News analysis: oral care – public protection sinks like lead

In the light of recent news stories about toxic lead found in cheap dental imports, lab technician Tony Griffin suggests that the UK’s dental authorities should strike while the iron’s hot by tightening regulations – now.

Nothing to worry about in those cheap dental crown and bridges etc imported into the UK? Or maybe there is a problem?…

Cheap dental appliances coming into the UK has worried British dental technicians, but we have been constantly told that standards will be met. Now it appears that concerns are being raised worldwide that patient safeguards are not in place, appliances may be putting individuals at risk.

Overseas laboratory appliances made from harmful materials cannot be dismissed. UK dental care patients may already be at risk. The concerns regarding toxic paint on children’s toys has cast a cloud on non-EU produced goods, to this we add oral health care appliances tainted with lead found in US dental appliance imports.

In the UK we are told, such concerns would be dealt with immediately and directly by those whose remit is public protection. The Dental Technologists Association (DTA), on behalf of its members and of the public, has consistently raised concerns regarding the general purchasing of appliances outside the EU.

Do we wait until hundreds of patients have been incorrectly fitted with faulty appliances? It is surely a dangerous option, leaving patients wondering if they are walking around with a time bomb of toxic materials within their mouths.

Patients will rightly ask about the source of their dental prosthesis having read the US story. Value for money cannot be the prime mover for provision of dental prostheses.
They are likely to ask searching questions: ‘Is that recently fitted appliance toxic and doing me damage’? ‘Has it been made under the strict requirements of the UK healthcare regulatory authorities by UK dental technicians?’

Within the UK, dental technicians have to fabricate dental appliances in strict conformance to the Medical Devices Directive (MDD) that is maintained under the Medical Health and Regulatory Authority (MHRA). Such dental appliances must have detailed records of the materials used, conformance to set standards and be made in registered dental laboratories by dental technicians. Dental appliances, as other consumer products from across the globe, are open to misunderstanding or unscrupulous profiteering by businesses who are more concerned at making a quick profit than maintaining the health and wellbeing of the patient.

Cheap and non complying materials may look fine visually, but over time can cause damage working against the patient’s well being.
Do the UK health authorities and Government realise that such damage caused by inappropriate and unscrupulous dental care provision is likely to be happening in an unregulated manner now?
Yes, the DTA has consistently expressed it concerns regarding public safety.

Is dentistry just for each and every individual patient to gain a Certificate of Compliance to assure them that the dental appliance uses the appropriate high standard dental materials?
Is the patent expected to check where the appliance is being made and that it is of the appropriate standard? The demand to have a Certificate of Compliance at the time of fitting an appliance is certainly going to come immediately from those who know the risks of poor quality materials that damage human tissues.

Using inappropriate materials in the mouth fitted from unscrupulous suppliers is often there for many years and has a slow degrading effect. Saliva can affect the surface of dental appliances and dissolve small quantities into the body placing the patient at risk. Those patients who were originally concerned about amalgam fillings, will now be wondering what cheap and nasty materials are being used to make all manner of dental appliances made to replace the original fillings.

Rather than saying again that the DTA was just crying wolf, the Government has now the need to take seriously our members concerns about overseas cheap dental appliances that can easily damage public health because they do not conform to strict UK standards for healthcare.

Setting the standards for appliances fitted to patients then allowing back door entry of non-conforming appliances is ridiculous in the extreme. The person who suffers in the long term is the patient who has put their trust in the UK healthcare provision.

• Tony Griffin qualified as a dental technician in 1969 in Derby, and then moved to Birmingham to manage a commercial dental laboratory.
A past president of Dental Technologists Association (DTA), Tony is still an active elected council member. He was a member of the GDC PCD curricula overview group and is a member of their Fitness to practise panel. He was instrumental in the development of the first Foundation Degree in Dental Technology, and the BSc (Hon’s) dental technology. Appointed Director of Health Science at Castle College, Nottingham in 2006. He is actively involved in health professions education, vocational skills and CPD.

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