) initiative working within NHS Education for Scotland (NES). SDCEP supports improvements in the quality of dental care by providing user-friendly guidance and advice on topics that are priorities for dental healthcare.

Dr David Felix, Postgraduate Dental Dean for Scotland, NHS Education for Scotland (NES) said:

“NES welcomes the publication of the implementation advice on Restricting the Use of Dental Amalgam in Specific Patient Groups as a helpful resource for dental professionals in Scotland and across the rest of the UK. This will encourage a consistent approach to the delivery of dental care within the terms of the new legal requirements and is another example of how the work of the Scottish Dental Clinical Effectiveness Programme supports the delivery of high quality safe, effective and person-centred healthcare."

Further information on the work of SDCEP is available at from where the new guidance can also be downloaded.


Ref: PR2018-016

Further information from:
Scottish Dental Clinical Effectiveness Programme, Dundee Dental Education Centre, Frankland Building, Small’s Wynd, Dundee, DD1 4HN (email: or telephone: 01382 425751)

Note to Editors
NHS Education for Scotland (NES) is a national special health board working to provide education, training and workforce development for those who work in and with NHSScotland. At any time this means NES is responsible for over 6,500 trainee healthcare professionals and also supports the recruitment of professionals into Scotland

NES is responsible for the implementation of the workforce development aspects of the Scottish Government’s Oral Health Improvement Plan, which was published in January 2018.