Safe mercury filling removal follows the SMART protocol, a set of guidelines developed by the International Academy of Oral Medicine and Toxicology (IAOMT). The protocol is designed to minimize mercury vapor and particle exposure for both the patient and dental team throughout removal.
Why the Removal Process Itself Matters
Traditional amalgam fillings (https://www.fda.gov/medical-devices/dental-devices/dental-amalgam-fillings) contain roughly 50% mercury. Research shows that mercury vapor is released during normal use (chewing, brushing, clenching), as well as during removal, when the filling is disturbed and heated by a drill. Without proper precautions, this can mean a temporary but significant spike in exposure. That's exactly why the IAOMT developed a structured set of safety measures specifically for removing amalgam fillings.
Walking Through the SMART Protocol
At Total Wellness Dental, Dr. Hieu Do and our expert team follow the SMART protocol closely, meaning:
- Using rubber dam isolation to create a barrier between mercury particles and vapor from reaching the mouth or airway during the procedure.
- High-volume suction, positioned close to the tooth to immediately capture vapor and debris.
- An alternative air source, like a nasal mask, so you're comfortably breathing clean air throughout the treatment.
- Protective barriers, including gowns, gloves, and coverings for both patient and dental team.
- Sectioning the filling into larger pieces with a slow-speed drill and a steady spray of water, rather than grinding it into fine, easily inhaled particles.
- Thoroughly rinsing your mouth after removal to remove any remaining particles.
Together, these steps reduce mercury exposure well below what would occur with a standard, unprotected removal.
"My Filling Isn't Broken, Do I Still Need to Replace It?"
It’s a most common hesitation among patients. And a fair question.
While an intact amalgam filling isn't necessarily an emergency, it does release small amounts of mercury vapor over time, particularly during chewing and brushing. Though it’s not strictly necessary, many patients choose to preemptively replace still-functional amalgam fillings in favor of a biocompatible, metal-free alternative, rather than waiting until the filling fails on its own.
Dr. Hieu Do can evaluate your existing fillings and discuss whether replacement makes sense for your specific situation.
Safe Mercury Filling Removal in Houston, TX
If you're considering having old amalgam fillings replaced, Dr. Hieu Do and the experienced and knowledgeable Total Wellness Dental team are standing by to walk you through the SMART protocol in detail. Contact us today to schedule a consultation!