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Howard Speaks: Should Amalgam Be Banned in the U.S.? by Dr. Howard Farran, DDS, MBA

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Categories: Restorative Dentistry;
Howard Speaks:  

by Dr. Howard Farran, DDS, MBA, publisher, Dentaltown magazine

The European Union (EU) has spoken: As of Jan. 1, 2025, dental amalgam is banned across the board, except for rare medical exceptions. By July 2026, manufacturing and importation will be off the table, too. Why? Mercury. The EU sees this as an environmental issue, tying the move to the Minamata Convention’s global push to reduce mercury pollution.

So, what about us? Will the U.S. follow suit and ban amalgam? Should we?


The real reason behind the push to ban amalgam
Let’s get one thing straight: The main driver behind amalgam bans isn’t direct patient health concerns—it’s the environment. Amalgam contains roughly 50% mercury, and its waste contributes to pollution. The Minamata Convention, signed by more than 140 countries (including the U.S.), aims to phase out mercury use wherever possible.

While some studies raise concerns about mercury exposure, the overwhelming consensus in science is that dental amalgam is safe for general use. If amalgam fillings were truly toxic, we’d expect dentists who have been handling it for decades to be suffering en masse—and that’s just not happening.


The case for keeping amalgam
If you’ve been practicing long enough, you already know why amalgam has stuck around: It works. It’s durable, moisture-tolerant and cost-effective. It lasts longer than composite in high-stress cases, making it a valuable option for certain patients—especially those with high caries risk, poor oral hygiene or financial constraints.

Yes, composites have improved. High-strength glass ionomers and bulk-fill resins offer better alternatives than ever before. But none of them completely replace amalgam’s unique benefits.

Take moisture control. If you’ve ever struggled to keep a molar bone-dry in a wiggly 5 year old or a medically complex adult, you understand why amalgam is still a tool in our restorative arsenal.

And let’s be real—phasing out amalgam could make dental care less accessible. The alternative materials cost more, and when cost goes up, care access goes down. Do we really want to make it harder for underserved communities to get reliable dental treatment?


Will the U.S. ban it?
The U.S. won’t ban amalgam anytime soon. Politics aside, outright banning amalgam in the U.S. would require a major shift in regulatory priorities. The FDA still considers it safe, and the ADA supports its continued use, though with an emphasis on minimizing mercury exposure in dental offices.

That said, amalgam’s days are likely numbered not because of a ban, but because of patient preference and industry trends. More and more patients want tooth-colored fillings, and the industry has been organically moving away from amalgam for years. Even dental schools now focus heavily on composite restorations, making amalgam less of a go-to.

So, will we see a full-on ban? Maybe down the line. But in the meantime, it’s more likely that amalgam will simply fade away, driven by environmental policies, evolving technology and changing patient expectations.


The bottom line
The decision to phase out amalgam isn’t based on it being unsafe for patients—it’s about global mercury reduction. If we lose it as an option entirely, public health dentistry could take a hit, especially for patients who struggle with composite failures.

Dentistry is always evolving, and the industry will adapt. But for now, amalgam remains a reliable, affordable, and clinically sound restorative material—and it’s not disappearing from the U.S. just yet.
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