DentaCare services

Removal of amalgam and placing a new filling

The procedure of removing amalgam (silver) fillings involves cutting the amalgam into as few fragments as possible using special drills, and the removal of these pieces. During the procedure the dental plaque is removed from the tooth in which the amalgam filling is to be replaced, and then the tooth is filled with a fine white restorative material.

The standard of removing amalgam (silver) fillings (SMART) was developed by IAOMT, an international organisation, which requires dentists to adhere to the following rules:

• all persons present inside the dental office during the treatment must be provided with disposable protective clothing;
• surgery staff should use vinyl protective gloves;
• dentist and dental assistant should be provided with airtight breathing masks with mercury filters;
• the patient should be connected to an external oxygen source through a nasal mask or cannula, so as not to inhale the vapours released from the removed fillings;
• cofferdam should be used to protect the patient’s mouth;
• a saliva ejector and suction device should be used during the procedure;
• the procedure should be performed using plenty of water to minimize treatment temperature;
• when the amalgam removal process is complete, the patient should rinse the mouth thoroughly with water.

Failure to follow the SMART standards as patients translates into high risk due to large quantities of mercury vapour that evaporate during the procedure (even as much as 4 times higher).