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Pakistan Dental Association Advisory Note

Restricting the use of Dental Amalgam in Children under 15 years, and Pregnant Women


Dental Amalgam is a commonly used restorative material, which is comprised of approximately 50% mercury. Numerous data related to dental mercury toxicity are available, which suggest that children are most susceptible to its toxic effect. Mercury toxicity in children is likely to cause neurological, reproductive, and renal problems, which are long-term. These problems are most likely to adversely affect their health, education and well-being. In many countries, the use of dental amalgam has already been banned, restricted or discouraged for children below 15 years of age & women that are pregnant or breastfeed their infants.


Worldwide recognition of the serious impact of mercury pollution led to the Minamata Convention on Mercury, which was named after Minamata city in Japan, where major industrial release of mercury waste took place during 1930s to 1960s. The Convention was adopted in 2013, and has been agreed upon and signed by almost 130 countries ever since, including Pakistan. The aim of the Convention is to reduce the trade and supply of mercury by preventing its unnecessary use in products and manufacturing processes, with the overall objective of reducing environmental mercury pollution and the consequent risk to human health. The Minamata Convention on Mercury also requires that participating countries phase-down their use of dental amalgam. Subsequently, the European Commission Regulation on Mercury was adopted by Member States on 17 May 2017 to ratify and enforce the Minamata Convention. It was decided in the regulation that from 1st July 2018, Dental Amalgam shall not be used for dental treatment of Deciduous Teeth, of Children under 15 years, and of Pregnant or Breastfeeding Women, except when deemed strictly necessary by the Dental Practitioner based on the specific medical needs of the patient.