Questions For Your Dentist About Removing Mercury Amalgam Fillings

Background: The IAOMT and its members are very concerned about excess exposure to mercury when old amalgam fillings are removed. The process of drilling out amalgam fillings liberates quantities of mercury vapor and fine particulates that can be inhaled and absorbed through the lungs. We have developed some simple methods for reducing this exposure, which all members of the IAOMT should be aware of. Accredited members, Fellows and Masters are all certified as being proficient in safe amalgam removal techniques. For more information, see the article, “Safe Removal of Amalgam Fillings” in the Featured Articles section of this website.

If your dentist is not an Accredited IAOMT member, ask these questions:

1. What is your position on the mercury issue? How much knowledge do youpossess about mercury?
   If a dentist is knowledgeable about the mercury issue and understands mercury biochemistry, it is likely they will take the removal process seriously. Be concerned if you hear, "I don't think the mercury in fillings is a big deal, but I'll take it out if you like. This is probably a dentist that isn't very concerned about removal protocols.

2. Do you use a rubber dam when removing amalgam?
   The rubber sheet greatly reduces the amount of particulates that go down the throat.

3. Is your suction system powerful and efficient? Do you use a special tip (such as "Clean Up," available from IAOMT) or its equivalent?
   Utilizing an efficient suction system in the oral cavity with a specialized adaptor or its equivalent is necessary to contain the mercury vapor and amalgam particles.

4. Do you apply copious amounts of water to the filling upon removal?
   Large amounts of water help contain the mercury vapor and fine particulate matter, as well as, cool the filling.

5. Do you remove the mercury/amalgam filling in large sections?
   By using a very thin bur and reducing the amount of drilling, the amount of mercury and fine particulates is minimized.

6. Do you utilize alternative air sources and/or equipment to reduce mercury inhalation?
   The dentist should employ one or more methods to prevent the patient from inhaling the mercury vapor and fine particulate matter.