For a very long time, “silver” mercury amalgam fillings were the norm in dentistry. Now, new research in JADA shows just how much things have changed.

Analyzing NHANES data from just over 17,000 Americans, the study authors found that amalgam tended to be much more common in some groups compared to others.

Nonamalgam restorations were the most common in the primary teeth of children older than 5 years and in the permanent teeth of adults younger than 40 years. Amalgam restorations were more common in older adults….

The study findings suggest a shift from amalgam to alternative restorative materials in the United States.

And a welcome shift it is – especially for children. Their smaller bodies and still-developing brains make them much more susceptible to the effects of mercury, a heavy metal that is especially toxic to the brain.

This is one reason why the FDA now advises against the use of amalgam in children, especially those under the age of 6, as well as women who are breastfeeding, pregnant, or planning on becoming pregnant, among others.

One day, all dentistry will be mercury-free. It’s a change we look forward to. Very much.

In the meantime, more and more adults are choosing to have their old amalgams replaced with nontoxic alternatives, such as composite fillings and ceramic/porcelain crowns. Not only do these materials have the benefit of being biocompatible; they have better aesthetics. Unlike “silver” fillings, these look like natural teeth.

If you’re thinking about having your own mercury fillings removed, it’s crucial that proper safety measures are taken. Just drilling out amalgam can expose both you and the dental team to extremely high amounts of mercury. Take a look:

One way you can be sure that your amalgams will be removed safely is to look for a biological dentist who is SMART certified. SMART stands for Safe Mercury Amalgam Removal Technique, a science-based protocol that was developed by the International Academy of Oral Medicine in Toxicology to protect patients, providers, and our planet alike. (Dentistry is one of the main sources of mercury pollution, introducing up to 35 tons of it to the environment every year.)

Here’s an overview of what SMART involves:

  • Amalgam separators are properly installed and maintained to collect mercury waste, keeping it from being released into the environment via wastewater.
  • High-volume air filters and aerosol vacuums are used in each room to remove mercury vapor and particulate that’s generated during the procedure.
  • Unless the patient declines or there are contraindications, the patient is given a slurry of charcoal, chlorella, or a similar adsorbent to rinse with and swallow before the procedure.
  • The patient is fully covered in protective gowns and drapes, including covering for the neck and head.
  • The dentist and team members likewise wear protective gowns, along with non-latex, nitrile gloves, face shields, and head coverings. They also wear properly sealed, respiratory grade masks rated to capture mercury or positive pressure, properly sealed masks providing air/oxygen.
  • To prevent nasal inhalation of mercury vapor or particulate, the patient wears a nasal mask or cannula through which oxygen is delivered.
  • A non-latex, nitrile dental dam is placed and properly sealed in the patient’s mouth. A saliva ejector is placed under the dam to further reduce mercury exposure.
  • An oral aerosol vacuum is placed close to the patient during the amalgam removal to capture mercury vapor and particulate.
  • The amalgam is sectioned into chunks with a small diameter carbide drill and removed in the largest pieces possible.
  • Great amounts of water are used to reduce heat. A conventional high-speed evacuation device is used to capture mercury discharges.
  • Once removal is complete, the patient rinses their mouth thoroughly, first with water, then with a slurry of charcoal, chlorella, or a similar adsorbent.

You’ll find a complete description of the protocol here, complete with scientific references.

As an accredited member of the IAOMT, Dr. Parsi is also SMART-certified. This makes his practice not only mercury-free but mercury-SAFE – and a trusted biological dentist for patients across San Diego.