Eliminating the Use of Dental Amalgam

Dental caries is the most common non-communicable disease worldwide, affecting more than 2.5 billion people, including 514 million school-aged children. Therefore, central to the phase down of dental amalgam use are efforts to strengthen public health approaches on dental caries prevention and oral health promotion, representing an important shift from the traditional restorative dental model. A renewed global focus on disease prevention would be a fundamental step towards better oral health, thereby reducing the need for restorative oral health care and fillings (including dental amalgam). Moreover, a focus on prevention and treatment of dental caries can be further supported by creating an enabling environment for the use of quality mercury-free products and minimal intervention.

Dental amalgam is a restorative material used to fill cavities caused by dental caries (tooth decay). Dental amalgam is a common filling material that has been a mainstay of dental restorative care around the world for over 175 years due to its ease of placement, material strength, longevity and cost-effectiveness. It is composed of a mixture of metals, consisting of elemental mercury (~50%) and a powdered alloy composed of silver, tin, and copper.  Mercury pollution may occur during the amalgam life cycle from production, supply, cavity placement, removal of fillings and disposal. Estimates suggest 30 to 40 per cent of mercury in amalgam enters solid waste streams, accumulates in water, soil and the atmosphere without breaking down. In this context, promoting the environmentally sound management of dental amalgam waste alongside prevention is key to reduce risks to human health and the environment. Furthermore, estimates suggest that between 3,000 to 5,000 metric tons of mercury are stored in the mouths of people worldwide in the form of dental amalgam, making the waste amalgam created by the dental industry a global issue.

A global shift away from dental amalgam is underway under the Minamata Convention on Mercury.

At COP‑6, countries agreed on a clear phase‑out date of 2034 for the manufacturing, import, and export of dental amalgam. In the meantime, countries must take steps to significantly reduce its use, while allowing dentists to use it when medically necessary.

Countries are also required to track and report their progress: they must develop national action plans or submit regular updates. 

These decisions mark a major step toward safer, mercury‑free dental care worldwide.