Dental Crisis Looms in Northern Ireland: Dentists Urge Immediate Action

IRELAND: In a stark open letter to the Permanent Secretary of the Department of Health (DoH), Peter May, over 700 dentists in Northern Ireland have raised alarm bells, warning of a looming “death spiral” in health service dentistry. 

The letter, backed by the majority of high street dentists, cites multiple challenges, including the impending ban on dental amalgam, budget freezes at Stormont, and an unsustainable contractual framework that could potentially jeopardize dental services.

“Despite clear evidence and repeated warnings issued by the British Dental Association about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities,” express the concerned dentists.

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Impending Ban on Dental Amalgam Adds Pressure

Northern Ireland is on the brink of facing the EU ban on dental amalgam from January 1, 2025. Dentists anticipate a substantial impact on costs and time pressures due to the shift to alternative materials. The combination of this impending ban, financial constraints, and a challenging contractual framework raises serious concerns about the viability of health service dentistry.

“Vital public services are at stake. Livelihoods hang in the balance. We ask that you are transparent with us, and with the patients who rely on our services,” plead the dentists.

The dentists highlight the financial strain imposed by the high volume/low margin model of NHS dentistry. Practices are already delivering certain treatments at a financial loss, leading to a significant migration of practitioners to the private sector. The financial situation is deemed unsustainable, and the dentists stress that authorities can no longer afford inaction.

“In this unprecedented call to arms, the signatories say the financial situation facing health service dentistry is now unsustainable, and that continued inaction by authorities is no longer an option,” emphasizes the letter.

Urgent Call for Reinvestment and Leadership

In a plea for immediate action, the dentists urge Stormont’s Department of Health to reinvest the significant underspend projected for this year’s dental budget to support struggling practices. They argue that these practices are unable to deliver pre-pandemic levels of activity and are on the brink of collapse.

“The dentists say it’s a service ‘on the brink’ and have called on the DoH ‘to show leadership and take action now’,” reports the letter.

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In response, a spokesperson for the Department of Health acknowledged the ongoing pressures on dental practices and expressed the department’s awareness of the challenges. The spokesperson outlined the additional investments made in General Dental Services via the Financial Support Scheme and Rebuilding Support Scheme, amounting to £88.1 million since April 2020. However, they noted that this support ended in July 2023 due to financial pressures.

“The Department recognises the concerns expressed by the profession and has committed to exploring measures to support the delivery of health service dental treatment,” the spokesperson added.

While the prohibition on dental amalgam aligns with the direction set by the EU and the UK, a final decision is pending. The Department is actively engaging with relevant government departments to address concerns and ensure a seamless implementation of any changes.

The dentists’ plea for immediate action reflects the urgency of the situation and the need for collaborative efforts to safeguard the future of health service dentistry in Northern Ireland.