basics of Safe Mercury amalgam removal Technique (SMART) in 2022

SMART is the abbreviation of Safe Mercury Amalgam Removal Technique. It is actually a set of recommendations and not any hard and fast rule. Licensed oral health practitioners are at their liberty to exercise their own sound judgement as far a particular treatment option is concerned to apply on their patients.

A renowned dentist with years of experience in amalgam removal in London explains certain things about the procedure in the paragraphs below. This effort is expected to shed enough light on the procedure.

First let us start with little history. This protocol recommendation on safe amalgam removal was last updated on July 2019. It was on July 2016 this protocol recommendation was officially renamed as the Safe Mercury Amalgam Removal Technique or SMART. A training course was launched at the same time for dentists to be certified in SMART.

Every dental amalgam restorations contain more or less 50% mercury. Extensive researches confirm these fillings emit mercury vapour. This mercury vapour in some way or the other makes a negative health impact not only on patients but also on dentists, dental staffs and other dental professionals. Even foetus in the womb is not spared by the negative impact of mercury vapour.

Harmful mercury vapour is released at higher rates while brushing, chewing, clenching and cleaning of the teeth. It is also released while placement, replacement and removal of mercury amalgam fillings in the tooth. On basis of the scientific evidence that is available, the IAOMT has come up with extensive safety recommendations to remove existing dental mercury fillings. The recommendations also look into the aspect of detailed protective measures meant to be utilised for the removal procedure.

The recommendations that have been proposed include standard measures like use of masks, water irrigation and high volume suction. In addition that there are many other additional protective measures as well. Now let us explore a bit the SMART protocol.

Basics of the SMART protocol

In order to collect mercury waste, an amalgam separator has to be installed properly followed by its utilisation and maintenance. This ensures the harmful substance is not released into the environment from the standard waste of a dental office.
The Smile Clinic London is one of safest places for hazard-free amalgam removal all over London. The practice is located on the West End Lane. Experienced and knowledgeable dentists associated with the practice opine, every room that is used for mercury fillings must have sufficient air filtration system in place. This will ensure fast removing of both mercury vapour and amalgam particles that are unavoidably generated during mercury filling removal.
Furthermore, the dentists suggest, if possible then windows in the room should be left open. This will bring down the concentration of mercury in the indoor air.
Absorbents like a slurry of chlorella, charcoal or anything else of similar category is to be given to patients for rinsing as well as swallowing before starting of the amalgam removal procedure.
Protective gear in forms of appropriate gowns and covers are essential for the dentist as well as the dental nurses and the patient. Everyone present inside the room should better be under proper protection. Sufficient quantities of particles will be generated during the procedure. A significant portion of those can settle on the arms, face, palms, neck and other parts of the anatomy of the individuals present inside the room.
The dentist and his or her team must have the palms covered with non latex nitrile gloves throughout the procedure.
Shields for the face as well as covering for the hair or head must be used by the dentist as well as the entire support staffs present in the room.
Properly sealed respiratory grade mask that is rated to capture mercury vapour should be worn by dentist and dental nurses present inside the room during the procedure.
The skin and clothing of a patient must be protected from amalgam particles and mercury vapour. A full body impermeable barrier along with a complete head, neck and face barrier need to be used.
The patient must be provided with external air or oxygen through a nasal mask to ensure the patient avoids inhaling mercury vapour as well as amalgam particles while undergoing the procedure. As a reliable alternative, a nasal cannula can be used but in that case it is important to make sure that the nose remains totally covered with an impermeable barrier.
A dental dam has to be placed and sealed inside the patient’s mouth before starting of the procedure. The dental dam should be made from non latex nitrile material.
In order to ensure the patient is less exposed to mercury, a saliva ejector can be placed under the dental dam.

The safety measures and precautions mentioned above are aimed to benefit everyone – a dentist, a patient and dental nurses or support staffs. Now the point is how can you get your amalgam removed safely without being exposed to the harmful vapour as well as the minute particles?

You may go online and search with strings like “safe amalgam removal near me”. A lot of people are applying this strategy and are getting positive results.