Safe Mercury Amalgam Removal Technique



Be SMART

(Safe Mercury Amalgam Removal Technique)

Introduction

There are polarised opinions (both from patients and the profession) on amalgam fillings' long-term safety. The pro-amalgam groups state that amalgam is durable, easy to place, and safe as a filling material. The anti-amalgam groups are worried about the effects of mercury in dental amalgam on both the patient and the clinical team's biological systems. 

So who’s right?

The World Health Organisation (WHO) considers mercury one of the top ten chemicals or groups of chemicals of major public health concern; "mercury vapour can produce harmful effects on the nervous, digestive, and immune systems, lungs and kidneys, and may be fatal. The inorganic salts of mercury are corrosive to the skin, eyes and gastrointestinal tract, and may induce kidney toxicity if ingested". 

Although mercury's toxic effects are well known, there is little evidence that dental amalgam fillings cause generalised harm to human health. However, there are individuals with distinctive sensitivities, and the British Dental Association recognises that 3% of the population are estimated to suffer from sensitivity to one of the constituents of an amalgam filling, which can produce serious side effects in susceptible individuals. 

We at Dove Holistic Dental Centre acknowledge and are sympathetic to the 3% of patients that suffer from sensitivity to amalgam fillings, but we care for more than just our patients. 

Environmental Responsibility

Here at Dove Holistic Dental Centre, we believe we have to play our part as short-term custodians of the environment. It is part of our eco-friendly ethos and in line with the Minamata Convention; a global treaty aimed to protect human health and the environment from the adverse effects of mercury. We don't, therefore, place amalgam fillings in our patients as this will help protect our environment in the long term (as we will have fewer amalgam fillings to replace in the future). However, we still have to replace failing amalgam fillings and unfortunately, drilling out amalgam fillings poses a higher risk to those who are more susceptible to dental amalgam constituents' ill effects. That's why we at Dove Holistic Dental Centre have adopted SMART for the removal of mercury fillings.

SMART

SMART (Safe Mercury Amalgam Removal Technique) is a set of standard operating procedures used for the safe removal of amalgam fillings in susceptible individuals. It is a set of protocols created by the International Academy of Oral Medicine and Toxicology and are based on scientific evidence. When amalgam fillings are removed or adjusted with a high-speed dental drill, mercury vapour, and amalgam micro-particles are generated. The amount generated can exceed the pre-operative amount of mercury vapour that was present and can result in a mercury peek in the blood. These operating procedures minimise the risk of inhaling and ingesting mercury vapour and dental amalgam micro-particles by those patients who are at increased risk.

What is involved SMART (safe mercury amalgam removal)?

Below outlines the steps we take to keep you safe at a holistic dental practice centre offering holistic dentistry.

  • Personal Protective Equipment: for both you and us to provide a barrier. 

  • High volume air filtration system: this system removes mercury vapour and amalgam particles generated during the removal of amalgam fillings. 

  • A pre-op charcoal rinse and trap: to help bind any mercury that may escape through the rubber dam. 

  • Dental dam: a latex-free sheet is placed around teeth and adequately seals the mouth to prevent any amalgam particles from falling into the mouth. 

  • Oxygen supply: An external oxygen supply is delivered via a nasal mask to ensure mercury vapour isn't inhaled during the amalgam removal procedure. 

  • A saliva ejector is placed under the rubber dam.

  • High-speed suction: placed closed to the teeth to catch amalgam particles. 

  • Amalgam chunking: we section the amalgam fillings into chunks and remove large pieces as much as possible to reduce the vapourisation effects. 

  • A post-op charcoal rinse: to help bind any mercury that may have escaped through the rubber dam. 

 

If you have any questions or feel that you may benefit from the SMART protocol outlined above,  please email us at info@dhdc.co 

We would be happy to talk through the procedure.

 

 

Davinder Raju