Oral health care and the environment
Oral health is essential to public health — but it also plays a crucial role in protecting our environment. While providing vital care, oral health services can contribute to environmental impacts such as:
- mercury releases from dental amalgam
- plastic and packaging waste from self-care products and personal protective equipment
- energy use and carbon emissions
- release of chemicals, including Bisphenol A, micro- and nanoparticles from resin composites
Recognizing these challenges, global efforts are now underway to make oral health care more environmentally sustainable.
A global commitment to environmentally sustainable oral health systems
The Global Oral Health Action Plan 2023–2030 (GOHAP) (WHA76(9)) sets a global direction for integrating environmental sustainability into oral health systems. One of the global targets is for 90% of countries to implement measures to phase down or eliminate the use of dental amalgam by 2030, in alignment with the Minamata Convention on Mercury. The GOHAP also promotes the adoption of mercury-free alternatives, sustainable procurement, and environmentally sound waste management practices.
There is a growing interest among Member States and other stakeholders in addressing the environmental impact of oral health care. This is reflected in the Bangkok declaration on oral heath - No Health Without Oral Health, adopted during the WHO Global oral health meeting, calling for environmentally sound oral health care practices.
These include promoting the efficient use of natural resources, using safe and environmentally sustainable oral health supplies, consumables and care products, implementing sustainable waste management, reducing carbon emissions, and phasing down—or phasing out where feasible—the use of mercury-containing dental amalgam, in alignment with UN initiatives on climate change and planetary health.
Driving change for a healthier planet
Use of dental amalgam
Dental amalgam—a commonly used material for fillings—has played a significant role in restorative oral health care for decades. Comprising around 50% elemental mercury by weight, its use raises concerns related to both mercury exposure and pollution. Mercury is classified by WHO as one of the top ten chemicals of major public health concern. Mercury exposure can occur during the placement and removal of dental amalgam fillings, particularly for oral health professionals and patients when proper safety measures are not in place. Mercury releases into the environment can occur at multiple stages throughout the lifecycle of dental amalgam - from manufacturing to final disposal. Once released, mercury cannot be destroyed and can enter the environment through various pathways, polluting air (via emissions from dental clinics, crematoria and waste incineration), water (via wastewater discharges), and soil (via landfill leachate).
A global call for action
To mitigate these risks, the Minamata Convention on Mercury, a global environmental treaty that entered into force in 2017, calls for a phase-down of dental amalgam. This mandate outlined in Annex A, Part II, was subsequently amended during the fourth and fifth meetings of the Conference of the Parties.
WHO supports this effort through its global health mandate from Member States (WHA67.11 and WHA74.5) promoting:
- preventive oral health care
- mercury-free alternatives to dental amalgam, and
- environmentally sound management of dental waste
These efforts align with the GOHAP which sets a global target: by 2030, 90% of countries will have implemented measures to phase down the use of dental amalgam, as stipulated in the Minamata Convention, or will have phased it out.
Supporting countries in transition
To accelerate global progress, the Global Environment Facility (GEF) is funding a three-year project “Accelerate implementation of dental amalgam provisions and strengthen country capacities in the environmental sound management of associated wastes under the Minamata Convention” (GEF7 Phasing Down Dental Amalgam Project).
This project is implemented by the United Nations Environment Programme (UNEP) and executed by WHO with targeted technical assistance from the UNEP Global Mercury Partnership. Focused on real-world impact, this project provides technical assistance and supports implementation of the Minamata Convention in Senegal, Thailand and Uruguay. It is led by a multisectoral approach, with collaboration between the national Ministries of Health and Environment.
Related links:
Global Environment Facility project page
Minamata Convention on Mercury
Other mercury projects executed by WHO:
Elimination of mercury measuring devices in healthcare
Elimination of mercury-containing skin lightening products
Use of plastics in oral health care
Plastics are widely used in oral health care, from everyday personal items such as toothbrushes and toothpaste tubes to products used in clinical settings such as resin composites, personal protective equipment, products packaging and other single-use plastics. While these products play an important role in hygiene, infection control and treatment, they also contribute significantly to plastic waste and environmental pollution.
Many of these plastics are not recyclable and can persist in the environment for hundreds of years, breaking down into microplastics that may enter water systems, soil, and even the food chain. In clinical settings, the use of disposable plastic items has increased, especially during and after the COVID-19 pandemic, raising concerns about long-term sustainability.
The ongoing negotiations for the United Nations Global Plastic Treaty provide an opportunity to reconsider the materials used in oral health care practices. This includes exploring alternatives to single-use plastics, promoting responsible procurement, improving recycling systems, and encouraging innovation in sustainable materials and packaging.
Related links
Plastics and Health initiative
Integrating sustainability and climate resilience into oral health care
As the world faces escalating environmental challenges—from climate change to pollution and biodiversity loss—health systems must evolve to remain effective, inclusive, and sustainable.
Healthcare facilities, including those delivering oral health services, are on the front lines of both climate impacts and environmental responsibility. They must be equipped not only to withstand climate-related shocks but also to reduce their own environmental footprint.
This includes ensuring safe management of dental materials, minimizing emissions from equipment and infrastructure, and adopting sustainable practices in water use, waste disposal, and energy consumption.
Related links
Learn more about WHO's work
Publications
Tracking progress on the implementation of the Global oral health action plan 2023–2030: baseline report
The aim of this report is to provide a comprehensive baseline assessment on the global oral health targets to track implementation progress of the Global...
This document incorporates all key policy documents that inform and define the renewed global oral health agenda towards 2030: the resolution on oral health...
Global oral health status report: towards universal health coverage for oral health by 2030: regional...
This regional summary draws on WHO’s Global oral health status report, published in 2022, which provides a comprehensive overview of the global oral...
Prevention and treatment of dental caries with mercury-free products and minimal intervention
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Report of the informal global WHO consultation with policymakers in dental public health, 2021: monitoring...
Despite advances in modern dentistry, untreated dental caries in permanent teeth was reported as one the most prevalent conditions assessed in the 2019...
The Minamata Convention on Mercury is a global, legally binding treaty, which was adopted in 2013 and entered into force on 16 August 2017. The core...
This document provides an annotated bibliography of World Health Organization (WHO) key information resources relevant to the Minamata Convention on Mercury...
Resolution WHA67.11. Public health impacts of exposure to mercury and mercury compounds: the role of...
The Sixty-seventh World Health Assembly, adopted this Resolution to welcome the formal adoption of the Minamata Convention on Mercury and encourage Member...
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