Dental Amalgam from the Past to the Present: Utilization among Ministry of Health Dental Clinics in the Makkah Region of the Kingdom of Saudi Arabia

Background: Amalgam fillings were invented and introduced to dentistry in France and England during the 1800s. It has since become one of the most reliable dental filling materials to treat dental caries. Dental amalgam contains approximately 50% elemental mercury, a source of occupational exposure among dental personnel and non-occupational exposure among patients. Objective: This study describes the use of dental amalgam in Makkah region dental clinics as a direct restorative material compared to composite and glass ionomer cement. Methods: This longitudinal retrospective study included 335 dental clinics in Makkah and Jeddah, the two largest cities in the Makkah region, Kingdom of Saudi Arabia. Annual statistical data were obtained from the Directorate of Dentistry, Makkah and Jeddah Health Affairs, Ministry of Health. Data related to the restorative materials used (composite, glass ionomer cement (GIC), and amalgam) were counted for 11 years starting from 2009 to 2019 for Makkah city, and the restorative materials used (composite, GIC, and amalgam) from 2018 to the first quarter of 2021 for Jeddah city. Results: There was a slight increase in the number of amalgam restorations in Makkah from 2009 (37.15%) to 2011 (43.52%), followed by a gradual decrease until 2019 (1.39%). In Jeddah, there was a slight increase in amalgam restorations from 2018 (9.39%) to 2019 (11.03%). However, the use of amalgam restorations reduced sharply in 2020 (3.27%) and in the first quarter of 2021 (3.53%). Conclusion: There is a recognizable decreased trend in amalgam utilization in the Makkah region. Amalgam use is being phased down despite the lack of official regulation on its use.