Short answer

Dental amalgam, the silver-colored filling material, is about half mercury by weight. (FDA) It can release small amounts of mercury vapor into the mouth, and the amount depends on the number and age of your fillings, along with habits like grinding your teeth or chewing gum. (FDA) For most people, the FDA considers this low-level exposure to pose little risk. (FDA)

What the research says

  • Amalgam is about half elemental mercury by weight. (FDA)
  • Several factors affect how much vapor amalgam fillings give off, including how many fillings a person has, how old they are, and habits such as grinding teeth or chewing gum. (FDA)
  • For most people, low levels of mercury vapor from fillings are not considered harmful, according to the FDA. (FDA)
  • In September 2020, the FDA recommended that certain high-risk groups avoid new amalgam fillings when possible, including pregnant women, nursing mothers, young children, people with certain neurological or kidney conditions, and people with a mercury allergy. (FDA)
  • The FDA does not recommend removing amalgam fillings in good condition unless there is a medical reason, as vapor release may be highest when a filling is placed or removed. (FDA)
  • The European Union banned dental amalgam as of January 1, 2025, though exceptions exist for certain medical needs. (European Commission)
  • In November 2025, Minamata Convention countries set a 2034 target to phase out dental amalgam worldwide, allowing exceptions for certain patient needs. (UN Environment Programme)

Where experts disagree

The American Dental Association says amalgam is a safe, durable, and affordable choice when a dentist and patient agree it fits the situation. (ADA) In July 2026, federal Medicaid guidance encouraged state Medicaid programs to restrict or stop covering amalgam, though this guidance is not binding. (ADA News) At the same time, the FDA continues to flag certain groups, such as pregnant women and young children, as needing extra caution around new amalgam placement. (FDA)

How we handle it at Natural Smiles

At Natural Smiles, Dr. Carlo Litano, DMD, is SMART certified through the IAOMT, and our team follows this protocol closely when removal makes sense. We use a nitrile dental dam, high-volume suction at the site, HEPA filtration with activated carbon, and supplemental oxygen for the patient. The filling is removed in sections, and the team wears full protective equipment throughout. When we replace an amalgam filling, we use a BPA-free ceramic composite that matches your tooth color and is bonded during the same appointment. Biocompatibility testing is available before treatment if you want to know how your body may respond to materials. A filling that looks intact is not pulled out as a matter of routine. We review your imaging and history together at a consult, then outline next steps and costs in writing before any work begins.

Sources

  1. FDA, Dental Amalgam Fillings
  2. FDA, Information for Patients About Dental Amalgam Fillings (2020)
  3. FDA, recommendations for high-risk groups (Sept. 24, 2020)
  4. European Commission, Mercury
  5. UN Environment Programme, Minamata Convention COP-6 (Nov. 2025)
  6. ADA, statement on dental amalgam (Feb. 2026)
  7. ADA News, CMS guidance on amalgam coverage (July 2026)
  8. IAOMT, Safe Removal of Amalgam Fillings (SMART)

Last updated October 1, 2026.