Dental amalgam has been used as a restorative material in dentistry for the past 150 years. This material has been used to restore posterior teeth throughout the world and is also used in South Africa. Dental amalgam has been the material of choice for patients presenting with large tooth decay areas, including the loss of cuspal areas. The reason for this is that dental amalgam was always considered strong and durable. Compared to alternate dental materials, this material could also withstand the significant forces associated with chewing and biting. Dental amalgam is also considered more cost-effective than alternate dental materials such as conventional glass ionomers, resin-modified glass ionomers, resin composite and ceramic restorations, making it more feasible and material of choice in lower economic countries, including South Africa.