A SMART idea: The ins and outs of the Safe Mercury Amalgam Removal Technique for “silver” fillings
At Modern Smile Dental, we combine the best of both worlds. We practice general dentistry, which focuses on providing complete care and services to prevent, diagnose, and treat conditions of the teeth, gums, and mouth. We also practice holistic dentistry, which accounts for the mouth’s health and the “rest of you.” One of the holistic dental care tenets is using biocompatible materials that exist in harmony with biological tissues. So, they support safety. For this reason, holistic dentists largely do not use mercury-containing “silver” fillings. Also, we try to stay away from using any other type of metal in the mouth, including metal crowns, implants, etc. Our Gaithersburg, Maryland, team also practices the safe removal of mercury fillings.
Why is it not enough to choose a ” mercury-free ” dentist?
For us, status as a mercury-free practice is a very good start. These practices do not place silver-colored fillings made from an amalgam of metals, including mercury. We have also invested in the garments, products, equipment, and many years of training to learn different aspects of biological dentistry. This knowledge spans heavy metal toxicities, their health consequences, and training to remove amalgam fillings safely.
Why does it matter how these fillings are removed?
During the traditional process of drilling out amalgam or mercury fillings, heat is generated, and particles may be produced that enter the broader environment. The tiny particulate matter and vapors produced as the filling is heated and removed can pose threats to you as a patient, our staff, and the planet. In turn, we follow the guidelines established by the International Academy of Oral Medicine & Toxicology in their SMART protocol.
What does SMART stand for?
SMART is the acronym for “Safe Mercury Amalgam Removal Technique.” It consists of 19 different components or precautionary measures. These include the addition of special protective garments, air filtration systems, and evacuation devices to protect against, capture, and safely dispose of contaminated materials. By minimizing the risk of mercury exposure during the removal and replacement of these fillings, we are doing our part to ensure the safety of our patients, team, and the broader community and environment (as improper disposal of mercury can threaten our waterways, too).
Why may I need to replace my fillings in the first place?
Modern Smile Dental appreciates that this is a personal decision. We are here to empower you with credible information. So you can make decisions that are in your best interests. Fillings, in general, do not have an “eternal shelf life.” There may come a day when they are simply worn, and this situation can threaten the surrounding natural teeth. An old or worn filling may allow harmful bacteria to enter, making the tooth vulnerable to more extensive damage. You may wish to replace that old filing with a metal-free one that blends better with your smile. Our composite and ceramic fillings can be perfectly color-matched to natural teeth and tooth structure. Our team in Gaithersburg, Maryland, is happy to provide you with a brochure for more information on the links between mercury amalgams and health effects. So you can make a well-educated decision.
In the meantime, contact our office today at (301) 850-0376. We look forward to “wowing” you with dentistry that defies the conventional.
Mercury removal video by the International Academy of Oral Medicine & Toxicology
I am Dr. Griffin Cole of the International Academy of Oral Medicine and Toxicology. Patients and dentists should make sure that each step of the safe Mercury amalgam removal technique or smart will applied during a dental appointment for filling removal. The first step is for patients to consult with their dentist before the mercury filling removal begins so that both the patient and dentist agree that all safety measures will be in place. This helps to ensure that the patient and dentist know exactly what to expect. It’s also helpful to watch the following example of the safe mercury amalgam removal technique or smart being applied. Each room where mercury fillings are removed should have adequate filtration in place, which requires a high-volume air filtration system capable of removing mercury vapor and amalgam particles generated during the removal of one or more mercury fillings. If possible, windows should be open to reduce the mercury concentration in the air. The patient should be given a slurry of charcoal chlorella or similar absorbent to rinse and swallow before the procedure unless the patient declines or there are other contraindications. Making this clinically inappropriate protective gowns and covers for the dentist, dental personnel, and the patient should be in place. All present in the room should be protected because substantial quantities of particles generated during the procedure will allude collection by suction devices. It has been demonstrated that these particles can be spread from the patient’s mouth to the patient’s knee and to the chest, shoulder, and neck of the dentist and dental assistant. Either a properly sealed respiratory grade mask, rated to capture mercury or a positive pressure. Properly sealed mask providing air or oxygen should be worn by the dentist and all dental personnel in the room. Non latex nitro gloves should be utilized by the dentist and all dental personnel in the room. Face shields and hair head coverings are to be utilized by the dentist and all dental personnel in the room in order to protect the patient’s skin and clothing. A full body impermeable barrier should be utilized external air or oxygen delivered via a nasal mask for the patient. Also should be utilized to assure the patient does not inhale any mercury vapor or amalgam particulate during the procedure. A nasal cannula is an acceptable alternative for this purpose as long as the patient’s nose is completely covered with an impermeable barrier. A saliva ejector should be placed under the dental dam to reduce mercury exposure to the patient. A dental dam that is made with non latex nitro material should be placed and properly sealed in the patient’s mouth, as well as a full head, face and neck barrier that is under and around the dam. During amalgam filling removal. The dentist should utilize high volume air filtration system in close proximity to the operating field that is two to four inches from the patient’s mouth to mitigate mercury exposure. High speed evacuation produces better capture when fitted with a cleanup device, which is preferred copious amounts of water to reduce heat and a conventional high speed evacuation device to capture mercury discharges should be used to reduce ambient mercury levels. The amalgam should be sectioned into chunks and removed in as large of pieces as possible using a small diameter carbide drill. Once the removal process is complete, the patient’s mouth should be thoroughly flushed with water and then rinsed out with a slurry of charcoal chlorella or similar absorbent during the opening and maintenance of suction traps and operatories or on the main suction unit. Dental staff should utilize the appropriate personal protection equipment described earlier. An amalgam separator should be properly installed, utilized, and maintained to collect mercury amalgam waste so that it is not released into the affluent from a dental office. Dentists must comply with federal, state, and local regulations addressing the proper handling, cleaning, and or disposal of mercury contaminated components, clothing, equipment, surfaces of the room, and flooring in the dental office. I hope that you’ll make the smart choice about your dental care by asking for safety measures during your mercury filling removal. For more information about the safe mercury amalgam removal technique or smart, including scientific research about why these safety measures are important, visit the smart choice.com from the International Academy of Oral Medicine and Toxicology.
