Why the SMART Protocol is Essential for Safe Amalgam Removal

The Importance of Using the SMART (Safe Mercury Amalgam Removal Technique) in Dental Care

Mercury amalgam fillings, commonly known as "silver fillings," have been used in dentistry for over a century. However, with growing awareness of the potential health risks associated with mercury exposure, many patients and dental professionals are opting to remove these fillings. While removing mercury amalgam fillings can be beneficial, the process must be done safely to avoid unnecessary exposure to mercury vapors and particles. This is where the Safe Mercury Amalgam Removal Technique (SMART) becomes essential.

In this blog, we’ll explore the importance of using the SMART protocol in a dental setting and how it protects both patients and our dental team during the amalgam removal process.

What is Mercury Amalgam?

Mercury amalgam is a mixture of mercury with other metals like silver, copper, and tin. While amalgam fillings are durable and long-lasting, they contain about 50% mercury, a toxic heavy metal. Over time, concerns have been raised about the potential health risks from mercury exposure, including its effects on the nervous, immune, and respiratory systems.

When amalgam fillings are removed improperly, they can release toxic mercury vapors or particles, which can be easily inhaled or ingested by the patient and dental staff, leading to increased exposure. To minimize these risks, the SMART protocol was developed by the International Academy of Oral Medicine and Toxicology (IAOMT) to ensure the safe removal of mercury amalgam fillings.

What is SMART?

SMART stands for Safe Mercury Amalgam Removal Technique, and it is a set of safety protocols designed to reduce mercury exposure during amalgam filling removal. This technique involves specialized equipment and procedures to protect patients, dental staff, and the environment from mercury exposure.

Why is SMART Important?

Here are several reasons why using the SMART protocol is crucial in dental settings:

1. Minimizes Mercury Exposure

The primary goal of SMART is to protect patients and dental professionals from mercury exposure. Mercury is a toxic substance, and inhaling its vapors or ingesting its particles can pose significant health risks. The SMART technique minimizes and isolates the release of mercury vapor during the removal process by using high-speed suction, rubber dams, and specialized air filtration systems.

The following protective measures are part of the SMART protocol:

• Use of a rubber dam to isolate the tooth and prevent mercury particles from being swallowed.
• High-volume suction to capture mercury particles and vapor as they are released.
• External air filters or oxygen for patients to prevent inhalation of mercury vapors.

By following these steps, dental teams ensure a safer removal process that protects both the patient and the team from unnecessary mercury exposure.

2. Protects Dental Teams

Dental professionals performing amalgam removal procedures are at risk of mercury exposure if proper safety measures are not in place. Repeated exposure to mercury vapor, even in small amounts, can have serious health consequences over time, such as neurological and respiratory issues.

The SMART protocol ensures that dental teams wear protective gear, such as respiratory masks, and use advanced filtration systems that reduce the risk of mercury inhalation during and after the procedure. This creates a safer working environment for dentists, hygienists, and assistants.

3. Ensures Environmental Safety

Mercury is not only harmful to humans but also to the environment. When mercury particles are released during dental procedures, they can enter the water supply and soil if not properly contained. Using SMART, dental clinics implement specific waste disposal protocols to ensure that mercury waste is safely collected and disposed of in an environmentally friendly manner. Specialized filtration systems and water traps help prevent mercury particles from entering the dental clinic’s wastewater system.

This environmental responsibility is crucial, as mercury pollution can have long-lasting effects on wildlife and ecosystems.

4. Prevents Potential Health Complications for Patients

Some patients may be particularly sensitive to mercury exposure, including those with pre-existing health conditions, allergies, or weakened immune systems. By adhering to the SMART protocol, dental professionals significantly reduce the risk of mercury-related complications, providing a safer experience for all patients.

The procedure involves minimizing the heat and friction generated during the removal of amalgam, which can otherwise increase mercury vapor release. SMART also employs a systematic process of breaking up the amalgam into larger chunks rather than grinding it down, reducing the likelihood of mercury release.

5. Promotes Patient Confidence

Knowing that a dentist follows the SMART protocol can increase a patient's confidence in the safety of their dental care. Patients concerned about mercury exposure or toxicity will feel more at ease knowing that their dentist is using the latest and safest methods to remove their amalgam fillings. This trust encourages more patients to seek treatment and feel empowered in their oral health decisions.

How SMART Works: Key Steps in the Protocol

To better understand the importance of SMART, here are some of the key steps involved in the technique:

Isolation: The tooth is isolated using a rubber dam to prevent mercury particles from entering the mouth or being ingested.

High-Volume Suction: Specialized suction devices are used to capture mercury vapors and particles at the point of removal.

Air Filtration: External air filters and oxygen are provided to ensure the patient and dental team are breathing clean air.

Protective Gear: Dental staff wear protective clothing, gloves, and masks, while patients may be provided with a nasal mask for clean air.

Amalgam Removal: The amalgam is removed in large chunks using minimal drilling to reduce the release of mercury vapor.

Water Filtration Systems: Special water filtration systems ensure that mercury particles do not enter the clinic’s wastewater system.

Safe Disposal: Mercury-contaminated waste is collected and safely disposed of according to environmental regulations.

Conclusion

The SMART protocol is an essential advancement in modern dentistry, providing a safer and healthier way to remove mercury amalgam fillings. By minimizing mercury exposure, protecting dental teams, safeguarding the environment, and promoting patient confidence, SMART offers numerous benefits that make it the gold standard for mercury amalgam removal.

At UMG Family Dentistry, we prioritize the safety and well-being of our patients and our staff. Our team is trained in the SMART protocol, ensuring that all mercury amalgam removal procedures are performed with the highest level of care and precaution. If you’re considering having your amalgam fillings removed, contact us today to learn more about how the SMART technique can benefit you and your long-term health.