Regional pressure builds for a mercury-free shift in dentistry
Dental amalgam is moving toward the exit in the WHO South-East Asia Region, and the Bangkok workshop made clear that the transition is no longer a theoretical policy exercise. Representatives from governments, WHO, UNEP, the Minamata Convention Secretariat, academia and professional organizations met on 13-14 July 2026 to review progress and coordinate the next stage of the phase-out of dental amalgam. The timing is significant because the global target for phasing out amalgam is set for 2034, leaving a narrow runway for countries that still rely on mercury-containing restorations in routine oral health care.
The meeting centered on implementation rather than aspiration. Participants examined national experiences, policy barriers, financing constraints and workforce readiness, with Thailand’s work under the GEF-7 Phasing Down Dental Amalgam Project serving as a practical reference point for the region. That framing matters because dental materials policy is not shaped only by clinical preference; it is also determined by procurement systems, waste management capacity, reimbursement rules and the availability of substitutes that dentists can use at scale.
Mercury-free dentistry is increasingly tied to environmental health as much as oral care. As countries reduce amalgam use, they also reduce mercury exposure across the supply chain, from clinic placement and removal to handling of waste and disposal. In clinical terms, the shift changes how restorative dentistry is delivered. In public health terms, it changes how whole systems manage a persistent toxic metal.
Thailand’s experience offers a working template for the region
Thailand’s experience under the GEF-7 initiative provided the workshop with a concrete example of what a national transition can look like when policy, training and monitoring move together. The report documents lessons, challenges and promising practices from across the South-East Asia Region, and the choice to foreground implementation suggests a simple truth: a phase-out succeeds only when alternative materials, professional confidence and regulatory alignment are available at the same time.
The workshop also exposed the unevenness of preparedness across countries. Some systems are further along in strengthening policies and regulations, while others still need to expand access to affordable alternatives and build a stronger clinical workforce capable of delivering mercury-free oral health care. A dentist cannot abandon amalgam in daily practice if composite resins, glass ionomers and other alternatives remain too costly, too limited in distribution or too difficult to place reliably in busy public clinics.
One sentence captures the clinical stakes plainly: the phase-out will fail where the substitute materials are inaccessible.
Policy, workforce and waste systems will determine the pace
Priority actions identified in the report are practical and interdependent. Countries need stronger policies and regulations to support the transition, but those rules will only work if procurement systems can secure affordable alternatives and if oral health teams are trained to use them competently. The workshop also pointed to the need for improved monitoring systems, a reminder that regulatory language without surveillance often produces weak compliance and poor feedback on implementation.
Waste management received similar attention because mercury does not disappear once a filling is removed or replaced. Environmentally sound management of mercury waste is essential to prevent contamination in clinics, transport chains and disposal pathways. For low- and middle-income settings, this creates a technical challenge that extends well beyond dentistry itself. It requires coordination between health ministries, environmental authorities, professional bodies and laboratory or waste-handling services.
The report’s emphasis on workforce capacity reflects a second reality: materials science is only one part of dental care. If clinicians are not trained in the placement, longevity expectations and case selection for alternatives, the transition can stall at chairside. In that sense, the workshop treated oral health reform as a systems problem, not just a product substitution exercise.
National action plans will decide whether the regional target is reachable
A major theme of the meeting was regional cooperation. Countries were encouraged to develop and implement national action plans, and the workshop identified opportunities for collaboration that could help accelerate progress toward the global phase-out target by 2034. Shared technical guidance, cross-country learning and coordinated policy development are all likely to matter because the region contains diverse health systems with different levels of financing, regulation and dental infrastructure.
Regional collaboration also reduces duplication. When one country has already tested a procurement model, regulatory pathway or training approach, others can adapt rather than start from zero. That is especially important in a field where small implementation gaps can slow adoption for years. Dentistry tends to change by habit as much as by evidence, and long-standing use of amalgam in public systems gives the material a level of inertia that policy statements alone cannot overcome.
The workshop report positions the Minamata Convention on Mercury as the legal and diplomatic backbone for this transition. The convention’s logic is clear: reducing mercury in health care protects both people and the environment. In oral health practice, the phase-out calls for a different balance of cost, durability, esthetics and environmental responsibility. The region now has to decide how quickly that balance can shift in everyday care delivery.
The unresolved challenge is implementation at scale
The report leaves no doubt about the direction of travel, but it also shows where the hardest work remains. Governments must align policies, financing, training and waste systems at the same time, and they must do so while maintaining access to affordable restorative care. For many countries, the practical question is not whether to move away from amalgam, but how to do it without widening inequities in oral health access.
Bangkok provided the setting for a regional agreement in principle. The pace of actual change will depend on whether national plans can translate workshop consensus into procurement rules, clinic-level practice and environmental safeguards that hold up outside the meeting room. The 2034 target is fixed; the capacity to meet it is still being built.