Europe has banned the manufacture and export of dental amalgam and will likely ban its use in the near future, but where does US health policy stand on this?
By Paige Anderson, CRDH
Between misinformation about its safety and concerns about its environmental impact compared to other options, dental amalgam has been a controversial material for many years.
Recently, the European Union passed legislation to ban its use completely, while the United States has taken a more gradual approach to phasing it out. Even within the U.S., there appears to be mixed messaging and varying approaches to the future of amalgam fillings. What accounts for these differences, and how does it affect the care patients receive?
A Worldwide Push to Phase Out Amalgam
The Minamata Convention on Mercury is an international treaty adopted by the United Nations in 2017. It governs the mining, trade, and use of mercury. The Convention supports the strategic reduction in the worldwide use of mercury, in favor of alternatives such as composite resin for dental restorations.
Following its adoption, UN members have taken varying approaches to fulfilling these goals. However, the Minamata Convention’s global ban on the manufacture and trade of mercury-containing dental amalgam will take effect as of January 1, 2035.
Why the Push to Move Away from Amalgam?
The International Association for Dental, Oral, and Craniofacial Research, along with other bodies such as the ADA, has confirmed that amalgam fillings are safe. So why the push to phase it out?
Beyond concerns about the safety of amalgam fillings, the Minamata Convention addresses the environmental impact of their manufacture and disposal. Because byproducts can leach into the water table, their use can increase environmental exposure for residents throughout areas where the material is produced and used. This concern is the main driver behind the EU’s sudden push to move away from dental amalgam.
Europe Banned Dental Amalgam Sooner Than Expected
As of January 2025, the EU Parliament declared a total ban on the manufacture and export of dental amalgam from the EU. This legislation does not ban the use of dental amalgam within the EU at this time. Yet, it significantly reduces dentists' access to the material in both the private and public health systems.
Several EU member states have already banned the use of dental amalgam for new fillings or limited its use for certain patients, such as children under 15 and pregnant women.
Mixed Messages in the US
Where the EU has taken a hard line on banning the material, the U.S. government has adopted a gradual phase-out plan. Organizations within the U.S., such as the ADA, continue to affirm the safety and efficacy of dental amalgam and argue its importance as an affordable option for populations with limited access to care.
However, some states and public health bodies, as well as the Indian Health Service, have already begun phasing it out or recommending that dentists use alternatives such as composite.
Amalgam Use in Practice: Is Europe Really Moving Away from Amalgam Faster Than the US?
On the surface, the EU’s active, enforceable approach may give the appearance that Europe is phasing out amalgam sooner than the U.S. However, the data show that this may be more a case of Europe playing catch-up than leading the way.
Amalgam Is Mostly a Thing of the Past in the US
Amalgam has seen its popularity decline in the U.S. for many years. As of 2022, it only accounted for about 6% of all dental restorations in posterior teeth, and rates have decreased further since then.
It’s increasingly common for dental practices to only offer composite. This may have to do with patients’ preferences for its superior aesthetics, as well as the additional operating costs associated with regulations for the proper disposal of amalgam waste products.
Some Areas of Europe Have Lagged Behind
On the other hand, in 2025, dental amalgam still accounted for between 20 and 30% of restorations placed in many areas of Europe. It was still the most commonly used filling material through the NHS in the UK as recently as 2024.
While some countries have much lower rates of amalgam use and others have already banned its use by public health dentists, Europe is generally behind the U.S. in phasing out the material.
What This Means for Your Practice
In all likelihood, your practice has already switched away from amalgam. Even for those who are still using it, the U.S. does not appear to be preparing a ban similar to what the EU has enacted.
With more materials being developed every year, most of which have an excellent lifespan and superior aesthetics to amalgam, as well as additional benefits such as bioactive glass for tooth regeneration, amalgam will likely fall out of use on its own. As ever, adopting proven improvements in the materials and techniques you use will help you stay competitive in a changing world.
Author: Paige Anderson is a certified registered dental hygienist with eight years of clinical experience and an English degree. She blends her two areas of expertise to create resources for dental providers so they can change lives by giving their patients the highest possible standard of care.
