Indian Health Service to Phase Out Mercury Dental Fillings by 2027: What Patients Should Know

The bottom line: The Indian Health Service (IHS) says it will phase out the use of mercury-containing dental amalgam fillings in its facilities by 2027. Federal health officials continue to say amalgam is safe for most people, and most patients with existing “silver” fillings do not need to have them removed. But the change will affect what materials are routinely used in IHS and tribal clinics going forward.

What is dental amalgam?

Dental amalgam—often called a “silver filling”—has been used in the United States for more than a century. It is a mixture of metals that includes elemental mercury, along with silver, tin, and copper.

Mercury helps bind the other metals into a durable material that can withstand chewing forces, especially in back teeth. Because of its strength and relatively low cost, amalgam has been widely used in public health and community clinics.

At the same time, mercury is a known environmental toxin. That has led to long-standing public and scientific debate about its use in medical and dental settings.

What the Indian Health Service announced

In February 2026, the Indian Health Service announced it will phase out the use of dental amalgam in its facilities and services by 2027, according to IHS and reporting by Reuters. IHS provides health services to American Indian and Alaska Native people through federally operated and tribally run clinics nationwide.

The agency’s decision aligns with broader efforts to reduce mercury use in healthcare and the environment. IHS has not described the move as an emergency action, but as a planned transition over time.

For patients who receive care in IHS or tribal clinics, this means that non-mercury alternatives are expected to become the standard for new fillings by 2027.

What the FDA says about safety

The U.S. Food and Drug Administration (FDA) states that dental amalgam is safe for most people. However, in a 2020 safety communication that remains in effect, the agency advised that certain groups may be more sensitive to mercury exposure and may want to consider alternative materials when possible.

According to the FDA, higher-risk groups include:

Pregnant people and those planning pregnancy
Women who are breastfeeding
Children, especially under age 6
People with pre-existing neurological conditions
People with impaired kidney function
People with known mercury allergy or sensitivity

Importantly, the FDA does not recommend removing existing amalgam fillings solely to reduce mercury exposure if the fillings are intact and there is no dental problem. Removal can temporarily increase mercury exposure and may weaken a tooth if not clinically necessary.

Do you need to replace your current silver fillings?

For most people, the answer is no.

If your amalgam fillings are in good condition and you have no symptoms, federal guidance does not recommend routine removal. Dentists generally replace fillings when there is decay, fracture, leakage, or another clinical reason.

If you are pregnant, planning pregnancy, or have one of the higher-risk conditions listed by the FDA, you may want to discuss material options with your dentist before getting a new filling. But that is a conversation—not an automatic need for removal.

What materials will replace amalgam?

The most common alternatives include:

Composite resin (tooth-colored fillings): These bond directly to the tooth and match natural color. They are widely used today but can be more sensitive to moisture during placement.
Glass ionomer materials: Often used in certain situations, including in children. They release fluoride but may not be as durable in large chewing surfaces.

The American Dental Association notes that both amalgam and composite materials are considered safe and effective. Each has advantages and trade-offs involving durability, appearance, cost, and technique sensitivity.

In recent years, many private dental practices have already shifted toward composites for aesthetic reasons and patient preference. The IHS transition may formalize that shift within federally supported clinics.

Why mercury reduction is a public health goal

Mercury can affect the nervous system at high levels of exposure. The Environmental Protection Agency (EPA) describes mercury as a persistent environmental contaminant that can accumulate in ecosystems and enter the food chain.

Reducing mercury use in products—including medical and dental materials—is part of broader U.S. and global efforts to limit environmental contamination. Dental offices are already required to use amalgam separators to reduce mercury waste entering wastewater systems.

The IHS phase-out fits within that larger environmental health context.

What this means for tribal communities

IHS and tribal clinics provide dental care to millions of American Indian and Alaska Native people, often in rural or underserved areas.

A transition away from amalgam may involve:

Training and workflow adjustments for dental teams
Supply chain planning for alternative materials
Potential differences in material costs

As of now, IHS has indicated a timeline through 2027 but has not publicly detailed how costs or reimbursement policies might change. Many IHS facilities operate under federal funding structures that differ from private insurance models.

For patients, the most noticeable change may simply be that new fillings are tooth-colored rather than silver.

What remains uncertain

Several practical questions will become clearer as the 2027 deadline approaches:

How quickly individual clinics will complete the transition
Whether there will be any short-term supply or training challenges
How material costs compare within federally funded systems over time

There is no indication from federal agencies that the phase-out reflects new evidence that amalgam is unsafe for the general population. Rather, it appears to align with precautionary guidance for higher-risk groups and broader mercury-reduction goals.

The takeaway for patients and families

If you have existing silver fillings, you likely do not need to take action.

If you receive care through an Indian Health Service or tribal clinic, expect non-mercury fillings to become standard by 2027.

If you are pregnant, caring for a young child, or have certain medical conditions, it is reasonable to ask your dentist about filling material options.

As always, the most important step for oral health is preventing cavities in the first place: brushing with fluoride toothpaste, flossing, limiting sugary drinks and snacks, and keeping up with regular dental visits. Policy changes matter—but daily prevention still does most of the work.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.