SINGAPORE, Feb 7 — Singapore dentists will scale back the use of mercury in tooth fillings but continue to rely on amalgam in selected cases, even as the World Health Organisation pushes for a global phase‑out by 2034.

The Straits Times reported that the WHO lists mercury as one of the top 10 chemicals of major public health concern and has called for an end to mercury‑based dental amalgams worldwide.

“Amalgam is (used) to restore large, load‑bearing back teeth, where durability and longevity are prioritised over aesthetics,” said Dr Alethea Foong, prosthodontics consultant at the National Dental Centre Singapore.

She added that amalgam is also preferred when moisture control is difficult, in patients with high caries risk or poor oral hygiene, and when cost‑effectiveness and reduced chair time are important.

The Singapore Dental Association (SDA) said the local dental community is aligned with the global direction but is reducing amalgam use while ensuring patients continue to receive safe and appropriate care.

Resin‑based composites are the most widely used alternative, but Dr Foong noted they carry a higher risk of restoration failure and secondary caries compared with amalgam.

She said composites require strict moisture control and have higher technique sensitivity.

A spokesman for the Faculty of Dentistry at the National University of Singapore (NUS) said existing amalgam fillings are stable and durable when maintained, though there is no local data on how many people have them.

He explained that amalgams emit small amounts of mercury vapour through evaporation and mechanical wear caused by chewing, tooth brushing and hot food or drinks, but exposure levels remain low.

The SDA also confirmed small amounts of mercury vapour may be released during placement, polishing or removal of amalgam fillings, consistent with international reviews.

Dr Foong said, “It is estimated that daily mercury vapour exposure from amalgam fillings is about 0.2 to 0.4 microgrammes a day per amalgam‑filled tooth surface, or 0.5 to 1 microgramme a day per amalgam‑filled tooth.”

She noted large trials found no significant differences in neuropsychological function, IQ or kidney outcomes between individuals with amalgam and those with composite restorations.

She added that exposure levels remain well below occupational thresholds associated with clinical toxicity.