Safe Amalgam Removal: Protocols and Procedures Followed by Biological Dentists

Amalgam fillings, also known as silver fillings, have been a popular choice in dentistry for their durability and affordability. They consist of a mixture of metals, including elemental mercury (50%), silver (20-35%), tin (12-30%), copper (2-15%), and traces of other metals. 

Concerns have been expressed over the release of mercury vapor from dental fillings when placed, removed, chewed upon, or exposed to temperature changes and temperature shifts. 

Elemental mercury contained within amalgam fillings may release as a vapor that can be inhaled or swallowed and eventually be absorbed by the bloodstream for distribution throughout the body. 

Although mercury released from amalgam fillings is generally considered safe by regulatory bodies, certain individuals may have specific health concerns that necessitate its removal. Now let’s review what methods biological dentists employ for safely extracting amalgam.

Pre-Removal Evaluation

Prior to initiating amalgam removal procedures, biological dentists conduct an in-depth evaluation of both oral and systemic health. This evaluation includes an in-depth examination of teeth, gums, and surrounding oral tissues, as well as reviewing medical/dental histories. 

Diagnostic tools, including dental X-rays, intraoral cameras, and biocompatibility testing, may be utilized to assess the condition of teeth, detect any underlying issues and examine surrounding tissues as well as to identify potential allergies or sensitivities.

An assessment allows your biological dentist Houston TX to customize a treatment plan tailored specifically to your individual needs and concerns.

Isolation and Protection

Proper isolation and protection protocols during amalgam removal are vital in order to minimize mercury vapor release as well as amalgam particles being inhaled.  

Biological dentists employ various techniques and equipment to establish a barrier and limit dispersion of mercury vapors and debris. One popular solution is using a rubber dam – an elastic membrane made of latex or non-latex material over the tooth being treated. 

It isolates a tooth from its surrounding oral environment, preventing debris and vapor from entering your mouth or being swallowed by swallowing, while high-volume suction devices are used to evacuate any aerosols generated during extraction and capture particles efficiently. 

Dental staff also utilize PPE such as gloves, masks, and protective eyewear in order to reduce their own exposure to mercury vapor and amalgam particles. A nasal mask or respirator should also be worn by both patient and staff to further decrease exposure.

Safe Removal Techniques

Safe amalgam removal techniques are designed to minimize mercury exposure and promote patient well-being. These techniques include:

Non-Drilling Approach

Rather than using high-speed drills that generate heat and aerosols, biological dentists often opt for a non-drilling approach to minimize the risk of mercury vapor release. 

They may use hand instruments, such as dental excavators, to gently separate the amalgam filling from the tooth structure.

Sectioning Technique

In cases where amalgam fillings are large or deeply seated, biological dentists may employ a sectioning technique.

This involves dividing the filling into smaller portions, making it easier to remove without excessive drilling. By reducing drilling, the release of mercury vapor can be further minimized.

Continuous Water Spray

During the removal process, a continuous water spray is used to keep the area cool and control any potential heat generated. The water spray also serves to reduce the formation of aerosols and minimize the release of mercury vapor.

Localized Vacuum System

Biological dentists may utilize localized vacuum systems placed near the tooth being treated. These systems help capture any debris or vapor generated during the removal process, preventing their dispersion in the air.

Air Filtration and Ventilation

Biological dentists employ various measures to minimize the dispersion of mercury vapor and particles, including:

High-Efficiency Particulate Air (HEPA) Filters

HEPA filters are used in the dental office to capture and filter out airborne particles, including potential mercury vapor and debris. These filters are highly effective in trapping microscopic particles, promoting cleaner and safer air quality.

Additional Air Purification Systems

In addition to HEPA filters, biological dentists may employ additional air purification systems, such as activated carbon filters or ionizers, to further enhance air quality and remove any potential contaminants.

Ventilation System Optimization

Dental offices practicing safe amalgam removal have well-designed ventilation systems in place. These systems ensure proper air exchange, reducing the concentration of airborne contaminants. Ventilation is carefully adjusted to create negative pressure within the treatment area, preventing the spread of mercury vapor to other parts of the office.

Mercury Detoxification and Aftercare

After amalgam removal, biological dentists may recommend specific detoxification protocols and aftercare measures to support the body’s natural detoxification processes and promote healing. These measures may include:

Nutritional Support

For optimal detoxification pathways and overall oral and systemic health, eating foods high in antioxidants like fresh fruits and vegetables, as well as taking supplements like Vitamin C, Selenium, or Glutathione Precursors, is highly recommended. These nutrients help support detoxification while strengthening antioxidant defenses in the body.


Staying well hydrated is crucial for effective detoxification, so patients are encouraged to drink plenty of filtered water each day to aid the flushing out of toxins from their system while simultaneously supporting optimal oral and systemic health.

Oral Hygiene

Maintaining good oral hygiene practices is emphasized post-amalgam removal. You’re advised to use non-toxic toothpaste and mouthwash that are free from harmful chemicals such as sulphates, artificial sweeteners, and triclosan. Regular brushing and flossing are encouraged to remove any residual debris and maintain a clean oral environment.

Follow-up Assessments

Biological dentists typically schedule follow-up assessments to monitor the patient’s oral health and overall well-being after amalgam removal. These assessments may include clinical examinations, dental X-rays, and biocompatibility testing to ensure the absence of any adverse reactions or complications. Regular monitoring allows dentists to address any concerns promptly and provide appropriate treatment if needed.

Material Selection for Tooth Restoration

Biological dentists prioritize the use of biocompatible materials for tooth restoration after amalgam removal. Common options for tooth restoration may include:

Composite Resins

Composite resins are tooth-colored materials composed of a mixture of plastic and glass particles. They provide a natural appearance and can be bonded directly to the tooth structure. Composite resins are free from mercury and are considered an alternative to amalgam fillings.

Ceramic Restorations

Restorations made of porcelain, zirconia, or lithium disilicate are highly biocompatible materials with excellent aesthetic and durability properties. They are custom-crafted in dental labs to match the color and shape of your natural teeth and are constructed from ceramic.

Biocompatible Metal-Free Options

If you have metal sensitivities, you can opt for non-metallic solutions like zirconia or composite materials as biocompatible alternatives that also provide strength and durability. These materials offer exceptional biocompatibility as well as aesthetic appeal. Choice of material depends on a number of factors, including its location, extent, and the patient’s preferences. 

Patient Education and Informed Consent

A crucial aspect of safe amalgam removal is patient education and obtaining informed consent. Biological dentists take the time to provide detailed information to patients, allowing them to make well-informed decisions. This includes:

Explanation of the Procedure

Dentists provide you with an overview of the amalgam removal procedure, outlining its techniques and equipment, as well as discussing steps taken to minimize mercury exposure.

Risks and Benefits

Dentists provide you with a thorough overview of all potential risks and benefits associated with amalgam removal as well as alternative restoration materials so that you can make informed decisions according to their unique situations.

Alternative Treatment Options

Biological dentists discuss various materials available as possible treatments and the potential outcomes and benefits associated with each material.

Aftercare Instructions

Dentists provide detailed aftercare instructions, including recommendations for oral hygiene, dietary considerations, and any specific precautions to take following amalgam removal.

Final Thoughts

Amalgam fillings are an increasingly popular type of dental fillings, yet their mercury-releasing nature may pose risks to health. When considering having them removed, it is crucial that you consult a biological dentist. They will help explain all potential risks and benefits as well as devise a safe treatment plan designed specifically for you.