Mercury Filling Removal

The old silver, metal fillings, also known as Amalgam fillings, contain more than 50% mercury. Mercury is a very toxic substance to the body. Mercury can be released into the body in several different ways including: chewing, drinking hot liquids, and teeth grinding. But one of the most dangerous ways it is released is through the removal of amalgam fillings.

We can replace these old fillings with porcelain or composite resin materials. Dr. DiNola and Dr. Clister have been trained in the technique of safe mercury/ amalgam removal. Dr DiNola is a member of the I.A.O.M.T. (International Academy of Oral Medicine and Toxicology). Dr. Clister is a member of IABDM (International Academy of Biological Dentistry & Medicine). The removal of amalgam fillings in the safest manor is our ultimate goal.

Holistic or biological approach using non-toxic restorative materials for dental work is another central philosophy we share. Overall health of our patients is The Dental Wellness Center’s priority.  Removal of mercury fillings safely, to prevent toxic mercury from being released into the body, is something we believe all dental practices should be doing, and are not currently required to do so. Well trained Dentists have studied techniques that utilize specialized equipment to minimize vapor and particle exposure.  We have a special air filtration system that is utilized along with supplemental oxygen for the patient. Another valuable layer of protection comes from our negative ion generator, which creates a field that a more purified quality of air. The dentists and staff also wear special safety masks to help eliminate possible vapor inhalation.  Special suction devices are also utilized during the removal procedure.

The various safety protocols utilized at the Dental Wellness Center adheres to those recommendations set forth by IAOMT (International Academy of Oral Medicine and Toxicology) and aspects of the Huggins Alliance. The IAOMT is a membership organization comprised of dental, medical, and research professionals involved in peer reviewed scientific research, education and promotion of biologic dentistry. This removal protocol can vary from dentist to dentist, but ultimately is designed and set forth to ensure the utmost safety for the patient, the doctor and the staff

Removal Guidelines are as follows:

1. Oral activated charcoal: there is some evidence that activated charcoal taken 10-15 min prior to amalgam removal can bind smaller particles of mercury is inadvertently swallowed., We consider this step an added value or another layer of protection, however very little elemental or inorganic mercury is absorbed thought the intestine.

2. Protective barriers: covering the patients face and clothing with protective barrier will prevent mercury particles from landing on the skin, clothes, or the eyes.

3. Use of a dental dam: a dental dam isolates the tooth or teeth that are being worked on. Some mercury free dentists don’t believe that this is absolutely necessary, but it’s our opinion that the dental dam is essential for the safe removal of mercury amalgam fillings. Even though mercury vapor can pass through the dental dam, we believe that the dental dam makes it easier to evacuate the filling material and prevent amalgam particles from being swallowed.

4. Keep the fillings cool during removal: removing amalgam fillings generates a tremendous amount of heat, which causes an increase in the release of mercury, both as vapor and as amalgam particles, during the entire removal process. Cooling the filling with water and air during this process dramatically reduces the amount of mercury vapor the filling releases.

5. High-volume evacuation (HVE): A special suction tip is used to remove the amount of aerosol spray and also helps capture more of the mercury vapors and particles.

6. Dental Air-Vac: A special air filtering system and evacuation suction is placed as close to the patient’s mouth as possible during the removal. This dental vacuum is very helpful in removing the mercury vapors.

7. Provide the patient, doctor and staff with alternative air source: We believe it’s best to provide the patient with an alternative air source while their amalgam fillings are being removed. This isn’t necessary after the removal process has been completed, when the tooth is being prepared for the new filling, and while the new filling is being placed. During the actual amalgam removal, the patient, doctor and assistant place an oxygen canella in the nose which receives its oxygen source from a tank. The patient is asked to breathe through the nose and avoid breathing through the mouth while the fillings are being removed.

8. Air Ionizer system: The office and dental operatory should be well ventilated. We feel reducing mercury exposure is just as important for the dentist and staff as it is for the patient. This two part system helps to capture the mercury vapors that get released during the removal process.

9. Remove gloves and dental dam and clean the patient’s mouth: once the amalgam fillings have been safely removed, the dentist and the assistant remove their gloves and the dental dam, and thoroughly rinse and vacuum the patients’ entire mouth for at least 30 seconds. The patient should make every effort not to swallow during this process.

10. Sulfur cream:  We apply a special material under our gloves which captures vapor partials.


"Excellent service with quality work.  Enough to have my entire family attend Dr. DiNola's office.  The staff is wonderful and very friendly.  I would definitely recommend my dentist!!"

Anjelica Aguilar, Cumberland, MD