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6/22/2017 » 6/25/2017
2017 OSAP Annual Conference

Amalgam Issue Toolkit stop 2-1-15

Background| Resources| Articles



Dental amalgam is a dental filling material used to fill cavities caused by tooth decay. It has been used for more than 150 years in hundreds of millions of patients.

Dental amalgam is a mixture of metals, consisting of liquid mercury and a powdered alloy composed of silver, tin, and copper. Approximately 50% of dental amalgam is elemental mercury by weight.

Dental amalgam fillings are also known as "silver fillingsā€ because of their silver-like appearance.

When placing dental amalgam, the dentist first drills the tooth to remove the decay and then shapes the tooth cavity for placement of the amalgam filling. Next, under appropriate safety conditions, the dentist mixes the powdered alloy with the liquid mercury to form an amalgam putty. (These components are provided to the dentist in a capsule as shown in the graphic.) This softened amalgam putty is placed in the prepared cavity, where it hardens into a solid filling.(Source: US FDA)To learn more about dental amlagam click here.

Dental amalgam is a product regulated by the US Food and Drug Administration (FDA). On July 28, 2009, FDA issued a final rule that: (1) reclassified mercury from a class I (least risk) device to class II (more risk) device; (2) classified dental amalgam as a class II device; and (3) designated a special controls guidance document for dental amalgam. Summary of Changes to the Classification of Dental Amalgam and Mercury provides more information regarding how the US FDA classifies dental amalgam.

FDA does not regulate the disposal of dental amalgam. The disposal of dental amalgam is regulated by the Environmental Protection Agency (EPA) and state and local authorities. In 2008, the EPA published a detailed study of dental amalgam.

On September 16, 2009, EPA published a final rule that limits emissions from medical waste incinerators. Mercury amalgam also accumulates on dental supplies, such as cotton swabs and gauze, and these materials are usually deposited in the regular trash. In local areas where trash is incinerated, the mercury in this trash can be released via air emissions. To avoid such mercury air emissions, dental offices should properly dispose of captured amalgam solid waste by sending it to a dental waste recycler.

The American Dental Association (ADA) has also issued best management practices for amalgam waste. The ADA Council on Scientific Affairs has also issued a statement on dental amalgam.

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Dental Amalgam

This website contains information about dental amalgam and other types of dental filling materials.

Final Rule for Dental Amalgam

Appendix II
White Paper: FDA Update/Review of Potential Adverse Health Risks Associated with Exposure to Mercury in Dental Amalgam

The findings of this White Paper were originally presented in draft form at a September 6 and 7, 2006, joint meeting of the Dental Products Panel and the Peripheral and Central Nervous System Drugs Advisory Committee (the Panel). After that meeting, FDA prepared a separate Addendum that addresses the Panel's comments.


Mercury in Dental Amalgam

General information about dental amalgam.

The Environmentally Responsible Dentist Dental Amalgam Recycling: Principles, Pathways and Practice

Contains a series of presentation topics regarding amalgam.

ADA, NACWA, & EPA Voluntary Dental Amalgam Discharge Reduction Program Memorandum of Understanding12-31-2008

On December 29 2008, the Office of Water signed this Memorandum of Understanding (MOU) with the American Dental Association (ADA) and the National Association of Clean Water Agencies (NACWA) to establish and monitor the effectiveness of a Voluntary Dental Amalgam Discharge Reduction Program.

Effluent Guidelines
Detailed Studies Dental Amalgam

Across the United States, many states and municipal wastewater treatment plants (publicly owned treatment works (POTWs)) are working toward the goal of reducing discharges of mercury to POTWs.

Dental Amalgam Poster 1 From NY.
Dental Amalgam Poster 2 From NJ.



A general information overview.
Future Use of Materials for Dental Restoration Report released by WHO October 11, 2011.

Amalgam Separators

The Bottom Line - Dental Amalgam Separators

Choosing an Amalgam Separator for Your Dental Office

Choosing an Amalgam Separator for Your Dental Office

Amalgam Separator Buyer's Guide

Purchasing, installing and operating dental amalgam separators - Practical issues

Dental Amalgam Separators Practical Considerations for their Installation and Use

Amalgam Best Management Practices
Dental Office Inspection Checklist
Survey of Amalgam Management


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WHO Contribution To Amalgam Debate Welcomed By British Dental Association The British Dental Association (BDA) welcomes the World Health Organization's (WHO) publication 'Future Use of Materials for Dental Restorations' which reports about using different materials in dental fillings reflecting the November 2009 meeting at WHO's Geneva headquarters regarding environmental and health factors that arise from using different filling materials.
Thirty-five year review of a mercury monitoring service for Scottish dental practices

Exposure of staff to mercury in Scottish dental practices is currently now very low. This is probably as a result of increased awareness to the toxicity of mercury and improved methods of preparing amalgam. It may be possible to reduce exposure further, although probably only slightly, by upgrading practices and using encapsulated mercury amalgam.

Biocompatibility of dental amalgams The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental amalgam.
Scant Risk Found in Prenatal Amalgam Exposure Prenatal amalgam exposure does not cause clear detrimental effects in humans, according to the first-ever study to look at the possibility.
WHO Calls for 'Phase Down' of Dental Amalgam

A World Health Organization (WHO) committee this month called for a worldwide reduction in the use of dental amalgam to cut the flow of mercury into the natural environment.

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Dental clinics: a point pollution source, not only of mercury but also of other amalgam constituents Current literature suggests that amalgam waste from dental clinics is a point-source of mercury pollution in the environment. However, apart from mercury, other amalgam constituents (e.g. Ag, Sn, Cu, and Zn) in dental clinics' wastewater have not been reported in the literature before.

Exposure to dental amalgam restorations in pregnant women

The aim of the present study was to identify factors potentially associated with amalgam fillings in pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa).
Oral health care during pregnancy recommendations for oral health professionals Diagnosis and treatment, including needed dental X-rays, can be undertaken safely during the first trimester of pregnancy. Needed treatment can be provided throughout the remainder of the pregnancy; however, the time period between the 14th and 20th week is considered ideal.
Neurological outcomes in children with and without amalgam-related mercury exposure: seven years of longitudinal observations in a randomized trial The current evidence is that potential neurobehavioral or neurological effects from dental amalgam mercury exposure in children are inconsequential.


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