Indian Health Service to End Use of Mercury-Containing Dental Amalgam by 2027

The Indian Health Service announced today it will end the use of mercury-containing dental amalgam in its facilities by 2027, transitioning to mercury-free restorative materials across IHS and tribal dental programs.

Dental amalgams have been widely used in restorative dentistry due to its material properties: strength, durability, and affordability, particularly for multi-surface restorations in molars and premolars. However, growing environmental and health concerns regarding mercury exposure, along with global efforts to reduce the use of mercury-containing materials, have prompted the agency to assess safer alternatives.

“This is a commonsense step that protects patients and prevents harm before it starts,” said HHS Secretary Robert F. Kennedy, Jr. “By switching to safer, mercury-free alternatives, IHS puts prevention first and upholds its responsibility to tribal communities and future generations. This is exactly the kind of practical, evidence-based action that defines the Make America Healthy Again agenda.”

“Protecting the health of our patients and our environment are top priorities for the Indian Health Service,” said IHS Director of Strategic Initiatives R. Kim Hartwig, MD. “As we move toward mercury-free restorative options, it’s important to understand the financial and operational implications of this transition so that we can continue to provide high-quality, accessible dental care in tribal and IHS facilities. Our holistic stewardship, including our lands, is a responsibility we embrace for future generations.”

Since 2007, IHS has reduced the use of dental amalgam, particularly among high-risk populations such as pregnant women and children under six years old. The agency will update its policies to eliminate amalgam dental restorations and invest in training and clinical infrastructure for composite and alternative restorations. IHS will also strengthen prevention efforts to decrease the need for restorative dental care.

This transition aligns with guidance from the U.S. Food and Drug Administration (FDA), which has raised concerns about mercury accumulating in the body and recommends non-mercury materials for certain populations. These high-risk populations include pregnant women and their developing fetuses; women planning to become pregnant; nursing women and their newborns; children under the age of six; people with neurological disease; individuals with impaired kidney function; and people with mercury sensitivities or sensitivities to metals such as silver, copper, tin.