Safe Mercury Amalgam Filling Removal with SMART TECHNIQUE
Lots of our patients from Noosa, and Sunshine Coast area had amalgam fillings placed when they were young. Now they are aware of the potential health risks with them and want to get them removed. Did you know when you are drilling into amalgam fillings, you can actually release more mercury into your body?! That’s why we do it the SMART way! Ultimately, that’s why many of our patients choose to come to us to have their amalgam removed.
At Wattle Street dental, we are SMART certified by IAOMT ( The International Academy of Oral Medicine and Toxicology ). Come and talk to our holistic dentist about your options.
What is SMART technique you might ask, here is a little video to explain:
Know Your Dental Mercury Facts: Here’s Why…
Dental amalgam fillings, which are made with a mixture of mercury, silver, copper, tin, and sometimes zinc, are still used in the United States and a number of other countries. Often called “silver fillings,” all dental amalgams are 45-55% elemental mercury. Mercury is toxic, and this poison is recognised as a chemical of major concern because it poses a dangerous threat to public health. Mercury accumulates in the body, and any amount of mercury taken into the body should be considered hazardous.
The use of mercury in dental amalgam fillings poses serious risks to human health, and dental mercury released into the environment can cause long-lasting damage to wildlife. The IAOMT is dedicated to sharing dental mercury facts so that professionals and consumers can recognise the threats of amalgam fillings.
How to remove amalgam with SMART technique
At Wattle Street Dental, we are very concerned about excess exposure to mercury when amalgam fillings are removed. The process of drilling out amalgam fillings liberates quantities of mercury vapour and fine particulates that can be inhaled and absorbed through the lungs, and this is potentially harmful to patients, dentists, dental workers, and their foetuses.
The following guidelines are recommended from IAOMT
The IAOMT safe amalgam removal protocol recommendations were most recently updated on December 6, 2016. Also, on July 1, 2016, the IAOMT protocol recommendations were officially renamed as the Safe Mercury Amalgam Removal Technique (SMART), and a training course for IAOMT dentists to become certified in SMART was initiated.
All dental amalgam restorations, also commonly referred to as silver fillings, contain approximately 50% mercury, and reports and research are consistent that these fillings emit mercury vapours.
Scientific research demonstrates that dental mercury amalgam exposes dental professionals, dental staff, dental patients, and foetuses to releases of mercury vapour, mercury-containing particulate, and/or other forms of mercury contamination.
Furthermore, mercury vapour is known to be released from dental mercury amalgam fillings at higher rates during brushing, cleaning, clenching of teeth, chewing, etc. and mercury is also known to be released during the placement, replacement, and removal of dental mercury amalgam fillings. Essentially, an unsafe amalgam removal process releases mercury vapour and particles that can be harmful to the patient, the dentist, the dental staff, and the environment.
Utilising the most up-to-date science and research, the IAOMT has developed extensive safety recommendations for removal of existing dental mercury amalgam fillings, including detailed protective measures that are to be utilised for the procedure. The IAOMT’s innovative recommendations build upon traditional safe amalgam removal techniques such as the use of masks, water irrigation, and high volume suction by supplementing these conventional strategies with a number of additional protective measures, the need for which have only recently been identified in scientific research.
• An amalgam separator should be properly installed, utilised, and maintained to collect mercury amalgam waste so that it is not released into the effluent from the dental office.
• Each room where mercury fillings are removed should have adequate filtration in place, which requires a high-volume air filtration system (such as an at source oral aerosol vacuum) capable of removing mercury vapour and amalgam particles generated during the removal of one or more mercury fillings.
• If possible, windows should be opened to reduce the mercury concentration in the air.
• The patient should be given a slurry of charcoal, chlorella, or similar adsorbent 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 elude collection by suction devices.117It 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.
• Non-latex nitrile gloves should be utilised 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.
• 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.
• In order to protect the patient’s skin and clothing, a full body, impermeable barrier, as well as a full head/face/neck barrier under/around the dam, should be utilised.
• External air or oxygen delivered via a nasal mask for the patient also should be utilised to assure the patient does not inhale any mercury vapour or amalgam particulate during the procedure.132,133,134A nasal cannula is an acceptable alternative for this purpose as long as the patient’s nose is completely covered with an impermeable barrier.
• A dental dam that is made with non-latex nitrile material should be placed and properly sealed in the patient’s mouth.
• A saliva ejector should be placed under the dental dam to reduce mercury exposure to the patient.
• During amalgam filling removal, the dentist should utilise an at source oral aerosol vacuum in close proximity to the operating field (i.e., two to four inches from the patient’s mouth) to mitigate mercury exposure.
• High speed evacuation produces better capture when fitted with a Clean Up 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
It is important to note that as a safety precaution, the IAOMT does not recommend amalgam filling removal for women who are pregnant or breast-feeding and that the IAOMT does not recommend that dental personnel who are pregnant or breast-feeding conduct work that disrupts amalgam fillings (including their removal).
Know Your Alternative to Mercury Amalgam fillings
Alternatives to amalgam include composite resin, glass ionomer, porcelain, and gold, among other options. Most consumers choose direct composite fillings because the white colouring matches the tooth better and the cost is considered moderate.
For porcelain option, we also have the state of art technology that allow us to make ceramic fillings or crowns within a day with CEREC. You don’t need to wear the temporary crowns, and the crowns are being made while you wait reading a magazine or watching Netflix on TV.
Make An Appointment Now
Visit our Sunshine Coast dental clinic to make an appointment for a consult to remove your amalgam fillings today in the SMART and safe way. Call 07 54477669.