After taking a little summer break from the blog, it feels especially good to be back with some very welcome news — and just in time for Mercury-Free Dentistry Week, too.
Last month, the US Department of Health and Human Services (HHS) announced that the Centers for Medicare & Medicaid Services (CMS) is urging every state Medicaid program to limit or stop providing coverage for “silver” amalgam fillings. Despite the name, those fillings are roughly 50% mercury, a potent neurotoxin.
States are simultaneously being encouraged to incentive providers to fill with composite resins instead.
Suffice it to say, this is another significant step forward in a movement that’s been building for years — one that’s also been racking up victory after victory lately. Earlier this year, the Indian Health Service announced that they will stop using amalgam in their facilities by 2027. Last fall, the Minamata Convention on Mercury committed to phasing out amalgam worldwide by 2034.
In announcing this latest action, HHS Secretary Robert F. Kennedy, Jr., put the cause plainly:
Mercury has no place in the mouths of our children or in modern American health care. For decades, 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. The Make America Healthy Again agenda means confronting outdated practices that needlessly expose Americans to toxic substances. Taxpayer dollars should support the safest care available — not yesterday’s materials.
That last point is especially important.
Too often, people with the fewest resources wind up bearing a disproportionate share of environmental and health burdens, often because safer or healthier choices cost more. Dental care has been no exception, with amalgam’s low cost only reinforcing its use in government-funded care.
This latest action starts to turn that old equation around. Mercury-free dentistry shouldn’t be something reserved for those who can afford the choice. Everyone deserves access to mercury-free care.
Of course, federal guidance alone doesn’t mean every state will suddenly stop the use of amalgam. The guidance is just that: guidance. It’s non-binding. So the work now moves to the state level. Already this year, Consumers for Dental Choice has launched a full-scale campaign to encourage them to act on the new federal guidance. Already, they’ve begun work on Medicaid reform in two states.
We think it’s important to realize that it’s not just individual patients who would benefit from such change. We all would. After all, any mercury that goes into a dental office must eventually come out in one way or another.
Sometimes, the path it takes is the wastewater stream in practices that don’t use amalgam separators to trap the metal. Improperly discarded capsules, amalgam scraps, cotton rolls, and other contaminated material can wind up sending mercury into the solid waste stream, where it ultimately gets incinerated or landfilled.
Of course, mercury also leaves an office embedded in patients’ teeth. The mercury that they constantly release eventually gets excreted, mainly through urine and feces. That’s another path into municipal wastewater. And if amalgam fillings are still there at the end of life, cremation can release their mercury into the atmosphere, while burial provides another potential route into soil and groundwater.
In other words, once mercury enters the dental cycle, managing it becomes a long-term proposition. The simplest way to reduce all of those downstream pathways is also the most obvious: Stop putting more mercury into the cycle in the first place.
That’s why every step away from amalgam matters, whether or not you personally have mercury fillings. Fewer amalgams placed today means less mercury that will need to be captured, managed, or kept out of our environment.
This Mercury-Free Dentistry Week, here’s to keeping the momentum going toward mercury-free dentistry for everyone.
