Demystifying the SMART process: What the Safe Mercury Amalgam Removal Technique means and why it matters
The Smile In Style offices in Sunbury and Moonee Ponds, Victoria, are led by Dr. Terry Rose who has been Accredited as a Biological Dentist by the International Academy of Oral Medicine & Toxicology (IAOMT). Dr Terry Rose is only one of four dentists in Australia to hold this prestigious title. The IAOMT is a 40-year-old network of dentists, healthcare professionals, scientists and researchers from around the globe. This global network is committed to researching and educating dentists on evidence based practices that enable dentists to use the safest techniques and biocompatible materials available to dentists.
As an active member of this organisation, Dr. Rose leads our practice and ensures that our offices adhere to the IAOMT’s SMART protocol, which stands for:
- Safe
- Mercury
- Amalgam
- Removal
- Technique
“Safe” refers to our approach to replacing an amalgam filling or dental restoration. This emphasis on safety also reinforces our use of non-toxic materials and products when replacing amalgam fillings. We replace amalgam fillings with either a resin material for smaller fillings or porcelain for larger fillings which offer greater strength and longevity. The materials that we use are appropriate for those with a history of sensitivities or adverse allergic reactions to metals and for those that are looking for a more attractive white smile.
Actual Patient Results
“Amalgam” refers to “traditional” metal fillings that comprise a blend of materials, including mercury. In fact, the IAOMT estimates that around half of each metal filling by weight is made up of mercury. This known toxin is then formulated with other metals such as tin, copper, and silver. So, this combination of metals produces fillings which are silver in colour. Most of the filling is made from mercury, not silver. “Amalgam” refers to how these traditional silver-hued fillings are an amalgamation or blend of metals.
“Removal & Technique” refers to the IAOMT’s removal technique to replace these metal amalgam fillings. The “technique” outlined below minimises the risk of exposure to mercury when removing the amalgam. There are dangers associated with the traditional filling removal process when amalgams are not removed and disposed of properly. Toxin may be released as vapours that can be inhaled and larger particles that may be swallowed. These byproducts can then present health risks to our patients, our staff, and our planet through our waterways, as mercury wastes are disposed of.
During the process of removing amalgam, we take a number of precautions which include:
- A chlorella drink is given prior to treatment and a mouth rinse post-treatment. Chlorella can help bind and prevent mercury absorption.
- Physical protective barriers – Masks, protective coverings, eyewear, in-mouth non-latex dental dams, and other steps are taken to prevent physical contact with mercury for the patient and staff.
- Oral evacuation – Generous amounts of water are used to continuously rinse particulate matter from the mouth while suctioning it away. Combined with protective dental dams, this prevents patients from swallowing dental amalgam particles during treatment. Additionally, the rinsing helps lower the temperature of the filling, reducing the amount of mercury vapour released.
- External air – A continuous supply of non-contaminated air or oxygen is delivered via a mask or similar apparatus, preventing inhalation of mercury vapour or particles.
- “Chunk it out” method – Rather than using a drill to grind the filling down, it is carefully removed in the largest possible pieces, minimising friction, and vaporisation.
- High Volume Evacuation Suction is used by the dental assistant to remove amalgam particles in the mouth.
- High Volume Air suction and Air Purifiers are used in the clinical room that is able to remove mercury vapour from the room.
- Amalgam separator use – This device collects mercury-contaminated waste before it can enter the sewage system, allowing us to dispose of it safely.
For your safety, all of the dentists at Smile In Style have been certified in the SMART amalgam removal protocol.
Phone the Smile In Style offices in Sunbury and Moonee Ponds, VIC, at 03 8001 6021 and 03 8400 4104, to learn more about how our dentists, Drs. Terry Rose, Sutanter Wander, Helen Luo, Meenakshi Rajcoomer, Darshan Brar, and Jasdeep Kaur can replace your old silver fillings with safe, white, metal-free ones!
