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Safe Mercury Removal

If you have chronic headaches or pain in the face, jaw, or neck, the cause may actually be in your temporomandibular joints (TMJ). These are your jaw joints, which can become damaged or dysfunctional over time.


Wayne Family Dental has a variety of therapies available for treating such TMJ disorders (TMDs).

  • Pregnant and nursing women, as well as those planning on pregnancy
  • Children, especially those younger than 6
  • People with neurological conditions such as MS, Parkinson’s, or Alzheimer’s
  • People with impaired kidney function
  • People who are sensitive or allergic to mercury or other components of amalgam

Altogether, that makes up nearly two-thirds of the US population.

Because mercury is so toxic, we keep our practice mercury-SAFE, as well. We take extra precautions when working on patients with existing “silver” fillings, such as never polishing them during a cleaning appointment. The heat and friction generated by polishing accelerates the release of mercury vapor from those fillings – vapor that is easily inhaled. Once in the lungs, mercury has a short journey into the bloodstream, which can then deliver and deposit it throughout the body.

When a patient needs or chooses to have old amalgams replaced, we follow the strict safety protocols established by the International Academy of Oral Medicine & Toxicology (IAOMT) to protect our patients, ourselves, and the environment. Dr. Choe is certified in the IAOMT’s Safe Mercury Amalgam Removal Technique, or SMART.

What Does the Safe Mercury Amalgam Removal Technique (SMART) Involve?

  • 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 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.

The scientific references supporting these procedures are available here.