Trump Administration Pushes States Toward Mercury-Free Dentistry
A new federal initiative encourages state Medicaid programs to phase out coverage of dental amalgam, signaling a potential shift in restorative dentistry and reimbursement policy.
The Trump administration is encouraging states to transition away from mercury-containing dental amalgam restorations for Medicaid beneficiaries. In a recent notification, the Centers for Medicare & Medicaid Services urged every state Medicaid director to consider restricting or ending Medicaid coverage for dental amalgam procedure codes (D2140–D2161) or incentivizing the use of resin-based composite restorations instead. The guidance follows an earlier announcement that the Indian Health Service plans to eliminate the use of dental amalgam in its facilities by 2027.
According to the United States Department of Health and Human Services, the policy reflects concerns about mercury exposure among vulnerable populations, including pregnant women, young children, individuals with neurological disorders, and patients with impaired kidney function. The notification also cites the United States’ participation in the Minamata Convention on Mercury, whose parties committed in late 2025 to phase out dental amalgam by 2034.
The guidance does not ban amalgam or change clinical standards of care. Instead, it encourages states to evaluate Medicaid reimbursement policies and expand the use of mercury-free restorative materials. If states adopt the recommendations, practices that treat Medicaid patients may see changes in covered restorative procedures, material selection, reimbursement patterns, inventory management, and patient education. Click here to read more.
