The World Health Organization (WHO) has released a new global guideline aimed at advancing environmentally sustainable and less invasive dental services for the prevention and management of dental caries.
The evidence-based recommendations are designed to help countries improve patient safety, enhance quality of care, and reduce environmental harm.
Dental caries remains the most common noncommunicable disease worldwide, affecting an estimated 2.7 billion people.
The condition often begins in early childhood and disproportionately impacts underserved communities. For decades, treatment has relied heavily on dental amalgam, a material that contains mercury and poses risks to both human health and the environment.
The new guideline supports the global phase-down of mercury use under the Minamata Convention on Mercury. It also aligns with broader oral health initiatives, including the World Health Organization’s Global Oral Health Action Plan 2023–2030 and the Bangkok Declaration.
“This guideline represents a landmark in global oral health,” said Dr. Benoit Varenne, WHO Dental Officer. “It provides strong evidence that safe, mercury-free, and less invasive interventions can effectively prevent and manage dental caries while protecting the environment.”
The recommendations contribute to the goal of achieving Universal Health Coverage for oral health by 2030. They emphasize prevention, non-invasive and minimally invasive care, and the replacement of mercury-containing amalgams with safer alternatives. WHO says these measures will also support the integration of oral health into primary health care systems and help countries meet international environmental commitments.
WHO Director a.i. Dévora Kestel said oral health policy must adapt to global sustainability goals.
“Oral health care must evolve to support planetary health,” Kestel said. “Promoting mercury-free products and less invasive procedures strengthens both environmental protection and access to essential oral health services.”
The guideline includes eight recommendations and two best practice statements. They are based on systematic reviews assessing clinical performance, toxicology, cost-effectiveness, and environmental impact.
Key measures include:
Population-wide prevention strategies, such as fluoride varnish programs and targeted dental sealants for high-risk children.
Non-invasive management of early and moderate lesions, including fluoride varnish and twice-yearly application of silver diamine fluoride.
Use of mercury-free restorative materials, such as glass ionomer cements and resin-based composites.
Safety protocols for handling resin materials and limiting bisphenol A (BPA) derivatives, particularly for vulnerable populations.
The guidance also outlines steps for governments, health ministries, professional associations, and frontline health workers. It encourages the integration of mercury-free and minimally invasive care into national policies, professional training, and community-based service delivery. Sustainable procurement and improved waste management are also highlighted as key strategies to reduce environmental impact.
WHO noted several research gaps, including the need for more long-term data on effectiveness, cost-efficiency, and environmental monitoring. The agency called for greater global collaboration to advance innovation in oral health care.
The guideline was developed under the WHO–UNEP Steering Committee and funded by the GEF7 Phasing Down Dental Amalgam project. Experts in oral health, public health, biomaterials, toxicology, and health systems contributed to the recommendations.
WHO will host a global webinar on March 19, 2026, from 13:00 to 14:30 CET to formally launch the guideline and present country experiences in implementing mercury-free dental care.