Amalgam Removal
Mountain & Sea Dental & Associates - Santa Barbara, California
The Safe Mercury Amalgam Removal Technique (SMART)
The International Academy of Oral Medicine and Toxicology (IAOMT) developed the “Safe Mercury Amalgam Removal Technique” (SMART) as a comprehensive set of guidelines for removing dental mercury (amalgam) fillings safely. The SMART protocol helps protect patients, dental staff, and the environment from harmful mercury exposure that can occur during removal.
Since its renaming in 2016 and most recent update in 2019, SMART has become the standard for dentists trained in mercury-safe practices.
Mountain and Sea Dental follows all SMART protocol recommendation in order to keep our patients, staff and the environment safe. Contact us today to discuss of the SMART procedure is right for you.
Why Amalgam Fillings Raise Concern
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Traditional dental amalgam fillings are roughly 50% mercury by weight.
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Studies consistently show that mercury vapor, and microscopic mercury particles, are released from amalgam fillings into the mouth and surrounding environment.
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Activities like chewing, teeth-grinding, brushing, even cleaning, can increase mercury vapor release.
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Removing or replacing amalgam fillings also generates a significant release of mercury vapor and particles.
For this reason, the removal process must be done carefully, otherwise, it can temporarily increase mercury exposure for you, the patient, and everyone in the dental office.
Safety Steps for Amalgam Removal
SMART follows many traditional safety practices (like using a rubber dam, water irrigation, and suction) — but also adds enhanced precautions modern research supports.
A dentist properly trained and certified in SMART will typically use the following measures:
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Amalgam Separator: A device to collect and securely contain amalgam waste — preventing mercury from entering wastewater.
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High-Volume Air Filtration & Vacuuming: Special vacuum systems located close to the mouth remove mercury vapor and particles during removal.
- Full Protective Barrier for Staff & Patient: This includes gowns, hair coverings, gloves (non-latex nitrile), face shields, and impermeable coverage to prevent contamination if particles escape suction.
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Dental Dam (Non-Latex): Isolates the tooth being treated to minimize spread of mercury dust or vapor.
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Saliva Ejector Under Dam: Helps reduce patient exposure to saliva containing mercury.
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Use of Small-Diameter Carbide Drill + Sectioning Amalgam: Removing the filling in large chunks minimizes the chance of aerosolizing mercury dust.
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Water Cooling, High-Speed Evacuation, and Clean-up Devices: These reduce heat (which can accelerate vapor release) and improve capture of amalgam particles and vapor.
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Thorough Rinse & Final Mouthwash: After removal, the mouth is flushed, then rinsed again with an adsorbent solution (like charcoal or chlorella) to help remove residual particles.
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Proper Disposal & Clean-Up Compliance: All contaminated waste — materials, clothing, traps, suction equipment — must be handled and disposed of in accordance with federal, state, and local regulations.
Importantly, SMART-certified dentists do not recommend amalgam removal for people who are pregnant or breastfeeding.
The Important of Safe Amalgam Removal
Choosing a provider trained in a proven protocol — such as the IAOMT’s Safe Mercury Amalgam Removal Technique (SMART) — minimizes your exposure and ensures a safer experience for both you and the dental team.
By choosing a SMART-certified dentist who follows proper removal protocols and disposal procedures, patients help minimize not only personal exposure but also environmental contamination.
Who is a Good Candidate for Amalgam Removal?
Deciding whether to remove mercury amalgam fillings depends on your dental health, overall wellness, and personal preferences. While many people can safely keep their existing amalgam fillings, certain situations make removal a stronger consideration — especially when performed using a safe protocol like SMART.
1. Your amalgam filling is damaged or failing
If a filling is cracked, leaking, worn down, or allowing bacteria to enter the tooth, replacement becomes necessary. In these cases, removal is a clear, dentist-recommended choice.
2. You have tooth decay around an old filling
Cavities can develop under or around aging amalgam restorations. Removing the failing material allows your dentist to clean the tooth and restore it with a healthier, modern alternative.
3. You’re experiencing sensitivity or allergic reactions
Some patients have documented sensitivities to metals or mercury-containing materials. If your provider suspects a reaction or irritation linked to an amalgam filling, removal may be beneficial.
4. You prefer to switch to biocompatible materials
Many people choose to replace metal fillings with tooth-colored composite or ceramic restorations for aesthetic or health-conscious reasons. If you want a more natural, metal-free smile, you may be a good candidate.
5. You’ve been advised by a medical or wellness professional
In certain health situations, your physician, functional medicine provider, or specialist may recommend reducing mercury exposure. In these cases, choosing a dentist trained in safe removal protocols is essential.
By choosing a SMART-certified dentist who follows proper removal protocols and disposal procedures, patients help minimize not only personal exposure but also environmental contamination.
Words from our Dental Patients:
“Dr. Carley was very knowledgeable and professional. We came to him for a second opinion and found him to be much more honest than the first dentist we went to. So he earned our business! All in all it was a great experience!”
“Excellent. Dr. Carley has taken good care of my dental needs; as I have had implants and quite a bit of work. He has also done great things for my sons many dental needs.”
Nothing short of excellent! I am extremely happy with the outcome of Dr. Carley’s dental work. Congeniality and integrity are the name of the game for Dr. Carley and his entire staff. I most highly recommend them.
Request Your Appointment Today
We’re ready to help make your smile health and bright!
Call (805) 316-3821 or contact Mountain and Sea Dental—your trusted dentist in Santa Barbara California—to learn more about our approach to dentistry and whole body health.
Our Santa Barbara Office
Office Hours
Monday: 8am – 5 pm
Tuesday: 8am – 5 pm
Wednesday: 8 am – 5 pm
Thursday: 7am – 4 pm
Friday: By Appointment
Phone
Address
2780 State St. #6
Santa Barbara, CA 93105