Safe Mercury filling Removal procedure

Safe Mercury Amalgam Removal Technique (SMART)

Safe Mercury Amalgam Removal Technique (SMART)

Treatment conducted by dentist Dr Anita Shukla, whom was SMART certified 7th July 2017 by The International Academy of Oral Medicine & Toxicology

The protocol as recommended by IAOMT:

Recommendation to take activated charcoal 1 hour before appointment (Body Fodder)
Open windows for ventilation
Protective gown, head cover and safety glasses worn by patient and dentist
Nose covered with nasal mask
Alternative medical air supplied through mask
Powerful suction and air filtration system is positioned near mouth, which removes 99.9% of any mercury released: IQAir Dental mercury flex vac
Tungsten carbide bur used to reduce aerosol spray from drilling
Tooth is isolated with a Clean up tip, which is boxed around the tooth and connected directly to the dental suction, so the majority of amalgam is aspirated and less is scattered across the mouth
Amalgam filling cut into large chunks until drops out of tooth, therefore reducing amalgam aerosol
Mouth rinsed with water
100% protection from mercury vapour not guaranteed: to help remove residual mercury from the body take 3 teaspoon chlorella (green algae supplement from Body Fodder) day before, day of, then day after amalgam removal

Contra-indications: Pregnancy or breast-feeding

Risks: Replacement of deep fillings close to nerve, may result in nerve pulp damage, consequently the tooth would then need root canal treatment or extraction. Teeth with large amalgam fillings are at risk of fracture

Local Anaesthetic: Scandonest – this is adrenaline-free, preservative free and latex free

Replacement Material

Venus Pearl composite, which is Bis-GMA free and BPA free and the bond used is HEMA-free. It is aesthetic and hard wearing.

Riva resin-modified glass ionomer cement will be used for teeth with poor prognosis or where moisture control is difficult, for cavities that are very deep or finish under the gum line.

Gold and ceramic inlays/inlays/crowns are more biocompatible, but these involve lab work, thus are more expensive.

Gold composition: 60% gold, 27% silver, 10% copper, 4% palladium

Ceramic options:

1. Zirconia (zirconium dioxide) stronger

2. Emax (lithium disilicate) more aesthetic