Safe Mercury Amalgam Removal Technique

In a previous article, we discussed five reasons why you should get your mercury amalgam fillings removed. We mentioned that our own Dr. Mandanas is trained in the safe removal of mercury amalgam. But what does that mean?

The Safe Mercury Amalgam Removal Technique or “SMART” was developed by the International Academy of Oral Medicine & Toxicology (IAOMT) as a set of scientific research-backed safety recommendations and protective measures for the removal of mercury amalgam silver fillings. It was built on traditional practices of safe removal combined with new conventions as scientific research continues to make new discoveries regarding mercury amalgam fillings. The technique protects both people and the environment from the harmful impact of mercury vapors and amalgam particulate. It is presented as a set of recommendations and not requirements, so it is up to the discretion of licensed practitioners to determine how they will use SMART in their practice. For this reason, it is important for you, the patient to be educated in SMART so that you can be an advocate for your own safety and the safety of those around you!

The Safe Mercury Amalgam Removal Technique (SMART)

The Safe Mercury Amalgam Removal Technique is fully outlined by the IAOMT but it can be summarized into ten steps. Be sure to view the IAOMT’s detailed outline for a complete understanding of the SMART process. Generally speaking, SMART involves the following requirements:

In order to prevent mercury amalgam from getting into the liquid waste of the dental office and releasing into the environment, the dentist should install an amalgam separator in their wastewater system.
The room where the mercury amalgam removal procedure occurs should have proper air filtration systems in place and any windows should be opened to remove the mercury vapor and amalgam particles released by the procedure.
Before the procedure, the patient should be given a mixture of charcoal (or a similar absorbent material) and water to rinse and swallow unless she declines or if she has a medical reason now to take it.
The patient, dentist, and dental personnel involved in the procedure should all be wearing protective gowns and covers to protect them from mercury amalgam particulate.
- The dentist and dental personnel should also be wearing non-latex nitrile gloves, face shields, hair/head coverings, and a proper mask.
- The patient should also be wearing a nasal mask, a non-latex nitrile dental dam, and a saliva ejector beneath the dental dam.
An oral aerosol vacuum should be used within two to four inches of the patient’s mouth.
Significant amounts of water and an evacuation device should be used to reduce heat and capture mercury discharges.
The mercury amalgam should be removed in as large of pieces as possible.
After the procedure, the patient’s mouth should be thoroughly flushed with water and rinsed a second time with the charcoal mixture.
The dentist and the dental personnel should comply with all federal, state, and local regulations for the proper cleaning and disposal of all mercury-affected clothes, covers, equipment, and surfaces.
Protective equipment should continue to be used during the maintenance of the suction system.

If you are interested in getting your mercury amalgam fillings safely removed, get in touch with Dr. Mandanas! As mentioned previously, Dr. Mandanas is fully trained in the SMART process and she will be an advocate with you for your safety. Dr. Mandanas is an integrative dentist who views the body as a whole and cares about the effects of dental materials, including mercury amalgam, on the rest of the body.