Safe Mercury Amalgam Removal Techinique Costa Rica

SMART Protocol for Mercury Amalgam removal

Amalgam is a silver-colored filling made with a mixture of mercury, silver, copper, tin and sometimes zinc. It contains 45-55% of elemental mercury, imparting strength to withstand heavy masticatory loads. Mercury is a bioaccumulative material and is now considered hazardous to health.

Scientific research demonstrates that anybody who is exposed to mercury vapors from dental amalgam including professionals, dental staff, patients, and/or fetuses are at risk of mercury contamination, which makes the need to follow strict rules and regulations crucial while dental amalgam fillings are placed, replaced or removed. To ensure safe removal of Amalgam, IAOMT has developed an extensive set of recommendations and guidelines for the procedure, known as SMART (Safe Mercury Amalgam Removal Technique).

Utilizing the available scientific evidence, the International Academy of Oral Medicine and Toxicology (IAOMT) has developed extensive safety recommendations for removal of existing dental mercury amalgam fillings, including detailed protective measures that are to be utilized for the procedure. The IAOMT’s recommendations supplement conventional safety protocol like the use of masks, water irrigation, and high volume suction with a number of additional protective measures.

For the patient

  • Patient rinses with activated charcoal before the procedure starts.
  • A dental dam is used for isolation of the tooth and to avoid contact of mercury particles with the surrounding oral tissues.
  • Protective gowns & eyewear for the patient.
  • Nasal mask to deliver oxygen and to avoid inhalation of any mercury vapors.
  • A saliva ejector is to be placed under the dental dam to reduce mercury exposure to the patient
  • Using copious amounts of water for irrigation, to reduce heat
  • A conventional high-speed evacuation device to capture mercury particles that are discharged.
  • Amalgam removal in larger chunks by sectioning them
  • Thorough rinsing of patients mouth with water & Charcoal once the removal is done

In the operatory

  • A mercury filter that separates & collects particles to avoid releasing them in the environment.
  • In-office air purifiers to be installed for the removal of mercury particles in the environment.
  • Amalgam separator for proper collection of mercury waste.
  • Adequate high- volume air filtration system in the operatory

For the dentist & dental personal- Protective gowns, Sterile non-latex gloves, face protection gear, properly sealed masks providing oxygen and covers are mandatory.

For safety reasons, the IAOMT does not recommend amalgam filling removal for expecting and lactating mothers, either as a patient or as dental personnel that can somehow come in contact with Amalgam or mercury.

To learn more about Safe removal of Amalgam at our holistic dental practice, give Dr. Ignacio Vargas a call at +1 (305) 810-4854 US & Canada.
You can also email us at

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