Safe Mercury Amalgam Removal

SMART stands for Safe Mercury Amalgam Removal Technique advocated by the International Academy of Oral Medicine and Toxicology (IAOMT), of which Dr Andrew Doig is a member. It is a particular technique developed to remove mercury fillings from teeth. It involves using special equipment and techniques to reduce and minimise the exposure of patients (and dentists) to the harmful mercury in silver fillings. Mercury is a toxic element that is scientifically proven to cause damage to the human body when ingested in large enough amounts. What people do not know also is that the silver fillings in our teeth also release mercury, albeit in smaller doses, as a vapour every time we chew on them.

The Minamata Convention is a world-wide movement that is changing the face of dentistry and the materials used in dental fillings. At Skye Dental, we follow the practices of the Minamata Convention and strictly avoid amalgam mercury-containing fillings.

SMART is the technique adopted by the dentists at Skye Dental and it is the best way to remove unwanted amalgam fillings but minimising the exposure to the mercury vapour released in the process. That way, you can be rest assured that the process is as safe as it can be.

Please ask one of our staff or the dentists if you wish to know more about this technique.

Here is a bit of background to Silver Amalgam Fillings and Health.

Those who have suffered from tooth decay are highly likely to have had their tooth restored to health using an amalgam (‘silver’) filling. Dental amalgam has been a popular, proven and inexpensive material used by dentists for more than 150 years, but recently it has attracted growing publicity over possible adverse effects on health.

Amalgam is often referred to as a ‘silver’ filling and is made by combining mercury with particles of silver and tin, mixed with smaller amounts of copper and zinc to improve its performance.

Dentists have a range of sophisticated filling materials available to them, each with their relative merits. An ideal one should be easy to use, tooth coloured, long lasting and without any adverse side effects. The ideal filling material with all these properties has yet to be developed.

Chemical changes in the silver amalgam take place over a period of time that help to seal the filling at the edges. These changes contribute to the fact that amalgam has been such a successful filling material.

Although the individual components that make up amalgam (mercury, silver, tin, copper, and zinc) may be toxic in high enough amounts, they combine to form a stable material that has some excellent properties. An analogy with salt is often used; both sodium and chlorine are harmful elements in their natural state, but when combined they form ordinary table salt, which is an essential part of daily life. Those searching the internet for information on amalgam will find a great many claims linking it with all manner of ailments and diseases, including allergies, neuralgia, dementia and cancer. There is no scientific evidence to support such claims.

Mercury is released from fillings in tiny amounts, sometimes during eating or brushing your teeth. However, there is no evidence to indicate that the amounts released are harmful; if there was, the Department of Health would advise dentists immediately. It is, of course, impossible to state that any material is completely safe in any situation and dentists are guided by current scientific evidence.

Amalgam fillings are not the only daily source of exposure to mercury; others include food, the environment and occupational exposure. Some foods such as fish in particular have a high mercury content.

"He's as mad as a hatter" was a term used to describe hat makers who used mercury as part of their trade. The consequent effect of exposure to mercury on their behaviour is the source of this popular saying. Since mercury is a toxic substance in large doses, dentists and their staff must take particular precautions when handling and disposing of amalgam in order to protect the well-being of their patients, staff and themselves. Long gone are the days when amalgam used to be mixed in a mortar and pestle! A recent study carried out in Scotland has indicated that dentists may need to be more concerned about long-term occupational exposure to mercury in the dental environment rather than about the levels of mercury to which their patients are exposed by their fillings.

People with known allergies to amalgam will require an alternative filling material, although such cases are extremely rare. In these exceptional circumstances the offending filling should be replaced with an alternative such as gold. As with all other operative procedures dentists will wish to minimise any intervention during pregnancy unless it is absolutely necessary. This will include the removal and placement of amalgam fillings.

A variety of factors are important when deciding on the type of filling most appropriate for restoring a tooth. These will include the size of the filling, its location, cosmetic concerns and, of course, cost. The dentist will be only too pleased to discuss the options so that an informed decision can be made.