With amalgam set to be banned globally from 2034, Kev Patel considers the potential impact on UK dentistry – is outlawing amalgam financially viable for practices and what are the benefits for patients?
While Europe moved to ban the use of dental amalgam from January 2025, millions of UK patients continue to receive the metal-based fillings as part of routine NHS dental care – raising renewed concerns about patient health, outdated policy and chronic underfunding in dentistry.
With a global phase-out date set for 2034, how will banning amalgam affect UK practices and patients, for better or worse?
Dental amalgam, commonly known as ‘silver filling’, contains approximately 50% mercury, a neurotoxic substance that has long been the subject of global health debate.
The European Union’s decision to phase out amalgam follows recommendations under the Minamata Convention on Mercury, citing environmental impact and potential health risks, particularly for vulnerable groups. Yet in the UK, amalgam remains widely used.
Why is amalgam still used in the NHS?
According to NHS data, amalgam still accounts for nearly 40% of all fillings placed in NHS dental treatments, largely because it is faster to place and significantly cheaper than composite alternatives.
A standard amalgam filling can cost the NHS up to 60% less than a tooth-coloured composite, while also requiring less chair time a critical factor in an overstretched system.
Kev Patel, CEO and founder of Bond Dental which operates NHS practices in London, says the issue is not a lack of clinical awareness, but a lack of viable alternatives within the NHS funding model.
‘From 1 January 2025, the EU moved to restrict routine use of mercury-containing dental amalgam, with exceptions only where a dentist considers it strictly necessary for a patient’s specific medical needs,’ says Dr Patel. ‘In the UK, it’s still legal and still used in some NHS settings, which is why this has become a UK consumer issue.’
What are the drivers behind the amalgam ban?
The health concerns associated with amalgam fillings include mercury vapour exposure, which can be released during placement, removal, and over time through wear. While UK regulators maintain that amalgam is safe at current exposure levels, multiple studies have highlighted potential links to neurological, renal, and immune system effects – particularly in pregnant women and children. As a result, amalgam use has already been restricted in the UK for these groups since 2018, mirroring earlier EU guidance.
Environmental impact is another major driver behind Europe’s ban. Dental amalgam is estimated to be responsible for up to one-third of mercury emissions into wastewater systems in some countries, contributing to long-term ecological contamination. Dr Patel argues that the continued reliance on amalgam is a visible symptom of a much deeper structural problem.
‘The bigger issue is the business model. If NHS fees don’t cover the real cost of providing care, practices end up effectively subsidising NHS work. Over time that pushes dentists to reduce their NHS commitment or step away, because you can’t run a practice at a loss.’
Would a ban negatively impact UK practices?
Dr Patel explained that the pressures facing NHS dentistry directly shape what treatments practices can realistically offer.
‘This affects what practices provide because NHS dentistry is under intense strain. When you’ve got high demand, limited appointment time, and a payment system that’s widely criticised as not fit for purpose, practice owners have to make choices that keep the service running day to day.’
For patients in England, a filling is classified as an NHS Band 2 treatment, with the Band 2 patient charge at £75.30 as of 1 April 2025.
‘That charge is the same whether the filling is amalgam or tooth-coloured,’ Dr Patel notes. ‘However, tooth-coloured fillings are much more time-consuming and technique-sensitive than amalgam. When one option takes longer but funding doesn’t reflect the extra time, practices have less capacity overall – and patients feel that as fewer available appointments.’
