Safer Amalgam Removal


Fargo Dentist - Safer Amalgam Removal - Dr. Jim Lundstrom

Removal of your amalgam involves cutting the amalgam with a dental bur which produces very small particles with vastly increased surface area, and vastly increased potential for subjecting the people present to a mercury exposure.  Taking out fillings with a high speed dental bur generates a cloud of particles, at least 65% of which are one micron or less in size.  These are fully respirable, get deep into the lungs, where the microscopic particles are broken down and the mercury is systemically absorbed within a few days.  This mercury exposure can be as much as a hundred times greater than that from the vapor.

The mercury free dentists of the world have been acutely aware of the excess exposure problem, and have devised a number of strategies for reducing the amount of mercury exposure to both patients and dental staff during amalgam removal.

If you should choose to make an informed decision to have your amalgams removed and replaced with a composite (“tooth colored”) restoration or an all porcelain crown; Lundstrom Family Dentistry offers a “safer” system for amalgam removal.  Dr. Lundstrom and his team follow the SMART (Safe Mercury Amalgam Removal Technique) protocol as set by the International Academy of Oral Medicine and Toxicology.  



SMART (Safe Mercury Amalgam Removal Technique) Protocol :

Patient Protection

  • Slurry of charcoal for patient to rinse and swallow before the procedure
  • Full body, impermeable barrier, as well as full head/face/neck barrier under/around the dam
  • External oxygen delivered via a nasal cannula for the patient
  • Dental dam made with non-latex nitrile material placed and properly sealed in the patient's mouth
  • Saliva ejector placed under the dental dam
  • At source oral aerosol vacuum in close proximity to patient's mouth
  • High volume evacuation
  • Copious amounts of water to reduce heat and a conventional high speed evacuation device to capture mercury discharges
  • Sectioning of amalgam into chunks and removal in large pieces, using a smaller diameter carbide bur
  • After removal, the patient's mouth is thoroughly flushed with water and then rinsed out with a slurry of charcoal

 Dentist & Team Protection

  • Protective gowns and covers for the dentist and assistant
  • Non-latex nitrile gloves for the dentist and assistant
  • Properly-sealed respiratory grade mask rated to capture mercury

Office & Environmental Protection

  • Amalgam separator that is properly installed, utilized, and maintained  (Amalgam separators are used to remove the mercury out of the dental waste water before it enters the city's sewer system.  Without an amalgam separator, the average dentist will release roughly three pounds of solid mercury per year. Reference: MARS Bio-Med Processing Inc.)
  • High-volume air filtration system

Aerosol Control

The SMART protocol can also be used to control and reduce virus, bacteria,
and aerosols from contaminating our patients and team. We use an "At
Source" oral aerosol evacuation system that helps to draw air away from the
patients face and directly into the evacuation system.

Dent AirVac states "The vacuums are designed specifically to remove and
filter potentially toxic vapors and microbiological contaminants away from
the immediate breathing area of the dentist, assistant, and patient."



Safe Amalgam Removal Fargo Dentist Dr. Jim Lundstrom

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