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Safe Guidelines for Removing Mercury Amalgam/Silver Fillings

Our Occupationally Mercury Safe office makes every effort to remove mercury amalgam/silver fillings in the safest way possible. We follow the recommendations of the International Association of Mercury Safe Dentists, the Intentional Academy of Oral Medicine and Toxicology, the American Dental Association, and other holistic dental organizations. 

The following basic amalgam removal protocols are what most Mercury Safe dentists utilize to protect the patient and we will provide a basic explanation of each. Keep in mind that while protecting you from excessive and unnecessary exposure to mercury vapor during amalgam removal is our primary goal, we are also concerned about protecting ourselves and the environment. Thus, some of the protocols we utilize, that aren't listed here, are meant more to protect us as they are you. Please know that our goal is to do all we can to protect you, our dentist, our staff, and the environment from mercury! Let us know if you have any questions.

1. Keep the Filling Cool During Removal

Drilling out an amalgam filling generates a tremendous amount of heat, which causes a significant increase in the release of mercury, both as a vapor and in amalgam particles, during the removal process. Cooling the filling with copious amounts of water and air while drilling substantially reduces the amount of mercury vapor, and particles, the filling releases.

2. Cutting the Amalgam into Chunks

Most Mercury Safe dentists use a removal process that’s commonly referred to as “chunking.” This involves less drilling, because the dentist only drills enough to cut the filling into chunks, which can then be easily removed by a hand instrument or suction.

3. Use a High-Volume Evacuator

Most mercury safe dentists use a more powerful suction system than the type used by most pro-amalgam dentists. We believe this is an important protocol in preventing mercury vapor and amalgam particles from entering the room. The evacuator tip should be kept close to the filling during the entire time the filling is being removed. This helps capture more of the mercury vapor and particles. Chunking, and keeping the filling cool, and evacuation during removal are three essential parts of the safe removal process because they are preventive in nature. Meaning they capture most of the mercury vapor and amalgam particles before they leave the area of your mouth..

4. Provide an Alternative Source of Air

We provide you with an alternative air source while your mercury amalgam fillings are being removed. An alternative source of air may not be necessary when the tooth is being prepared for the new filling, or while the new filling is being placed. 

5. Use a Non-Latex Rubber Dam – or Equivalent Isolation System

A rubber dam isolates the tooth or teeth being worked on and allows us to have better access to the tooth. It was once believed that the traditional rubber dam would protect a patient from breathing mercury vapor in through the mouth. We now know that mercury vapor can readily pass through a rubber dam made out of latex, the most commonly used rubber dam material. It can also pass around the rubber dam. Many patients have heard that the rubber dam offers a great deal of protection and should absolutely be included as part of the safe removal protocol. Some people will even insist on its use to protect them from mercury vapor.

But because the rubber dam does not protect you from inhaling some mercury vapor through your mouth during the removal process, it does not absolutely have to be used when removing amalgam fillings. There also may be situation where a dental procedure can't be completed with a rubber dam in place. Each situation is unique and we will adjust as necessary. With or without a rubber dam, incorporating the first 4 steps listed above will provide you with the greatest source of protection from mercury vapor. 

A Note to You

We ask that, during the actual removal process, that you concentrate on breathing through your nostrils and avoid breathing through your mouth while your mercury amalgam silver fillings are being removed. We ask this because breathing through your nostrils offers more protection against mercury vapor than breathing through your mouth. Also, some patients have some anxiety about the dental visit and tend to want to breathe through their mouths.

6. Post Removal Clean Up

We will follow up amalgam removal by thoroughly rinsing the patients mouth, removing and safely disposing of the protective covering we used to protect you. We then thoroughly clean the equipment and instruments used in the removal process. Everything that is disposable is safely recycled.

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