Medicaid should not cover dental amalgam, or fillings that contain mercury, the officials said.
Federal health officials on July 22 encouraged state Medicaid officials to stop covering dental fillings containing mercury.
The Centers for Medicare and Medicaid Services (CMS) sent letters to the Medicaid director in each state urging them to phase out mercury-containing dental fillings by restricting or ending state Medicaid coverage for dental amalgam, fillings that combine mercury and other materials to treat cavities.
“Americans should feel confident that the health care they receive is always working in their best interest,” CMS Administrator Dr. Mehmet Oz said in a statement.
“That’s why we’re urging state Medicaid programs to end the use of mercury-containing dental fillings. This is a straightforward and meaningful step that reflects our shared commitment to safe, higher quality care for all Americans and supports the Trump Administration’s broader goal to Make America Healthy Again.”
Health Secretary Robert F. Kennedy Jr. added: “Mercury has no place in the mouths of our children or in modern American health care. For decades, we have relied on a material that contains one of the world’s most toxic heavy metals when safe, effective mercury-free alternatives are widely available. The Make America Healthy Again agenda means confronting outdated practices that needlessly expose Americans to toxic substances.”
The letters to the state officials noted that the Indian Health Service, which provides healthcare to American Indians, announced in February that it would end the use of mercury-containing fillings by 2027, citing “health concerns regarding mercury exposure.”
Researchers have found signs that amalgam can cause health problems, including higher mercury concentrations in the blood, and patients attributing health problems to the amalgam.
The Minamata Convention on Mercury, signed by the United States in 2013, advises countries to restrict the use of amalgam and identify alternatives, and some countries have already phased out the fillings.
Certain groups such as the American Dental Association say amalgam fillings are safe.
The U.S. Food and Drug Administration says there is limited data on long-term health outcomes of amalgam in young children, and advises that populations such as children under 6 may face a greater health risk due to mercury exposure.
Alternatives to amalgam fillings include composite resin, porcelain, and glass ionomer.
The International Academy of Oral Medicine and Toxicology says that composite fillings are as durable as amalgam and are the most frequently chosen alternative because the white coloring matches the teeth well, and the cost is moderate.
