IHS Says Goodbye to Amalgam Fillings
The Indian Health Service will phase out mercury-containing dental amalgam fillings by 2027, accelerating a shift already underway across dentistry. The move aligns federal tribal health care with global mercury reduction efforts while reflecting dentistry’s broader transition to resin-based alternatives.
The era of the “silver filling” is officially winding down at the Indian Health Service. The federal agency serving roughly 2.8 million American Indians and Alaska Natives has announced it will fully transition away from mercury-containing dental amalgams by 2027, a timeline that puts it ahead of global phaseout targets.
For decades, amalgam has been a dependable workhorse: durable, cost-effective, and forgiving in less-than-ideal clinical conditions. But times have changed. Since the United States Food and Drug Administration reclassified amalgam from low to moderate risk in 2009, utilization has steadily declined. Within IHS facilities, use has dropped from 12% of patients in 2005 to just 2% in 2023.
However, the American Dental Association asserts that amalgam fillings are safe, offer a high level of durability, and are cost-effective.
Growing environmental concerns, global mercury reduction agreements, and evolving patient preferences have all played a role. The World Health Organization has encouraged countries to move away from dental amalgam, and signatories to the Minamata Convention have agreed to phase it out by 2034. IHS is getting there early.
For clinicians, this shift likely feels less like a revolution and more like a formal acknowledgment of what is already happening chairside. Composite resins dominate restorative care for esthetic and patient-centered reasons, and many practices have long since reduced or eliminated amalgam use. Click here to read more.
