The SMART Protocol for Mercury Amalgam Removal

The SMART Protocol
for Mercury Amalgam Removal

Safe Mercury Amalgam Removal Technique

Is Mercury Safe in our Bodies?

At SHDC we consider two important questions regarding mercury amalgam fillings…

  1. Should we still be using the mercury material?
    Based on the research, the precautionary principle and the fact there are excellent alternatives, in our opinion, the answer is definitely no. With that in mind, we haven’t used mercury at SHDC for over 35 years.
  2. How can we remove these mercury fillings from the patient’s mouth with maximum safety?
    This is important for both the patient and the dental team.

Latest Scientific Research

The dental team at Sydney Holistic Dental Centre regularly reviews our protocols, to stay as up to date as possible.

The International Academy of Oral Medicine and Toxicology (iaomt.org) in the United States, have done a great deal of scientific research on the effects of mercury amalgams, both for patient welfare and also for dental professionals’ welfare – for the dentist and chairside assistants who are doing this procedure throughout our working day.

Ideally, materials used for dental restorations should not interfere with the body’s normal functions and should be conducive to good health

Health Risks of Mercury

The most commonly used dental material in the last 170 years is dental mercury amalgam, which contains one of the most toxic substances, mercury.

Dental amalgam contains 50% mercury, 20-35% silver, 6-15% copper, 8-15% tin and occasionally small amounts of zinc.

Temperature, corrosion and friction from chewing or clenching increases the rate of mercury released from amalgams. After chewing or increases in temperature from, say a warm drink e.g., coffee or tea, the levels of mercury vapour in the mouth are elevated for up to 90 minutes.

Smart amalgam removal

What is SMART?

SMART is the Safe Mercury Amalgam Removal Technique, which is a set of safety measures to reduce mercury exposures for both patient and the dental team during a dental amalgam filling removal. These safety measures were developed as a result of scientific research collected by the International Academy of Oral Medicine and Toxicology (IAOMT).

The SMART protocol is now regarded as the highest international standard and safest procedure for the safe removal of mercury amalgam. (If you are interested we have the references available.)

SMART Mercury Amalgam Removal at SHDC

These procedures are conducted with the utmost care, following the accredited SMART system. They include the following steps:

  • Draping of the patient so that aerosols do not settle on your clothes and hair.
  • Use of a rubber dam around the tooth with the amalgam to be removed. This sheet of rubber acts as a diaphragm and protect the patient’s airway and soft tissues of the mouth, ensuring no mercury debris can be swallowed or inhaled.
  • Use of a separate nose piece to ensure the patient can breathe purified, oxygenated air, avoiding any mercury vapour being inhaled through the patient’s nose.
  • Use of copious amounts of water and high-speed suction to dampen vapours and remove mercury waste.
  • Use of special tungsten carbide burs to remove mercury in chunks, rather than grinding the mercury away and creating more vapour.
  • Additional high strength suction with special filtration to remove mercury and to direct vapours away. *see below ‘the elephant in the room’
  • Charcoal mouth rinse is provided before and after the procedure to enhance detox from heavy metals.
  • The dental team use specific mercury vapour filtered masks.
  • The highest standard HEPA air filtration systems and negative-ion generators are used in each surgery room and waiting rooms to maintain a pure air environment. This is standard throughout our day whether doing mercury removal or not.

The New Elephant in the Room!

*A recent introduction at SHDC to support the SMART protocol is a new and specific suction tube and mercury filtration system, placed between the patient and the dentist. Because it’s such a large tube, we call it the ‘elephant in the room.’

Why does SMART matter?

All dental amalgams also referred to as silver fillings, contain 50% mercury (a neurotoxin) which is constantly released in the form of an invisible vapour. The process of drilling out amalgam fillings releases even higher quantities of mercury vapour and fine particulates that can be inhaled and absorbed through the lungs and skin. This is potentially harmful to patients and the dental team.

SHDC is SMART Certified

Our dental clinic has obtained SMART certification from the IAOMT based on thorough completion of coursework related to mercury and the safe removal of amalgam fillings.