Amalgam has been the restorative method of choice for many years due to its low cost, ease of application, strength, durability, and bacteriostatic effects. Factors that have led to recent decline in use are a lingering concern about detrimental health effects, aesthetics, and environmental pollution. The aesthetic issue is due to the fact that the metallic color does not blend very well with the natural tooth color. This is especially a concern when used on front teeth, but it can be addressed using alternative dental materials. The environmental concerns are regarding mercury emissions during preparation and from waste amalgam upon cremation of deceased individuals.

Amalgam is an "excellent and versatile restorative material" and is used in dentistry for a number of reasons. It is inexpensive and relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity when compared to other direct restorative materials, such as, composite. However, this difference has decreased with continual development of composite resins.