Safe Amalgam Removal
When dentally necessary or for cosmetic concerns, we offer the safe removal of silver amalgam fillings and biocompatible replacement fillings. Because mercury is so toxic to life, strict safety procedures must be followed to protect your health, as well as that of our team, and our environment. Dr. Shields has advanced training in the safe removal of mercury amalgam fillings and is SMART-certified through the International Academy of Oral Medicine and Toxicology. If you’re immune compromised, she is happy to work with your healthcare providers in facilitating your care.
Safe Mercury Amalgam Removal Technique (SMART)
- We have an amalgam separator installed and maintain it properly. This device keeps amalgam waste from entering the wastewater and polluting the environment.
- High-volume air filters are in our operatories to remove mercury vapor and particles cast into the air during amalgam removal.
- The patient is given a slurry of charcoal or chlorella to rinse and swallow before the procedure to protect against any mercury that may enter the circulation during the procedure.
- The dental team wears protective gowns and head-coverings, as well as non-latex, nitrile gloves and properly sealed respiratory-grade masks rated to capture mercury.
- The patient is provided full body and head covering, as well as a head, face, or mask barrier. They are also given air or oxygen through a nasal mask to prevent mercury vapor and amalgam particulate from being inhaled.
- An Isolyte mouthpiece is placed to prevent amalgam from entering the throat. (Dr. Shields finds this mouthpiece protects better than the traditional rubber dam.)
- An at-source oral aerosol vacuum is placed 2 to 4 inches from the patient’s mouth to further minimize mercury exposure.
- The amalgam is sectioned into chunks with a small-diameter carbide drill and removed in the largest pieces possible.
- Copious amounts of water are used during cutting to reduce heat, and a high-speed evacuation device is used to capture mercury discharges.
- After removal, the patient’s mouth is thoroughly flushed with water, then rinsed with a charcoal or chlorella slurry.
- The dental team safely disposes of all mercury-contaminated components and clean all instruments and equipment, as well as the operatory as a whole, according to federal, state, and local regulations on the handling of mercury.
For more on this protocol, including scientific references supporting these safety measures, visit the IAOMT’s website.