The amalgam removal process needs to be very safe. The drilling on the silver-mercury filling releases a tremendous amount of mercury vapor. It is essential, especially if you have higher sensitivity to toxic substances that you are well-protected during this highly critical phase of the treatment.
We have two different protocols. One is a protocol that is advocated by the International Academy of Oral Medicine and Toxicology, and we have another protocol that is even more stringent that the Academy's. With either protocol we create an extremely safe environment where we are practically eliminating the exposure of the patient to mercury during the removal phase.
For example, one approach that I use is to place a rubber dam with a special ring around the tooth that has the silver-mercury filling, then squeeze a flowable composite material that literally flows between the rubber dam and the tooth
and the clamp. Then we use a light on it and it becomes solid so that a one-hundred percent seal is accomplished.
The seal is tested with water and air to check that nothing seeps in and that we do have a perfect seal.
Next an oxygen mask is placed on the patient's nose. We use a minimum of two very high-speed vacuum systems, one custom-manufactured for our office and the other is the high-speed suction that evacuates the material into a system which traps all the debris, such as the silver-mercury filling.
This is what we term "mercury-safe" dentistry. Just being "mercury-free" is not sufficient to protect the patient because it's also important to practice in the "mercury-safe" environment.
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