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Mercury Free, Mercury Safe
At our holistic, functional dental practice, your overall health and well-being are our top priorities. After an initial comprehensive evaluation, we create a personalized oral health plan. When necessary, this may include restoration of health with biocompatible materials, and in some cases, it may require use of the Safe Mercury Amalgam Removal Technique (SMART) to remove existing restorations prior to restoration. Being mercury-free aligns with longevity for the patient both in oral and whole body health, and being mercury-safe minimizes mercury exposure to protect patients, our care team, and the environment prior to restoring teeth with more biocompatible materials.
General Disclaimer:
It is important to understand that advice given here does not replace that given by your individual dental provider. A chief role of a doctor is to provide the patient with comprehensive information related to their health including recommendation and interpretation of various diagnostics, risks and benefits of treatment options if needed (including those associated with no treatment), referral to specialists and/or additional opinions, alternatives, and questions.
Doctors should reference what is supported by scientific evidence as well as their clinical experience when considering the patients genetic predisposition, environmental influences, nutrition and hydration habits, lifestyle and behavioral patterns, health history, and overall future goals. It is only with this 360-view that a patient and doctor can sufficiently collaborate, and that the patient can make decisions that facilitate their recovery and/or optimize their ongoing health journey.
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All this being said, if your current dentist isn't asking you about how you sleep and breathe, what you eat and drink, your daily habits and lifestyle, your neurocognitive or psychological health, other labs (specifically Vit D), or your whole body functionality, you are definitely missing an opportunity to optimize your health. And we would recommend coming to see us or finding a holistic, functional family dentist in your area with whom to collaborate.
First off, why are mercury fillings a problem?
All silver-colored fillings are dental amalgams, and each and every one of these fillings is comprised of 45%- 55% mercury. (2) Although a number of other countries have banned or limited their use, dental mercury amalgams are currently used on ~45% of direct dental restorations worldwide,(3) including in the USA.(4)
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Mercury is continuously emitted from amalgam fillings, and it is absorbed and retained in the body, particularly in the brain, kidney, liver, lung, and gastrointestinal tract.(5) The output of mercury can be intensified by the number of fillings and other activities, such as chewing, teeth-grinding, and the consumption of hot liquids.(6) Mercury is also known to be released during the placement, replacement, and removal of dental mercury amalgam fillings.(7)
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What risks exist to whole-body health if a patient has this material in their mouth?
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For the General Population:
Mercury in amalgam fillings has been linked to a number of health conditions. Individual response to mercury varies, and some of the factors known to potentially impact those exposed to mercury include their allergies, diet, gender, genetic predispositions to adverse reactions from mercury, the number of amalgam fillings in the mouth, and concurrent or previous exposures to other toxic chemicals such as lead (Pb). Scientific studies have identified dental mercury as a potentially causational or exacerbating factor in the following conditions:
Allergies, especially to mercury
Alzheimer's disease
Amyotrophic lateral sclerosis (Lou Gehrig's disease)
Antibiotic resistance
Autism spectrum disorders
Autoimmune disorders/ immunodeficiency
Cardiovascular problems
Chronic fatigue syndrome & chronic inflammatory condition
Complaints of unclear causation
Hearing loss
Kidney Disease
Multiple sclerosis
Oral lichenoid reaction and oral lichen planus
Parkinson's disease
Periodontal disease
Psychological issues such as depression & anxiety
Reproductive dysfunction
Suicidal ideations
Symptoms of chronic mercury poisoning
Thyroiditis​​
Pregnant Women and Children:
Studies have documented the negative impact mercury can have on pregnant women and children, and mercury from dental amalgam fillings in mothers has been recognized for its potential risk to fetuses and children who are being nursed. For example, higher numbers of maternal fillings have been correlated with higher levels of mercury in breast milk and have been associated with lower IQ in children.
Additionally, authors of a study from 2011 cautioned: “Changes in dental practices involving amalgam, especially for children, are highly recommended in order to avoid unnecessary exposure to Hg [mercury].”(8) Children exposed to mercury from dental amalgam may experience subtle neuropsychological deficits, including issues with memory, attention, and motor skills. Although some studies suggest that these effects are minor and not clinically significant, the potential risks to developing brains warrant caution​.
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For more information: Pregnancy, Children, & Dental Amalgam Mercury Fillings.
Dental Personnel & the Environment:
There are dangers to dental personnel who routinely work with amalgam, and the Norwegian Labour and Welfare Service has officially recognized mercury injury as an occupational disease. (4) And as a potent environmental toxin, the safe removal and disposal of mercury-containing dental waste is critically important to mitigate environmental pollution that could affect water sources and wildlife. Many countries and regions have already moved to banning or restricting the use of mercury amalgam to mitigate its environmental impact​ (AEGIS Dental Network)​, and many others are insisting on the use of safe practices for their removal and disposal. Unfortunately, these requirements are not the standard of care in the United States, and it is only from advanced education that certain doctors invest in the advanced training to protect themselves, the environment, and to be able to offer this service to their patients.
What does it mean to be mercury free?
There are safer and demonstrably more effective alternatives to mercury amalgam filling material, such as composite resins, glass ionomer cements, and zirconia inlays and onlays. These materials do not pose the same health risks and are preferred for dental restorations, particularly for patients in high-risk categories. The availability of these biocompatible materials makes the use of mercury amalgam unnecessary and outdated​ ​ ​
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While mercury amalgam fillings have been a staple in dental practice for many years, the associated health risks and the availability of safer alternatives make it prudent to avoid their use. Patients are encouraged to discuss these concerns with their dentists and consider alternative materials for dental restorations to ensure their long-term health and well-being.
What does it mean to be mercury safe?
While mercury-free dentists no longer place amalgam fillings and use biocompatible alternatives, mercury-safe dentists apply special techniques to remove existing amalgam fillings. In fact, the IAOMT has developed rigorous recommendations for removing existing dental mercury amalgam fillings to assist in mitigating the potential negative outcomes of mercury exposure to patients, dental professionals, office staff, and others.(9)
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The SMART (Safe Mercury Amalgam Removal Technique) method developed by the International Academy of Oral Medicine and Toxicology (IAOMT) is an advanced approach and set of standardized safety measures to remove mercury amalgam fillings safely and reduce the potential exposure to mercury. This technique prioritizes patient safety and environmental protection by minimizing mercury exposure during removal. While following the SMART method, various precautions are taken, such as utilizing a rubber dam to isolate the tooth being treated, providing patients with a nasal mask to prevent inhalation of mercury vapors, and using high-volume suction to capture any mercury particles released during the procedure. Special tools and techniques are also employed to minimize the dispersion of mercury vapor and particulate matter. ​​​
Our patients can rest assured that we follow the entire SMART protocol, and we also have additional safety measures to protect our patients, our team, and our environment. For those who are not our patients but are interested in this procedure, we recommend you use the IAOMT Patient Resources to educate yourself on the protocols so you can ensure your doctor follows all recommended guidelines prior to your procedure. While there is centralized certification, it is up to the doctor discretion to actually follow these recommendations with each procedure, so it is important that patients are well informed so they can appropriately ask questions and advocate for themselves or their family members.
What to Expect Before, During, and After the Procedure?
Pre-Op Consultation & Preparation:
While SMART-certified dentists are all trained in the protocols for the procedure itself, Dr. Rosellini's advanced training in functional medicine allows for more robust screening and preparation prior to the SMART procedure to ensure an optimal clinical outcome. This pre-op consultation includes a deep dive into the patient's whole body functional health, lifestyle, habits, and health history. It is with this information that we build a personalized plan that facilitates the patient's near- and long-term goals. Sometimes that personalized plan includes an immediate SMART procedure; while in other cases, the patient may have better results if they first address issues with their gut health, sleep and breathing, immune system, nutrition and hydration, etc. On occasion, we recommend a patient get additional laboratory tests and/or a consultation with another specialist (functional medicine MD, naturopath, nutritionist, etc) to ensure the patient is sufficiently prepared for next steps. ​
During the SMART Procedure:
Pending how many mercury amalgam fillings that a patient has in their mouth and where in their mouth they are AND the functional health of the patient, we will recommend the SMART procedure be performed on one side of the mouth, one quadrant or "corner" of the mouth, OR one tooth at a time. For the procedure, the patient will be draped head to toe in protective equipment, including a rubber dam to isolate the teeth planned for treatment. There are multiple air evacuation and purification systems used including 3 types of suction, air purifier, and an open window when possible. The patient will be on 100% supplemental oxygen during the removal procedure. The filling will be removed in large chunks to minimize the need for grinding and vaporizing the material. And the tooth will be treated with ozone therapy prior to placement of the biocompatible material.
During the removal part of the procedure, you will see your dental team in gas masks and in full coverage to protect ourselves from the material. We are empathetic to our patients that this can sometimes be physically or mentally/emotionally challenging expterise, so we aim to make it as gentle and efficient as possible.
Post-Op Protocols:
Even after the SMART procedure is complete, it is important that the patient understands how to optimize their healing and ongoing recovery, specifically supporting their detox pathways. This is where having comprehensive pre-op workups can be so valuable because we ideally will know where the patient is potentially deficient in their natural ability to heal and/or just how "sick" a patient may be and how we can best support their systems post-operatively. This can include but may not be limited to supplementation, lymphatic drainage support, lifestyle/behavior modifications, referral to other functional health providers for ongoing support. In general though, most patients will benefit from supporting their body’s essential pathways:​
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Hydration: Drinking plenty of water helps flush toxins from the body.
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Nutritional Support: A diet rich in antioxidants (fruits, vegetables, nuts, and seeds) aids in detoxification.
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Supplementation: Certain supplements, such as vitamin C, vit D3/K2, magnesium, selenium, zinc, omega-3 fatty acids, and activated charcoal, can support the detox process, though you should consult with us or a healthcare provider before starting any new supplement regimen.
Frequently Asked Questions:
Q: Is the removal of mercury amalgam fillings safe?
A: Yes, when performed using the SMART protocol, the removal process is designed to minimize mercury exposure and is considered safe for most patients.
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Q: Will I feel any different after my amalgam fillings are removed?
A: Some patients report feeling a sense of improved well-being after removal, possibly due to a reduction in the body's mercury load. However, individual experiences vary. Immediately after the procedure, a patient may experience sensitivity as anticipated from any routine dental procedure.​
​Q: How do I know if I should have my amalgam fillings removed?
A: If you have concerns about your amalgam fillings or have experienced health issues potentially linked to mercury exposure, we recommend scheduling a consultation to discuss your specific situation.
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Q: What are the alternatives to mercury amalgam fillings?
A: We offer a range of safer, biocompatible materials for dental restorations, including composite resins and ceramic fillings, which are not only aesthetically pleasing but also health-conscious choices.
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For more detailed information on the Safe Mercury Amalgam Removal Technique, or to schedule a consultation, please contact our clinic. Our dedicated team is here to ensure your dental and overall health are cared for in the safest, most holistic manner possible.
Conclusion
As a holistic dental practice, we are committed to prioritizing your overall health. In line with this commitment, we practice the Safe Mercury Amalgam Removal Technique, to ensure that the process of improving your dental health does not inadvertently harm your overall health. We believe in providing dental care that is not only effective but also safe and in harmony with the body's overall well-being.
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REFERENCES:
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1 World Health Organization. Mercury in Health Care [policy paper]. August 2005.
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2 Ibid.
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3 Heintze SD, Rousson V. Clinical effectiveness of direct Class II restorations—a meta-analysis. J Adhes Dent. 2012; 14(5):407-431.
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4 Makhija SK, Gordan VV, Gilbert GH, Litaker MS, Rindal DB, Pihlstrom DJ, Gvist V. Dental practice-based research network restorative material: Findings from the characteristics associated with type of practitioner, patient and carious lesion. J Am Dent Assoc. 2011; 142: 622-632.
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5 Many scientific studies support this, but an example from a reputable government agency is Health Canada. The Safety of Dental Amalgam. 1996: 4. 6 Scientific studies support this fact, but one example of this being reported from a reputable U.S. environmental group is State of Connecticut Department of Environmental Protection. Fillings: the choices you have: mercury amalgam and other filling materials [brochure]. 2006: 3.
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7 Health Canada. The Safety of Dental Amalgam. 1996: 4.
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8 Al-Saleh I, Al-Sedairi A. Mercury (Hg) burden in children: The impact of dental amalgam. Sci Total Environ. 2011; 409(16):3003-3015.
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9 IAOMT. Safe Removal of Amalgam Fillings. Available from: https://iaomt.org/safe-removal-amalgam-fillings/.
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Clarkson, T. W., & Magos, L. (2006). The toxicology of mercury and its chemical compounds. Critical reviews in toxicology, 36(8), 609-662.
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Richardson, G. M., Wilson, R., Allard, D., Purtill, C., Douma, S., & Gravière, J. (2011). Mercury exposure and risks from dental amalgam in the US population, post-2000. Science of The Total Environment, 409(20), 4257-4268.
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