Welcome to my practice. I am Dr. Bruce Vafa, and today I want to have an honest, detailed conversation about a topic that sits at the very heart of holistic dentistry: your fillings. Specifically, those silver-colored fillings that many of us received years ago.

If you have these fillings, you might have heard them referred to as “silver fillings.” However, that name can be a bit misleading. While they look like silver, they are actually composed of a mixture of metals, primarily mercury. In fact, dental amalgam is approximately 50% mercury by weight. This is a concern for many of my patients who are becoming increasingly aware of what goes into their bodies and how it affects their overall wellness.

As a holistic dentist, my priority isn’t just fixing teeth; it is ensuring that your oral health supports your systemic health. This brings us to a critical procedure we perform here: the safe removal of these fillings. It is not enough to simply drill them out. Doing so without the right precautions can release significantly high levels of mercury vapor, which is harmful to you, the dental staff, and the environment. This is why I strictly adhere to the Safe Mercury Removal Protocol, commonly known as SMART.

Understanding the Need for SMART

You might be wondering, “Dr. Vafa, if these fillings have been in my mouth for years, why worry about taking them out now?” It is a valid question. Over time, amalgam fillings can crack, leak, or wear down. But the biggest concern during the replacement process is the release of mercury vapor.

When a dentist drills into an amalgam filling using standard methods, friction creates heat. This heat causes the mercury within the filling to turn into an invisible, odorless, and tasteless gas. Without protection, this vapor can be inhaled or absorbed by the body. Research has shown that mercury is a neurotoxin, and minimizing exposure is paramount for health.

Data Point: According to the International Academy of Oral Medicine and Toxicology (IAOMT), drilling out amalgam fillings without safety measures can release particulate matter and mercury vapor in concentrations that significantly exceed safety limits established for occupational health.

Because of this, I don’t just “remove” fillings. I follow a rigorous, science-based safety system. This system is designed to drastically reduce the amount of mercury exposure during the Amalgam Removal process.

The SMART Protocol: A Step-by-Step Breakdown

The SMART protocol was developed by the IAOMT to protect patients and dental teams. It involves a series of specific safety measures that act as layers of defense. When you come to me for this procedure, here is exactly what you can expect.

1. Pre-Procedure Rinse and Protection

Before we even begin the actual work, we start with preparation. I will ask you to rinse with a charcoal slurry or a chlorella mixture. Activated charcoal is excellent at binding to toxins. If any microscopic particles were to get into your mouth during the procedure, the charcoal helps catch them before your body can absorb them. It is a simple step, but it sets the stage for a safe procedure.

2. Protective Body Barriers

You have probably worn a paper bib at the dentist before. For SMART Amalgam Removal, we take this much further. I will cover your upper body with an impermeable barrier. This isn’t just to keep your clothes clean; it ensures that no mercury particles land on your skin or clothing, where you might accidentally carry them home. We also cover your face, leaving only the mouth exposed, to protect your skin from vapor and splatter.

3. External Air Source

Breathing clean air is the most critical part of this protocol. I cannot stress this enough. During the removal, you will not be breathing the air in the room right in front of your mouth. Instead, I will provide you with a nasal mask that delivers 100% pure oxygen or clean air from an external tank. This ensures that while we are working on your tooth, you are inhaling fresh, clean air, bypassing any potential vapor being generated near your mouth.

4. The Dental Dam (Rubber Dam)

We use a non-latex dental dam for every removal. This is a protective sheet that isolates the tooth we are working on from the rest of your mouth. It acts as a physical wall. It prevents mercury chips or particulate matter from falling into the back of your throat, being swallowed, or touching your gums and cheeks. It is sealed tightly to ensure nothing slips past it.

5. High-Volume Filtration and Suction

This is where the technology really shines. We use a high-volume aerosol suction device. You might hear us call it an “elephant trunk” or a Dental Air Vac. This large suction tube is positioned very close to your face. It creates a powerful vacuum that pulls the air away from the operating field continuously. It captures mercury vapor and particles at the source before they can spread into the room.

Additionally, inside your mouth, we use a specialized high-volume evacuator tip. This isn’t the standard saliva ejector you might be used to. It is much more powerful and is essential for capturing water, spray, and debris instantly.

6. The Chunk Removal Technique

The technique I use to actually remove the filling is very specific. In traditional dentistry, a dentist might grind the filling away, turning the whole thing into dust. That creates a massive amount of vapor. Instead, I use a thin bur to cut the filling into large chunks. By sectioning the filling, I can pop it out in big pieces. This “chunking” method drastically reduces drilling time and, consequently, reduces the amount of vapor released.

7. Copious Water Irrigation

Heat is the enemy here. Heat causes mercury to vaporize. To combat this, we use large amounts of water while drilling. This keeps the tooth and the filling cool. The water also helps to weigh down particles so they can be easily suctioned away rather than floating into the air.

Protecting the Environment

My commitment to safety extends beyond the dental chair. We have to consider where that mercury goes once it leaves your mouth. We cannot simply wash it down the drain, as it would eventually contaminate our water supply and harm wildlife.

Data Point: The EPA estimates that dental offices are responsible for a significant portion of the mercury found in wastewater treatment plants. To combat this, regulations now require the use of amalgam separators, which capture mercury waste before it enters the sewage system.

In my office, we utilize advanced amalgam separators. These devices filter the water from the suction lines, trapping the mercury particles so they can be disposed of as hazardous waste properly and legally. By choosing a dentist who uses SMART, you are also making an environmentally responsible choice.

Why Air Quality in the Office Matters

You might notice large air filtration units in my treatment rooms. These aren’t just standard fans. We use high-efficiency air filtration systems designed to remove mercury vapor and other contaminants from the ambient air. This protects you, but it also protects me and my dedicated staff. We perform these procedures regularly, so maintaining a mercury-free environment is essential for our long-term occupational health.

For more information on the regulations and science regarding dental amalgam, you can visit the FDA’s page on Dental Amalgam. It is important to look at high-authority sources when making decisions about your health.

Replacing the Silver: The Biocompatible Upgrade

Once the amalgam is safely removed, we don’t just leave a hole in your tooth. This is the exciting part! We get to restore your tooth with materials that are not only safer but also look just like your natural enamel. I use biocompatible composite resins or ceramics.

These modern materials have several advantages over the old metal fillings:

• Bonding Strength: Unlike metal, which sits in a pocket in your tooth, composite bonds directly to the tooth structure. This can actually strengthen the remaining tooth and prevent future fractures.
• Aesthetics: The new filling will be color-matched to your existing teeth. When you laugh or yawn, no one will see a dark grey spot. They will just see a healthy, white smile.
• Less Sensitivity: Metal is a conductor of heat and cold. Many patients find that their old metal fillings make their teeth sensitive to ice cream or hot coffee. Composite materials are insulators, which often reduces this temperature sensitivity.
• Conservation of Tooth Structure: Because we bond the material, I often have to remove less of your natural healthy tooth structure compared to what was required for amalgam fillings.

Is SMART Amalgam Removal Right for You?

I find that patients seek out Amalgam Removal for many reasons. Some do it strictly for cosmetic reasons—they are tired of the dark look of metal in their mouths. Others are directed to my office by their physicians or naturopaths as part of a larger detoxification strategy. And many simply want the peace of mind that comes with knowing they no longer have mercury in their bodies.

It is important to note that removing fillings is a personal medical decision. During your consultation, we will look at the condition of your current fillings. If they are structurally compromised, leaking, or if there is decay underneath them, removal is usually the clear clinical choice. If you are removing them for holistic health reasons, we will discuss the protocol to ensure you feel comfortable and informed every step of the way.

The Holistic Difference

When you choose a holistic dentist, you are choosing a practitioner who looks at the big picture. I treat the patient, not just the tooth. The SMART protocol is a perfect example of this philosophy in action. It acknowledges that dental procedures have systemic effects. It respects the biology of your body and the delicate balance of your health.

I have invested in the training and equipment for SMART because I believe it is the gold standard of care. I want you to leave my office healthier than when you arrived, without the burden of unnecessary toxic exposure.

Taking the Next Step Toward Wellness

Navigating the world of dental health can sometimes feel overwhelming, but you do not have to do it alone. If you have silver fillings and are concerned about the mercury content, or if you simply want to restore your smile to its natural beauty, I am here to help.

By using the Safe Mercury Removal Protocol, we can ensure that your journey to a metal-free mouth is safe, comfortable, and effective. Your health is your most valuable asset, and protecting it is my highest priority. Let’s work together to create a smile that is not only beautiful but also supports your overall well-being for years to come.