Move Toward Mercury-Free Dentistry
Dental amalgam, used in dentistry for over 160 years, contains about 50% mercury and was once preferred for its strength, low cost, and ease of use. However, growing awareness of mercury’s toxicity has led to global efforts to phase it out. By 2030, the use of dental amalgam is set to be completely eradicated.
The World Health Organization (WHO) has warned that even small amounts of mercury can cause serious health and environmental harm, including developmental defects in children. The UNEP Global Mercury Assessment (2013) reported that dental amalgam accounts for 21% of global mercury consumption. Since mercury is highly toxic and non-degradable, continued use leads to its dangerous accumulation in the environment.
Studies since the 1980s have shown that mercury vapor continuously releases from amalgam fillings—especially after chewing. A single 0.4 cm² filling can release about 15 µg of mercury per day, which may accumulate in the brain, kidneys, and lungs, contributing to neurodegenerative diseases, renal impairment, and even infertility in those with long-term exposure.
Global Action: The Minamata Convention (2013)
The Minamata Convention on Mercury (2013) called for a complete phase-down of dental amalgam to protect human health and the environment. It proposed nine measures, including:
Promoting dental caries prevention and oral health.
Setting national goals to reduce mercury use.
Encouraging mercury-free alternatives and related research.
Training dental professionals in safe, mercury-free techniques.
Adjusting insurance policies to favor non-mercury restorations.
Using only encapsulated amalgam and ensuring safe waste management.
Strategic Interventions
The implementation focuses on:
Waste Management: Safe handling, amalgam separators, and lifecycle management of dental waste.
Knowledge Management: Public awareness and communication programs.
Health System Strengthening: Integrating mercury-free materials into essential medical lists, making them affordable, and training dental professionals for preventive, minimally invasive care.
Advantages of Mercury-Free Dentistry
Modern alternatives such as composites and glass ionomer cements (GICs) are safer, equally durable, and minimally invasive. They preserve more natural tooth structure, can be repaired easily, and in some cases release fluoride to prevent decay. These materials also pose no known environmental or health hazards.
Recent Advances
Innovations like Resin-Modified GICs, Compomers, Giomers, Nano-ionomers, and Zirconia-reinforced GICs have revolutionized restorative dentistry. These materials combine aesthetics, strength, biocompatibility, and fluoride release while eliminating mercury exposure entirely.
Conclusion
The global phase-out of dental amalgam is a public health necessity. Moving toward mercury-free dentistry requires worldwide collaboration in research, funding, and education. Preventive care must remain the cornerstone of oral health, reducing the need for restorations altogether.
The future of dentistry lies not in silver fillings but in safe, sustainable, and biologically compatible materials—a true sign of progress.
“The world hates change, yet it is the only thing that has brought progress.” – Charles Kettering.
Dr Hysum Mushtaq is Sr Dental Surgeon
