Safe Mercury Amalgam Removal (SMART)

Although they’re called “silver” fillings, the amalgam used to create them is actually about 50% mercury, one of the most toxic natural elements on Earth. It is especially dangerous when inhaled as vapor.

Yet every person with amalgam fillings experiences such exposure every day.

Contrary to popular opinion, mercury does not stay fixed within an amalgam filling. Small amounts of vapor and particulate are released with every bite, swallow, and exposure to heat. At least some of that mercury vapor gets inhaled, and from the lungs, it’s a quick trip into the bloodstream, which can then carry it throughout the body.

While some mercury may be naturally excreted by the body, some will remain, bioaccumulating just as it does in fish. Mercury has a particular affinity for organs like the kidneys, liver, and brain, and is well-known for its neurotoxic effects in particular. Mercury exposure has been linked with numerous neurological and mental health disorders, not to mention autoimmune, cardiovascular, and gastrointestinal issues.

Because of this, special safety measures should be followed whenever these fillings need to be removed from the mouth – a process that naturally generates a great deal of vapor and particulate matter.

Here at Dental Wellness of Albany, we follow the Safe Mercury Amalgam Removal Technique (SMART), a science-based protocol developed by the International Academy of Oral Medicine & Toxicology to keep patients, dental workers, and our planet safe.

An accredited member of the IAOMT, Dr. Herzog is fully certified in the SMART protocol. Here’s what that protocol involves:

• Amalgam separators are properly installed and maintained to collect mercury waste, keeping it from being released into the environment via wastewater.
• High-volume air filters and aerosol vacuums are used in each room to remove mercury vapor and particulate that’s generated during the procedure.
• Unless the patient declines or there are contraindications, the patient is given a slurry of charcoal, chlorella, or a similar adsorbent to rinse with and swallow before the procedure.
• The patient is fully covered in protective gowns and drapes, including covering for the neck and head.
• The dentist and team members likewise wear protective gowns, along with non-latex, nitrile gloves, face shields, and head coverings. They also wear properly sealed, respiratory grade masks rated to capture mercury or positive pressure, properly sealed masks providing air/oxygen.
• To prevent nasal inhalation of mercury vapor or particulate, the patient wears a nasal mask or cannula through which oxygen is delivered.
• A non-latex, nitrile dental dam is placed and properly sealed in the patient’s mouth. A saliva ejector is placed under the dam to further reduce mercury exposure.
• An oral aerosol vacuum is placed close to the patient during the amalgam removal to capture mercury vapor and particulate.
• The amalgam is sectioned into chunks with a small diameter carbide drill and removed in the largest pieces possible.
• Great amounts of water are used to reduce heat. A conventional high-speed evacuation device is used to capture mercury discharges.
• Once removal is complete, the patient rinses their mouth thoroughly, first with water, then with a slurry of charcoal, chlorella, or a similar adsorbent.

You can view the scientific references for these procedures here.
https://iaomt.org/resources/safe-removal-amalgam-fillings/

While many may benefit from replacing old mercury fillings with biocompatible alternatives – per FDA guidelines, about two-thirds of the population should not have mercury placed in their mouths – for safety’s sake, we do NOT recommend amalgam removal for those who are pregnant or breastfeeding.

Ultimately, the choice of whether to keep or replace mercury amalgam fillings is yours to make on the basis of your own needs, beliefs, and values. We are happy to provide educational material on the matter so you can make the most informed decision possible.

Rest assured that if you decide to go mercury-free, we will be doing everything possible to safeguard your total health through limiting exposure to this potent neurotoxin.