There is a longstanding division in professional opinion regarding the safety of mercury-containing dental amalgams. This split is especially evident between legacy dental authorities and holistic or biologically oriented dental organizations, with a third group of institutionally-endorsed bodies taking an increasingly nuanced position.
Organizations such as the American Dental Association (ADA) continue to promote dental amalgam as a safe, cost-effective, and time-tested restorative material. These authorities maintain that mercury in amalgam is stable and that any vapor released during chewing or brushing is too low to cause harm in the general population. However, critics argue this stance reflects institutional inertia and resistance to newer research on chronic low-dose exposure.
Agencies such as the U.S. Food and Drug Administration (FDA) and the World Health Organization (WHO) have traditionally aligned with the ADA's safety assessment. However, in recent years, both have softened their positions. In 2020, the FDA issued updated guidance recommending that certain high-risk groups – including children under six, pregnant women, nursing mothers, and individuals with neurological or kidney disorders – avoid mercury-containing fillings when possible. The WHO, while not issuing a direct ban, has encouraged global efforts to phase down amalgam use under the Minamata Convention on Mercury.
In contrast, groups such as the International Academy of Oral Medicine and Toxicology (IAOMT) strongly oppose the use of dental amalgam due to mercury toxicity concerns. They advocate for mercury-free alternatives and strict removal protocols, citing research that supports the bioaccumulation of mercury in body tissues and its potential to trigger autoimmune, neurological, and renal dysfunction – especially in genetically susceptible individuals.
Across the globe, momentum is shifting. The European Union banned the use of amalgam in children under 15, as well as pregnant and breastfeeding women, starting in 2018. Several countries, including Sweden and Norway, have moved toward eliminating amalgam use altogether. In contrast, many U.S. dental offices continue to use amalgam as a first-line filling material, often without informing patients of mercury content or alternatives.