Dental Amalgam, Mercury Exposure, and Best Management Practices: A Comprehensive Review

Abstract

Dental amalgam has been used for more than a century as a cost-effective, durable restorative material, yet it remains controversial due to its mercury content and its potential impact on occupational health and the environment. Mercury is a well-recognized neurotoxin, and dental personnel are particularly susceptible to chronic exposure during amalgam manipulation, removal, and inadequate waste disposal. In the environment, inorganic mercury released from dental settings may convert into methylmercury, a highly toxic compound that bioaccumulates in aquatic ecosystems and poses serious public health risks. Studies in India highlight significant gaps in awareness and adherence to mercury hygiene protocols, with improper disposal practices, lack of protective measures, and absence of regulatory compliance frequently reported. Globally, the Minamata Convention on Mercury has catalyzed efforts to reduce or eliminate amalgam use, with several countries instituting complete bans or major phase-down strategies. This review consolidates current evidence, discusses environmental and occupational hazards of mercury exposure, examines international and national policy directions, and outlines best management practices for safer amalgam handling and disposal. Strengthening institutional protocols, professional training, and adherence to environmental guidelines is essential for ensuring safe and sustainable dental practice.