Delegates to the Minamata Convention on Mercury have agreed to phase out dental amalgam by 2034, prohibiting the manufacture, import, and export of mercury-based fillings after that date.

The agreement, adopted at the Sixth Conference of the Parties (COP-6) in Geneva this month, was met with applause and standing ovations in plenary sessions, marking what many delegations described as a historic milestone for global environmental and public health policy.

The 2034 deadline represents a carefully negotiated compromise. Initially, many countries proposed a 2030 phase-out date, but intense deliberations led to the extended timeline to provide dental professionals and healthcare systems adequate time to prepare for the transition.

The FDI World Dental Federation and the International Association for Dental, Oral, and Craniofacial Research, supported by the American Dental Association and International Dental Manufacturers Association, worked throughout the negotiations to ensure an evidence-based, patient-centered approach that would avoid widening oral health inequalities globally.

"As we move toward the eventual phase-out of dental amalgam, it is essential that the needs of our members, and the patients they serve, remain at the heart of every decision," said Enzo Bondioni, Executive Director of FDI. "This outcome provides much-needed time and clarity for our members to plan, prepare, and implement the necessary national policies."

The decision adds dental amalgam to Annex A of the Minamata Convention, establishing clear parameters for the global phase-out. After 2034, countries party to the treaty will no longer be permitted to manufacture, import, or export dental amalgam.

The agreement includes an important exception allowing amalgam use when deemed necessary by dental practitioners based on individual patient needs, providing flexibility for complex clinical situations during the transition period.

The Minamata Convention, which entered into force in 2017 and now includes 153 member countries, is named after the Japanese city where thousands suffered severe mercury poisoning from industrial wastewater in the mid-20th century. The treaty aims to protect human health and the environment from mercury exposure across all stages of the mercury lifecycle.

Monika Stankiewicz, Executive Secretary of the Minamata Convention, highlighted several challenges associated with dental amalgam use, including mercury exposure risks for dental practitioners, disposal costs, and mercury emissions from crematoria.

Dental amalgam, a restorative material used for over a century, consists of approximately 50% elemental mercury combined with silver, tin, and copper. While major dental organizations have long maintained that amalgam is safe for patient use, environmental concerns about mercury release and growing availability of alternatives have driven policy changes worldwide.

Some countries, including Northern Ireland, had already set their own phase-out dates, with December 31, 2034 previously established as a regional deadline.

The transition away from amalgam will accelerate the adoption of alternative restorative materials already widely used in dentistry:

Composite Resins: The most common amalgam alternative, composite fillings are tooth-colored materials made from plastic resin reinforced with glass particles. They bond directly to tooth structure and provide excellent aesthetics, though they typically cost more than amalgam and may have slightly shorter lifespans in some applications.

Glass Ionomer: These materials release fluoride, which can help prevent further decay, making them particularly useful in certain clinical situations.

Ceramics: Porcelain-based materials offer excellent durability and aesthetics but come at a higher price point.

Gold: Though expensive and highly visible, gold remains one of the most durable filling materials available.

The economic implications of the phase-out have been a central concern throughout negotiations. Research indicates that amalgam fillings generally cost less initially and tend to last longer than composite alternatives, raising questions about affordability and access, particularly in underserved communities and developing nations.

However, advocates for the phase-out note that mercury prices have risen significantly since the Minamata Convention's adoption, narrowing the cost gap between amalgam and alternatives. Additionally, many dental schools now dedicate more teaching time to composite placement than to amalgam, with some programs no longer teaching amalgam placement at all.

The nine-year timeline is designed to allow healthcare systems to adapt payment structures, train practitioners, and ensure adequate supplies of alternative materials are available globally.

For dental practices in the United States and other developed nations, the 2034 deadline provides ample time for transition, as many practices have already substantially reduced or eliminated amalgam use in favor of tooth-colored alternatives.

The timeline allows for:

The agreement emphasizes the importance of prevention alongside material substitution. By reducing the incidence of dental caries through improved oral hygiene, fluoridation, and preventive care, the overall need for restorative materials can be decreased.

Dr. Christopher Fox, CEO of IADR, stated that the outcome reflects progress made through research investment into mercury-free alternatives from both public and private sectors, while emphasizing the continued need for innovation in developing affordable, effective, and sustainable restorative materials.

The next Conference of the Parties (COP-7) is scheduled for June 2027, coinciding with the tenth anniversary of the Minamata Convention. Between now and then, member countries will be developing national strategies to meet the 2034 deadline while maintaining quality patient care.

For the dental profession, this decision represents both a challenge and an opportunity—a chance to accelerate the transition to modern restorative materials while ensuring that no patient is left without access to necessary dental care during the transition.

The agreement underscores a fundamental shift in global health policy: the recognition that environmental protection and patient care are not competing priorities but complementary goals that require coordinated international action.

As one era of restorative dentistry prepares to close, another opens—one that promises to deliver the same level of care with reduced environmental impact and continued innovation in dental materials science.

The Minamata Convention on Mercury is a global treaty to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds. The convention is administered by the United Nations Environment Programme (UNEP).