Indian Health Service to Phase Out Mercury-Containing Dental Amalgam by 2027

The Indian Health Service (IHS) said it will stop using mercury-containing dental amalgam in its facilities by 2027 and transition to mercury-free restorative materials across all IHS and tribal dental programs.

Dental amalgam has long been used in restorative dentistry because of its strength, durability and affordability, particularly for multi-surface restorations in molars and premolars. But growing environmental and health concerns about mercury exposure, along with global efforts to reduce mercury use, prompted the agency to move to alternatives.

“This is a commonsense step that protects patients and prevents harm before it starts,” said Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services. “By switching to safer, mercury-free alternatives, IHS is putting prevention first and honoring its responsibility to tribal communities and future generations. This is the kind of practical, evidence-based action that defines the Make America Healthy Again agenda.”

“Protecting the health of our patients and safeguarding our environment are top priorities for the Indian Health Service,” said R. Kim Hartwig, director of strategic initiatives at IHS. “As we transition to mercury-free restorative options, we must carefully consider the financial and operational impacts to ensure continued delivery of high-quality, accessible dental care in tribal and IHS facilities. Stewardship of our communities and our lands is a responsibility we proudly uphold for future generations.”

Since 2007, IHS has reduced its use of dental amalgam, particularly among high-risk groups such as pregnant women and children younger than 6. The agency said it will update policies to eliminate amalgam restorations and invest in training and clinical infrastructure to support composite and other alternative materials. It also plans to expand prevention efforts to reduce the need for restorative dental procedures.

“Aesthetic and environmental concerns have led to increasing usage of resin composite as an alternative to amalgam,” Dr. Jessica A. Rickert (Prairie Band Potawatomi Nation) told Native News Online. “Composites are basically plastic matrixes incorporating glass and minerals. This trend began in the early 2000s, but they were not reliable, durable, or strong then. Biomaterials research has resulted in excellent composites available today. Composite restorations are more costly than amalgams, due to the cost of the materials and the increased time required for these procedures.”

The American Dental Association (ADA still says dental amalgamdental amalgam is a safe, affordable and durable restorative material.

The shift aligns with guidance from the U.S. Food and Drug Administration, which has raised concerns about mercury accumulating in the body and recommends nonmercury materials for certain populations. Those groups include pregnant women and their developing fetuses, women planning to become pregnant, nursing mothers and infants, children younger than 6, people with neurological disease or impaired kidney function, and individuals with mercury or other metal sensitivities.