What You Should Know About Mercury Amalgam Removal

mercury amalgam fillingsHolistic dentists and dental specialists across the globe are acutely aware of the risks of mercury amalgam fillings. Not only do they present a risk to patients’ day-to-day lives, the process of mercury amalgam removal must be done with extreme care to reduce the risk of releasing mercury vapors.

All too often, practitioners of traditional dentistry have little regard for the risks involved when removing mercury amalgam fillings. Not only that, but the majority of time the old mercury filling is simply replaced with a new one, perpetuating a cycle of risk for the patient.

The “old guard” dental establishment continues to push the orthodoxy claiming that a mercury amalgam filling is a stable compound with little or no mercury emissions. Yet they also are quick to blame holistic dental professionals for “unnecessarily exposing patients to excess mercury” when patients elect to have amalgam fillings removed.

Clearly, the truth must be one or the other!

The truth is that holistic and mercury-free dental professionals have developed several techniques that reduce mercury exposure for both patients and dental staff during the removal of mercury amalgam fillings. But, before we get into that, let’s clarify what mercury amalgam is.

Sometimes simply called “amalgam”, mercury amalgam is a combination of materials. It is primarily comprised of mercury, silver, tin and copper but may also contain zinc, indium or palladium. You may have heard mercury amalgam referred to as “silver amalgam” or “silver filling”, but these are laymen terms that have more to do with describing the amalgam’s color rather than its composition.

Mercury amalgam has been used in dentistry for 150 years. It’s appeal in traditional dentistry originated from the pliability it lends to the alloy powder’s filling material. When combined, the mercury and the alloy powder becomes a soft compound can be pressed into the tooth, yet also hardens quickly and withstands the pressures of biting and chewing.

For much of dental history, amalgam was believed to be an inert material that released no mercury vapors once set into the tooth. Today, however, even the most stalwart of traditional dental practitioners know that mercury vapor is released as amalgam fillings wear down.

If you or a family member is considering having amalgam fillings taken out, here are the techniques your holistic dentist will use to assure safe mercury amalgam removal.

Preferred Procedures for Mercury Amalgam Removal

Cooling the Amalgam Filling and “Chunking”

The majority of holistic dentists keep the drilling out of mercury amalgam fillings to an absolute minimum. Whenever drilling out is necessary, the filling is cooled with water and air. Cooling is essential since drilling can create a substantial amount of heat, and heat can significantly boost the release of mercury vapor and amalgam particulates.

That’s why holistic dental professionals overwhelmingly practice the removal process commonly called chunking. Chunking requires far less drilling, since drilling is done solely to break the filling into chunks that can then be easily plucked by a handheld device or by suction. Chunking and cooling the filling go hand-in-hand for safe mercury amalgam removal and are the preferred and recommended procedure most used by holistic dentists.

Some holistic dentists may recommend that the patient swallow activated charcoal approximately ten to fifteen minutes prior to mercury amalgam removal as an optional safeguard. In the event that particulates of mercury are swallowed, the particles will bind with the charcoal and pass harmlessly from the body through the digestive track. Again, this is an optional safeguard. Studies show that mercury absorption via the intestinal track is highly unlikely. However, if your dentist recommends it, doing so will certainly do no harm.

High-Volume Evacuators and Providing Patients with an Alternative Source of Air

For the most part, holistic dentists use a stronger suction system than what is used by old-guard, pro-amalgam dentists. A superior suction system is a vital tool needed to optimally reduce patient exposure to mercury vapor and amalgam particulates. Ideally, the evacuator tip will be set no farther than a half inch from the filling for the duration of the mercury amalgam removal. This helps ensure maximum capture of vapor and particles.

While some holistic dentists don’t feel the precise position of the evacuator is a strong factor in mercury vapor reduction, virtually all do agree that high volume suction equipment, along with cooling the filling and chunking, are absolute musts for the safe removal of amalgam fillings. Many holistic professionals also believe an alternative air source should be made available to patients during the removal process. This way, if the above procedural steps aren’t part of the removal process, mercury vapor inhalation is still kept to a minimum. However, an alternative air source is not always a necessity. For example: if a tooth is being prepped for a new filling or during the actual placement of the new filling, alternative air isn’t needed.

That being clarified, an alternative air source is strongly recommended during drilling and chunking. A nasal hood provides the air flow, allowing patients to breathe air from an oxygen tank or a source from outside the office. Patients should always breathe through the nostrils while wearing a nasal hood. Breathing through the mouth during mercury amalgam removal defeats the purpose of providing alternative air, exposing patients to vapors.

If your dentist practices mercury safety but does not offer an alternative air source, ask why and ask what he or she is doing to replace the need for an alternative air source.

Most holistic dentists agree that mercury amalgam removal should not be undertaken during pregnancy, nursing or when health issues such as allergies or immune system problems are a concern. However, should removal still be deemed necessary under these circumstances, an alternative source of air must certainly be provided.

The Use of Rubber Dams

A rubber dam is a thin, rectangular sheet of latex that isolates the tooth being worked on. At one time, conventional dental wisdom advised the use of rubber dams to prevent patients from inhaling mercury vapor through the mouth. Now, however, it is well known that mercury vapor passes through the latex. The belief that rubber dams prevent vapor inhalation persists to this day, with many patients insisting on their use during mercury amalgam removal.

While it is accepted by most contemporary dental professionals that rubber dams do not offer vapor protection, they are still highly useful in the evacuation of the filling and in preventing particles from entering the mouth. It’s important to understand that swallowed amalgam particles do not release vapor as they move through the digestive system, and do not threaten patient health. However, using a rubber dam in order to avert as much exposure as possible is still a sound procedural practice. Another advantage to using rubber dams is during the replacement of the amalgam filling with a composite. The dam provides a convenient, dry holding area for the composite filling.

Ultimately, however, the use of a rubber dam is up to the dental professional and patient preference. Putting the dam in place and removing it after a procedure can cause mild discomfort for some. And there will be a percentage of patients who can’t tolerate dams at all. In some cases the position or location of the tooth being worked on will prevent the use of rubber dams.

Cleaning the Patient’s Mouth and Immediate Clean Up after Mercury Amalgam Removal

When the procedure is complete, the patient’s mouth will be thoroughly rinsed and vacuumed. At least fifteen seconds should be taken to clean the mouth from front to back in order to ensure that the mercury amalgam removal is absolute and to remove any residual vapor from the oral cavity. During this process, patients should avoid swallowing any water. It is recommended that patients should gargle with a small amount of water, getting as far back into the throat as possible while doing so. Again, the water should not be swallowed but, rather spitted or vacuumed out.

Office Air Purification and Filtering

While holistic dentists do not make or use amalgam fillings, they remove them on a daily basis. As such, most dental professionals who practice mercury safety will protect themselves and their staff from this constant exposure. Proper air purification and filtering is an important part of their safety regimen. While this is a safeguard that mainly benefits the professionals and staff (a patient is exposed to mercury vapor and particulates too briefly during an office visit for air filtration to be an issue), nevertheless, good air purification is a plus for everyone.