End use in children & pregnant women

Dentists providing mercury-free care to low-income children in Philippines

The Minamata Convention lists “promoting the use of cost-effective and clinically effective mercury-free alternatives for dental restoration” as a measure to phase down amalgam use.  It is especially important to promote mercury-free dental fillings for use in the populations most vulnerable to the neurotoxic effects of mercury: children and pregnant women.

Why is it effective?

Consistent with the precautionary principle, ending amalgam use in children and pregnant women starts to phase down amalgam use immediately. Some amalgam manufacturers warn that amalgam is “Not suitable for use in children and during pregnancy.”

As the WHO report Future Use of Materials for Dental Restoration says, “Alternative restorative materials of sufficient quality are available for use in the deciduous dentition of children.” After all, children are more likely to lose their milk teeth (also called deciduous teeth or baby teeth) before any dental restoration fails.

Where has it been effective? 

Many nations already have policies that discourage, restrict, or prohibit the use of amalgam in children, pregnant women, and other sensitive populations. For example:

  • Sweden: As Sweden’s KEMI explains, one of its most important phase-down measures was “to phase out use of amalgam in children and young people.” Amalgam use was prohibited in children and youth by 2009, in advance of the general phase out of amalgam use in Sweden.
  • Denmark: Denmark does not permit amalgam use in children’s milk teeth, among other restrictions.
  • Germany: In 1994, Germany required amalgam suppliers to amend their instructions to include a precaution against amalgam use in children and women of childbearing age. According to a report prepared for the European Commission, Germany now recommends “not to use dental amalgam on children, pregnant and nursing women, people with kidney problems, when in contact with other metals, such as braces, and in people with mercury sensitivity.”

How can it be implemented?

Nations can employ many strategies to end amalgam use in children and pregnant women, including:

  • Caution parents and pregnant women: Develop posters, distribute brochures, require consent forms, post notices on government websites, issue press releases, and collaborate with healthcare providers and civil society to caution parents and pregnant women against amalgam use.
  • Advise dentists: Send notifications to dentists, advising them against amalgam use in children and pregnant women.
  • Require labeling precautions: Require manufacturers to label their products with a precaution against the use of amalgam in children and pregnant women.
  • Prohibit in milk teeth: Prohibit the use of amalgam in children’s milk teeth.
  • Prohibit in government facilities: Prohibit the use of amalgam in children and pregnant women in government-run facilities and programs.
  • Set a phase-out date: Announce a date for phasing out amalgam use in children and pregnant women nationwide.