Indian Health Service to Cease Mercury Amalgam Use by 2027

IHS Commits to Mercury-Free Dentistry

The Indian Health Service (IHS) has declared its intention to eliminate the use of mercury-containing dental amalgam across all its facilities and tribal dental programs by 2027. This move signifies a significant shift towards mercury-free restorative materials, prioritizing patient health and environmental protection. The announcement was made on February 9, 2026, marking a definitive timeline for the transition.

Driving Factors Behind the Policy Change

The decision by the IHS is influenced by increasing concerns over mercury exposure and its potential health and environmental impacts. Dental amalgam, traditionally valued for its strength and affordability, contains approximately 50% elemental mercury. The agency's transition aligns with global efforts to reduce mercury use, notably the Minamata Convention on Mercury, an international treaty signed by the U.S. in 2013, which aims to protect human health and the environment from mercury pollution.

The U.S. Food and Drug Administration (FDA) has also issued guidance recommending against dental amalgam for certain high-risk populations. These groups include:

• Pregnant women or those planning to become pregnant
• Nursing women and their newborns
• Children under six years old
• Individuals with neurological diseases
• People with impaired kidney function
• Those with known mercury sensitivities or allergies to other amalgam components

Transition to Alternatives and Prevention

The IHS has been progressively reducing its reliance on dental amalgam since 2007, particularly for vulnerable populations such as pregnant women and young children. As part of the new policy, the agency plans to update its guidelines, invest in comprehensive training for dental professionals, and enhance clinical infrastructure to support the widespread adoption of mercury-free alternatives. Furthermore, the IHS will strengthen its prevention efforts to minimize the overall need for restorative dental care.

Common mercury-free alternatives that will be utilized include:

• Composite resin (tooth-colored fillings made from plastic and glass)
• Glass ionomer cements
• Porcelain and ceramic fillings

These materials offer aesthetic benefits and eliminate concerns related to mercury vapor release.

Official Statements and Global Context

HHS Secretary Robert F. Kennedy, Jr., commented on the decision, stating, 'This is a commonsense step that protects patients and prevents harm before it starts. By switching to safer, mercury-free alternatives, IHS puts prevention first and upholds its responsibility to tribal communities and future generations.' IHS Director of Strategic Initiatives R. Kim Hartwig, MD, added, 'Protecting the health of our patients and our environment are top priorities for the Indian Health Service. 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.'

This initiative by the IHS precedes a broader global commitment. Parties to the Minamata Convention on Mercury recently agreed to a worldwide phase-out of dental amalgam by 2034, underscoring the international momentum towards mercury-free dentistry.