The U.S. Indian Health Service (IHS), which serves more than 2 million Native Americans and Alaska Natives annually, will stop using mercury-containing amalgam fillings by 2027, according to the U.S. Health and Human Services (HHS).
Instead, IHS, an agency within the U.S. Department of Health and Human Services, will use mercury-free restoration materials and step up caries prevention efforts, according to an HHS press release dated February 9.
“Protecting the health of our patients and our environment are top priorities for the Indian Health Service,” IHS Director of Strategic Initiatives Dr. R. Kim Hartwig said in the press release. “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.”
Within the next year, the agency will remove policies referencing mercury amalgam restorations and implement training and infrastructure that use composite and other restorative materials, it said. Also, it will invest in prevention efforts to reduce the need for restorative dentistry.
HHS Secretary Robert F. Kennedy Jr. praised the change.
“This is a commonsense step that protects patients and prevents harm before it starts,” Kennedy said in the press release. “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.”
Since 2007, the IHS has reduced its use of dental amalgam, especially with populations considered at high risk of toxicity, including pregnant women, and children under 6 years old, according to HHS.
The decision aligns with previous U.S. Food and Drug Administration (FDA) recommendations discouraging using mercury amalgam in certain high-risk populations. In September 2020, the FDA advised that high-risk individuals, such as pregnant women, avoid getting dental amalgam fillings "whenever possible and appropriate." For the first time, the agency also listed patients with multiple sclerosis, Alzheimer's disease, and Parkinson's disease as high-risk individuals for amalgam fillings.
