Dental amalgam is a strong and long-lasting filling material made from a mix of metals, including mercury. It has been used safely for generations and is especially useful for back teeth, where chewing forces are highest.

The Oral Health Foundation does not consider dental amalgam to present a significant health risk for the general population. For most people, it remains a safe, effective, and affordable option.¹⁻⁴

We do not advise removing or replacing amalgam fillings unless there is a confirmed allergy or a clear clinical need. Removing healthy fillings can weaken the tooth and may temporarily increase mercury exposure during the procedure.

Although amalgam remains safe and effective, the Oral Health Foundation supports a gradual phase-down of its use. This aligns with global efforts to reduce mercury emissions and protect the environment, while ensuring patient safety remains the top priority.⁷

Our position

We believe:

• Dental amalgam is safe and effective for most patients.¹²³⁴

• Existing amalgam fillings should only be replaced when clinically necessary.

• Patients should have access to mercury-free alternatives when appropriate.

• The phase-down of amalgam should be managed gradually and guided by clinical evidence.

• Patient safety and clinical need must always come before material policy.

• The transition to mercury-free dentistry should support environmental protection.⁷

Scientific reviews from leading authorities – including the World Health Organisation (WHO  )¹, FDI World Dental Federation², Swedish Medical Research Council³ and US FDA⁴ - continue to support the safety of amalgam for most people, while encouraging long-term progress towards preventive, minimally invasive and mercury-free dentistry.

Safety

Research over more than 150 years shows that dental amalgam:

• Is durable, reliable and clinically effective.¹²³⁴

• Does not cause systemic diseases in the general population.¹³⁴⁵⁶

• Releases very small amounts of mercury vapour — well below recognised safety thresholds.⁵

• Causes allergic reactions only in very rare cases worldwide.

Claims that amalgam causes conditions such as Alzheimer’s disease, autism or Parkinson’s disease are not supported by credible scientific evidence.¹⁵⁶

The Oral Health Foundation recognises that, under today’s environmental principles, a new mercury-based product would be unlikely to receive regulatory approval – which reinforces the need for continued innovation in mercury-free materials.

Alternatives to amalgam

Patients who prefer not to have amalgam should talk to their dentist about suitable alternatives. These include:

• Composite resins (white fillings).

• Glass ionomers.

• Ceramic restorations.

Each option has different strengths, lifespan expectations and costs. No mercury-free material currently matches every property of amalgam in all situations.

Concerns have been raised about bisphenol A (BPA) in some composites, but scientific evidence shows that exposure from dental treatment is extremely low compared with everyday sources and is not considered a health risk.⁶

Mercury-free materials are widely available in UK dentistry, including on the NHS depending on clinical need and local commissioning.

The environment

In line with the Minamata Convention on Mercury, the Oral Health Foundation supports responsible environmental management of mercury-based dental materials.⁷ This includes:

• Amalgam separators in dental practices.

• Proper collection and recycling systems.

• Ongoing efforts to reduce mercury emissions.

Conclusion

Dental amalgam remains a safe and effective treatment for most people. A sudden ban would risk patient care and drive unnecessary removal of healthy fillings.

A managed, evidence-based phase-down – guided by clinical need and patient safety – is the right approach.

The Oral Health Foundation will continue to review this policy as scientific evidence and restorative materials evolve.

References

1. World Health Organization (2011). Future use of materials for dental restoration. Geneva: WHO.
2. FDI World Dental Federation (2020). Policy statement: Dental amalgam and the Minamata Convention.
3. Swedish Medical Research Council (1992). Potential biological consequences of mercury released from dental amalgam. Stockholm.
4. US Food and Drug Administration (2020). Recommendations about the use of dental amalgam in certain high-risk groups. Silver Spring, MD: FDA.
5. National Council Against Health Fraud (2002). Position paper on dental amalgam.
6. Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) (2015). Opinion on the safety of dental amalgam and alternative dental restoration materials. European Commission.
7. United Nations Environment Programme (UNEP) (2013, amended 2023). Minamata Convention on Mercury.