The World Health Organization (WHO) released new guidelines in March 2026 calling for a global shift toward mercury-free dental restorative materials — accelerating the phase-down of dental amalgam under the Minamata Convention on Mercury. As of May 2026, Canadian dental practices should understand how these international commitments translate into domestic policy and what steps Health Canada expects from providers.
Dental amalgam has been a workhorse restorative material for more than 150 years, valued for its durability, ease of placement, and low cost. But the environmental and occupational health concerns associated with mercury have pushed the global dental community toward a tipping point. For Ontario dentists and practices across the Greater Toronto Area, the question is no longer whether amalgam will be phased out — but how quickly your practice needs to adapt.
What the WHO Guidelines Recommend
In March 2026, the WHO published guidelines calling for environmentally friendly, less invasive, and affordable oral health care. The recommendations were developed as part of the Global Environment Facility (GEF)-funded project on phasing down dental amalgam use globally. The core recommendations include:
- Prioritize prevention — fluoride varnish, pit-and-fissure sealants for children, and non-invasive management of early carious lesions
- Scale up mercury-free restorative materials — specifically glass ionomer cements (GICs) and resin-based composites as the primary alternatives to dental amalgam
- Invest in dental workforce training — ensure clinicians are proficient in adhesive and minimally invasive restorative techniques
- Strengthen environmental controls — proper waste management and amalgam separator use in dental facilities
The guidelines position these recommendations within the broader framework of the Minamata Convention on Mercury, which established a phased approach to reducing mercury use across all industries, including dentistry.
The Minamata Convention Timeline: Amalgam Phase-Out by 2034
The Minamata Convention on Mercury, ratified by Canada, set a global target to phase out mercury use — including dental amalgam — by 2034. This is not a voluntary aspiration. It is a legally binding international agreement, and signatory nations are expected to demonstrate measurable progress.
Canada has already implemented two of the measures required under the Convention: establishing national objectives for dental caries prevention and promoting best environmental practices in dental facilities to reduce mercury releases. However, the phase-down is expected to accelerate in the coming years, particularly as alternative materials continue to improve.
Where Canada Stands on Amalgam Use
Health Canada has historically maintained that dental amalgam is safe for use in most patients when handled properly, while acknowledging the environmental imperative to reduce mercury emissions. The latest Canadian Dental Association (CDA) Essentials publication references Health Canada's updated guidance on this topic, signalling increased institutional attention.
In practice, amalgam use has already declined significantly across Canadian dental offices. Most practitioners in Ontario and the GTA now use composite resin or glass ionomer as their default direct restorative material. However, amalgam remains in use for specific clinical situations — particularly in posterior teeth with subgingival margins, patients with high caries risk, or settings where moisture isolation is challenging.
Pro Tip: Audit your practice's current amalgam usage. If amalgam represents more than 5% of your direct restorations, develop a transition plan now. The practices that adapt early will face less operational disruption when stricter regulations arrive.
Mercury-Free Alternatives: What Works in 2026
The two primary mercury-free alternatives endorsed by the WHO are glass ionomer cements (GICs) and resin-based composites. Each has specific clinical advantages:
Resin-Based Composites
Modern composites offer excellent aesthetics, good mechanical properties, and versatile handling. The latest generation of bulk-fill composites has addressed many of the early concerns about polymerization shrinkage and depth of cure. For practices in Toronto, Mississauga, and across the GTA, composites are already the default material for most direct restorations.
Glass Ionomer Cements (GICs)
Glass ionomer cements release fluoride, bond chemically to tooth structure, and are less technique-sensitive than composites in moisture-compromised environments. High-viscosity GICs have improved significantly and are now viable for load-bearing posterior restorations in many clinical scenarios. The WHO specifically highlights GICs as the preferred option for underserved populations and pediatric patients.
Bioactive Materials
Emerging bioactive restorative materials that promote remineralization and integrate with tooth structure are gaining traction in the research literature. While not yet mainstream, these materials represent the next generation of mercury-free options that Canadian practices should monitor.
Environmental Compliance: Amalgam Separators and Waste Management
Ontario dental practices are already required to use amalgam separators to capture mercury-containing waste before it enters the municipal wastewater system. The Royal College of Dental Surgeons of Ontario (RCDSO) includes proper waste management as part of its infection prevention and control (IPAC) standards.
As the phase-down accelerates, expect increased scrutiny of dental facility waste management practices. Ensure your amalgam separator is ISO 11143 compliant, regularly maintained, and that disposal records are properly documented.
Pro Tip: Review your amalgam separator maintenance logs quarterly. Non-compliance with environmental regulations can result in fines from provincial environmental authorities, and RCDSO audits may include waste management as part of their review scope.
What Ontario Practices Should Do Now
Even though a full amalgam ban is not yet in place in Canada, proactive practices in the GTA and across Ontario should take the following steps:
- Review your restorative material inventory — identify how much amalgam you currently stock and use
- Invest in continuing education — ensure your clinical team is proficient in adhesive dentistry and bulk-fill composite techniques
- Update patient communication — patients increasingly ask about mercury in dental fillings, so prepare clear, evidence-based responses
- Verify environmental compliance — confirm your amalgam separator meets current standards and that waste disposal is documented
- Monitor regulatory updates — follow Health Canada, CDA, and Ontario Dental Association (ODA) communications for any changes to amalgam guidelines
The Bigger Picture: Prevention Over Restoration
Perhaps the most significant aspect of the WHO guidelines is the emphasis on prevention. The goal is not simply to replace amalgam with another material — it is to reduce the need for restorations altogether. This aligns with the direction Canadian public health policy has taken, including water fluoridation, school-based sealant programs, and the preventive care provisions within the CDCP.
For practice owners, this means that investing in preventive services — including patient education, fluoride application, and sealant programs — is both clinically responsible and strategically sound as the industry moves toward a mercury-free future.
Frequently Asked Questions
Q: When will dental amalgam be fully phased out in Canada?
The Minamata Convention on Mercury sets a global target to phase out mercury use, including dental amalgam, by 2034. Canada has ratified the Convention and is implementing a phased approach. While no Canadian province has banned amalgam outright, usage has declined significantly, and practices should prepare for increasingly restrictive guidelines in the coming years.
Q: Are mercury-free dental fillings as durable as amalgam?
Modern resin-based composites and high-viscosity glass ionomer cements have closed much of the durability gap with amalgam, particularly for small-to-moderate restorations. Bulk-fill composites now offer improved depth of cure and reduced polymerization shrinkage. For large posterior restorations under heavy occlusal load, indirect restorations such as onlays may be preferred over direct composite.
Q: What should I tell patients who ask about mercury in their existing fillings?
Health Canada maintains that existing amalgam restorations do not need to be removed solely due to mercury content. Replacement should be based on clinical indications — such as secondary caries, fracture, or marginal breakdown — not mercury concerns alone. Provide patients with factual information and refer to Health Canada and the CDA for evidence-based guidance.
EBIKO Dental will continue monitoring the mercury-free dentistry transition and its implications for Canadian practices. For the latest Canadian dental industry updates, visit ebiko.ca.