For decades, your and our tax dollars have helped pay for a lot of things we may not personally support. That includes using mercury to fill the teeth of patients with government-funded dental care.
But that may be starting to change.
Last week, the US Department of Health and Human Services announced that they had encouraged the Centers for Medicare & Medicaid Services (CMS) in every state to restrict or end coverage for dental amalgam. They also suggested incentivizing dentists to fill with composite instead.
Good news, to be sure. But it’s also just a recommendation. States aren’t required to take action of any kind. Even so, the message from HHS was unusually direct. “For decades,” noted Robert F. Kennedy, Jr., in a news release,
we have relied on a material that contains one of the world’s most toxic heavy metals when safe, effective mercury-free alternatives are widely available….
Taxpayer dollars should support the safest care available — not yesterday’s
materials.
Dental amalgam is roughly 50% mercury. By the time Medicaid was created in 1965, it had already been the standard filling material for generations. It was simply what dentists used to repair decayed teeth, with the added “virtues” of being cheap, durable, and easy to place. Those qualities helped keep it entrenched — not only in public insurance programs but in private dental insurance, as well.
But composite resins have come a very long way since then. Early tooth-colored resins couldn’t always match amalgam’s performance, particularly when placed in molars. This fueled the idea that amalgam “lasts longer.”
That’s hardly the case today.
A couple of years ago (2024), an Israeli study looked at real-world data from a nationwide dental system serving more than 650,000 patients. Over the 8-year study period, the overall failure rate for amalgam fillings was 17.38%. For composite resin fillings? Just 11.87%.
“Composite is superior to amalgam,” the research team concluded, “and therefore it is reasonable to cease using mercury-containing amalgam.”
A more recent systematic review found no statistically significant difference in overall failure risk between amalgam and composite — yet more evidence against the old assumption that composite fillings don’t hold up as well.
Of course, the recent HHS announcement marks just the latest stage in the movement toward mercury-free dentistry. The FDA already recommends against mercury amalgam for a large part of the US population. Earlier this year, the Indian Health Service announced that it will stop placing amalgam by 2027.
And under the Minamata Convention on Mercury, countries around the world have now agreed to phase out dental amalgam by 2034.
Now Medicaid reimbursement is on the table. And private dental insurers should be paying attention, too.
Insurance policies tend to have an enormous influence over patients’ treatment options and what they’ll ultimately pay out of pocket — as if they were the ones examining your mouth.
We believe treatment decisions should be a matter only for dentists and their patients. We believe biocompatibilty matters and that any treatment decisions be made within the context of each patient’s unique health history and current needs.
The insurance company isn’t the one who’ll be living with the dental work, after all.
Our office has been mercury-free for years. When a tooth needs to be restored, we use mercury-free, tooth-colored materials selected with both the tooth and the person attached to it in mind.
We’re also mercury-safe. “Mercury-free” just means we don’t place amalgam. “Mercury-safe” means that when an existing amalgam needs to be removed, we follow strict safety protocols to minimize mercury exposure to you, our team, and our shared environment.
Nearly 200 years after dentists began putting mercury amalgam into people’s teeth, perhaps it’s time for the people writing the checks to catch up with the dentists and patients who’ve already moved on.
