Safe Mercury Amalgam Removal Technique (SMART)


Become Mercury-Free Today!

Our dental practice stands out safe replacement fillings amalgam to mercury by more bio-compatible materials, Zirconia Crowns and Inlays as well as Composite

We perform the Safe Mercury Amalgam Removal Technique (SMART) in our practice according to the International Academy of Oral Medicine and Toxicology – IAOMT.

Our dental practice is regulated by the IAOMT Academy to perform the SMART procedure. Learn more about the IAOMT SMART Program.

Mercury Removal
  • Avoid Mercury Vapors
  • Avoid Neurological Symptoms
  • Protect the Environment

Safe Mercury Filling Removal Protocol

Mercury toxicity has been documented 2,000 years ago; Mercury (Hg+) is a metal with a particular characteristic, which of being liquid at room temperature. This compound is found in organic form (Hg), inorganic (Hg+, Hg2+) and also in the form of vapor in his elementary State (Hg0).

The organic form of mercury is more toxic than the inorganic form.

Then it will be true that:

  1. The mercury vapors can be inhaled by nasal mucosa, from the systemic circulation and bronco-pulmonary apparatus accumulating in the olfactory bulbs, pituitary gland and may cause electrolyte imbalances, mercury may be accumulated in red blood cells and can reduce the ability to transport oxygen.
  2. That the percentage of oxyhemoglobin from 70% decrease up to 20-30%.
  3. It has been scientifically demonstrated a remission of sequential related pathology, after removing amalgam fillings.
  4. That there may be neurological symptoms: depression, migraines, etc.
  5. Symptoms of oral cavity: bleeding, halitosis, metallic taste, leukoplakia, cancer sores.
  6. Immunologic symptoms: allergy, asthma, sinusitis.
  7. 7. Endocrine symptoms: fatigue, hypoxia, excessive perspiration, muscle weakness, edema, inhibition of the immune system

It is claimed that oral bacteria can methylate the mercury in the presence of negative reduction potential and the high negative charge amalgam may be at risk, and that the presence of electro galvanic currents in the mouth can influence the rate of release of mercury from amalgam fillings which are anodic and hence metal ions and being the saliva a liquid electrolyte could be transferred to the oral environment.

In the USA there are several associations, like IAOMT, that require total removal of mercury compounds in dentistry, the problem became public knowledge some years ago, through publications, books and television shows.

Today, with Metal-Free fillings and Zirconia Oxide prosthesis these threats no longer exist.

Did you know that?

  1. The amalgam was superior to composite fillings but it is no longer acceptable due to the toxicity of mercury.
  2. The amalgamation is considered to be one of the biggest sources of mercury pollution.
  3. When amalgam fillings need to be removed, you must follow a specific Protocol to protect against mercury contamination.
  4. Only one gram of mercury can contaminate 20,000 pounds of food.
  5. Now even mercury thermometers have been forbidden.
  6. In the distant past dentists worked the amalgams with bare hands and the mercury in excess was cleaned by throwing it into the garbage can.

Safe Amalgam Removal Technique

  1. Isolation of the tooth with a rubber dam Isolation kept wet, the better to catch any piece of amalgam.
  2. Exhaustive use of gloves to protect Dentists and Assistant hands.
  3. Strict use of special disposable masks from the part of all the operators.
  4. Double surgical suction straw, one of which should almost cover the tooth so that it cannot escape any mercury vapor and with abundant irrigation of water. Better to use two suction tubes so that the inlet stream is crossed. In this way, the staff doesn’t need any breathing equipment because no mercury vapor can enter into the environment.
  5. Hi Vacuum – HVE = High Volume Evacuation, that are discharging the air outside of the studio and first separate the amalgam powders before.
  6. Environmental Vacuum enabled, although this protective garrison for the air of the studio is quite excessive because, if the procedures are properly carried out, no mercury vapor can escape the high speed surgical aspiration. This vacuum environment, in our study is always active even when we do not remove amalgams. The environmental air circulators equipped with filters have no sense. It is always better to expel and renew the air in the study continuously, rather than recycle it uselessly into the internal environment.
  7. Removal of the shutter slit with tungsten carbide cutters paper thin, operated so as to drive on the outskirts of the shutter, milling the minimal amount of amalgam as possible, or if the tooth allows it, milling only the dentin. In some cases it is necessary to cut across the filling, in order to single out or use small chisels to facilitate easy removal.
  8. Compressed air turbines amalgam with mixed air/water spray are great, but we also use hand pieces with high-speed micro-motors (200,000 rpm) than having a much higher torque of the turbine, allow a finer removal, delicate, accurate, precise; safe and does not carbonize amalgam which in this case is withdrawn and may not enter the environment. Moreover, by using these hand pieces, you do not need to cover the face of the patient because nothing can escape the suction flow.
  9. During removal, staff always wear masks, goggles, gloves and is always on a vacuum cleaner air environment with a span of 2000 cubic meters/hour that expels outside the premises.

In our clinic we use the Amalgam Removal using the Enucleation Technique with isolation dam and continuous suction during removal. This guarantee for the patient but also to our warranty and protection because we could also breathe vapors of mercury if we use the traditional protocol (Swedish Technique).

Amalgam poisoning and hair test. For your peace of mind, our dental clinic, can advise you how to do the hair for hair test reveal any chronic poisoning by mercury.

The Enucleation Technique

With the coring technique, the amalgam removal is sectioning along the interface (contact edge) between the filling and the tooth using the fact that there is a “chemical bonding” (tie-accession), between the amalgam and the dental enamel.

With this system the drill never touches the mercury amalgam. With this amalgam removal protocol we personally never had any problems and our patients didn’t too. We do not charge surcharges for the removal of amalgam. You only pay for new fillings.

With the described method it is possible to eliminate the amalgam, in a whole block, at least in 70% of cases. Operate with the aid of an optical stereo-microscope or goggles prismatic magnifiers, much easier maneuvering of the perimeter amalgam to remove.

We perform the Safe Amalgam Removal Technique according to IAOMT’s Protocol

La Sabana

San José, Costa Rica


Monday to Friday 8am - 6pm

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