Safe Amalgam Removal Using the SMART Protocol

If you’ve ever wondered whether those old “silver” fillings in your mouth could be doing more harm than good, you’re not alone. Traditional amalgam fillings contain about 50% mercury — a metal known to release toxic vapors when disturbed! This neurotoxin can mess with your nervous system and cause all sorts of health problems.

The International Academy of Oral Medicine and Toxicology (IAOMT) created the Safe Mercury Amalgam Removal Technique (SMART) protocol to solve this problem. It’s a step-by-step method dentists use to remove and replace mercury amalgam fillings as safely as possible.

Keep reading to find out more about mercury fillings, the SMART method, and whether removal is the best option for you!

What You Should Know About Mercury Fillings

Mercury fillings, also called silver fillings, have been the most commonly used cavity fillers in America for over 150 years. They were once considered a breakthrough in dentistry due to their cheap, durable, and easy-to-place nature.

The high mercury level (nearly 50%) in these fillings makes them dangerous, and here’s why. Mercury is not just another metal — it’s a well-known toxin that can release vapors whenever you chew, drink something hot, or grind your teeth.

Mercury toxicity can cause tremors, dementia, autism, miscarriage, immune system dysfunction, and many other health problems.

What Are Amalgam Fillings?

Amalgam fillings are the traditional silver fillings many people have in their teeth to treat cavities caused by tooth decay. Dentists often call them:

Silver fillings
Dental amalgam
Mercury fillings

Many European countries have banned their use, but the American Dental Association (ADA) insists that mercury fillings pose no health risk. Dentists worldwide still use this cheap amalgam in people’s mouths — including children and pregnant women.

They are known to expose people (including children) to poisonous mercury vapors, leading to mercury toxicity. Despite evidence against their use, they are still legal and used frequently in dental care.

Why People Choose to Have Them Removed

People go for amalgam removal mainly because of the high mercury content and the risks of mercury toxicity. In some cases, leaving the fillings in may be the safer option, though, as removing these fillings temporarily increases your mercury exposure. It’s important to consult your dentist to decide if removal is right for you.

Daily activities like brushing your teeth, drinking hot beverages, or grinding your teeth can release mercury vapors you breathe in. Over time, this exposure may contribute to mercury poisoning (or mercury toxicity), which may cause:

Autoimmunity
Alzheimer’s disease
Autism spectrum disorders
Fatigue
Headaches
Heart disease
Memory loss
Kidney problems
Insomnia (with dangerous effects on overall health)
Miscarriage
Motor skill dysfunction
Multiple sclerosis
Personality changes, including anxiety and irritability

Another reason some patients opt for removal is purely cosmetic. The metallic color of amalgam fillings can be distracting, and many prefer a natural, tooth-colored alternative.

Note: Even the World Health Organization (WHO) has recommended that countries begin the process of phasing down the use of mercury amalgam fillings by 2030, especially in vulnerable populations or when other options are available. These recommendations come from the 2013 Minamata Convention.

Safe Removal vs. Standard Removal

Standard amalgam removal typically involves drilling out the filling, which may release harmful mercury vapors.

In contrast, safe removal isolates the tooth and sections the amalgam with focused suction and ozonated water to reduce exposure. Following IAOMT (International Academy of Oral Medicine and Toxicology) guidelines, this method offers a much safer experience overall.

The Best Materials for Your New Fillings

Composite fillings are one of the most common replacements for mercury amalgam. They’re mercury-free, tooth-colored, and blend in naturally with your smile.

Mercury-free or biological dentists may also recommend other biocompatible options, such as:

Composite resin
Porcelain
Zirconium
Glass ionomer
Dental gold

These dental materials are biocompatible, meaning they’re safe for your body. They are also not linked to toxic or allergic reactions associated with mercury and other heavy metals.

woman looking to the left with her hair in a bun

Who Should Have Amalgam Fillings Removed?

If you have concerns about mercury levels, aesthetic preferences, or cracked fillings, then safe removal of amalgam fillings might be right for you!

Exposure to mercury vapors is the highest when fillings are being put in and taken out. Because of this, it is sometimes safer to leave the mercury fillings in.

Risk factors that inform a dentist’s decision to remove include:

Mercury toxicity levels (tests can measure the amount of mercury in your blood)
Teeth grinding (bruxism)
Age of filling
Age of patient
Lifestyle factors

Removal using the SMART method provides a safe experience, but you should always consult with your dentist if you’re pregnant, breastfeeding, or have a sensitivity to heavy metals.

Understanding the SMART Method

The SMART protocol is the safest way to remove mercury amalgam fillings. It uses multiple layers of protection for patients, staff, and the dental environment, including:

A rubber dam to shield your mouth
Disposable covering for the hair and skin of the patient and staff
A HEPA filter and high-volume vacuum above patients
Chlorella and/or activated charcoal to remove traces of mercury
Ozonated water before and after mercury replacements
Dental office air purification system
Oxygen supply to breathe through the nose

Dr. Gerry Curatola is a biological dentist trained and certified by the IAOMT to safely remove toxic fillings following the SMART protocol.

Our dental care specialists at Rejuventation Dentistry will walk you through each step to ensure your comfort and safety.

Step-By-Step: How Safe Removal Works

1. Patient consultation. The process begins with a review of your dental history, the number of fillings, and any sensitivities.
2. Air filtration setup. Before the appointment, your dentist will install an advanced air filtration system and may open windows to reduce mercury in the air.
3. Protective measures for patient and staff. You may receive a slurry of activated charcoal or chlorella. Both staff and patients will wear protective coverings, masks, face shields, and respirators.
4. Nasal air supply & dental dam. You will wear a nasal mask to deliver clean air through the nose. A non-latex dental dam and face/neck barriers prevent mercury from being swallowed or absorbed.

5. High-volume suction and filtration. During the procedure, your dentist will place suction devices, a high-speed evacuation device, and saliva ejectors to capture vapors and particles.
6. Controlled sectioning of the filling. The dentist uses a small-diameter carbide drill to section the amalgam into chunks while applying copious amounts of water to keep the tooth cool. This helps minimize heat and reduce the release of mercury vapors.
7. Thorough rinse and second detox support. After the removal, the dentist will thoroughly flush your mouth with water and will usually give you another slurry of activated charcoal or chlorella.
8. Safe cleanup and disposal. Afterward, the dental staff will carefully dispose of the mercury waste, used protective gear, and sterilize the equipment.

Detoxing After the Procedure

Many patients benefit from a gentle detox protocol after exposure to dental mercury to help the body clear lingering toxins. You can accomplish this by supporting your natural detox systems: sweating, digestion, hydration, and nutrition.

Sweat it out. Aim to break a sweat daily through exercise, a steam room, or an infrared sauna. Always shower afterward to prevent reabsorption through the skin.
Keep digestion moving. Regular bowel movements are key. A high-fiber diet helps, along with avoiding food allergens or anything that disrupts your digestion. This prevents toxins from being reabsorbed into your bloodstream.

Stay hydrated. Drink plenty of filtered water to support your kidneys and overall detox function.

The Best Material for Your New Fillings

Composite fillings are probably the best material for your new fillings. Not only are they mercury-free and side-effect-free, but they are also tooth-colored.

Mercury-free dentists may use the following biocompatible materials for cavity fillings:

Composite resin
Porcelain
Zirconium
Glass ionomer
Dental gold

These dental materials are biocompatible, meaning they do not negatively affect your body like mercury or other toxins and heavy metals. Biocompatible materials are not associated with any allergies or adverse side effects.

greyscale of someone's palms touching together

Dietary Supplements for Detox

Your dentist may recommend specific supplements to assist detoxification. Common options include:

Chlorella
Spirulina (best with barley grass juice extract)
Activated charcoal
Organic sulfur
N-acetyl cysteine
Methionine (dl-methionine)
Zinc, selenium, magnesium
Garlic extract
Cilantro essential oil
Milk thistle
Fiber supplements
Vitamin C, Vitamin E
Glutathione (liposomal glutathione is best)

Foods To Avoid During Detox

You should avoid foods that can add to your toxic load or stress your system, including:

Seafood (particularly tuna and salmon)
Alcohol
Sugar and artificial sweeteners
Chewing gum
Food allergens
Processed foods

Foods to Support Detox

At the same time, you can load up on foods that naturally support detox pathways, including:

High-protein foods
Fresh organic vegetables
Healthy fats (seeds, nuts, egg yolks, avocados, sugar-free yogurt)
Unprocessed oils (avocado oil, sesame oil, flax oil)
Healthy spices (garlic, ginger)
Vitamin C-rich foods
Wild blueberries, celery, apples (skin on)
Plenty of filtered water

What Makes Our Approach Different?

At Rejuvenation Dentistry, we recognize that mercury fillings can create long-term complications. This is especially true for people who grind their teeth or have high exposure to other heavy metals through their job.

As members of the IAOMT, we use advanced equipment and techniques that prioritize both your dental health and overall wellness. We focus heavily on the mouth-body connection because healthy teeth support a healthier system!

Here’s what sets us apart:

Mercury-free and mercury-safe practices
Fluoride-free dentistry
Focus on whole-body health and prevention
The most natural and least invasive treatments possible
Avoidance of unnecessary root canals
Biocompatibility testing for all dental materials
Emphasis on nutrition and lifestyle counseling
Ozone therapy for enhanced healing and protection

FAQs

Why should you use an IAOMT-certified dentist?

The International Academy of Oral Medicine and Toxicology sets safety standards, such as the SMART method, to ensure patients get health care they can be confident in. IAOMT-certified dentists aid in overall health and well-being by utilizing non-toxic materials and best practices.

How much does mercury filling removal cost?

The average cost is between $150 and $900 per filling, depending on the material and any issues with the filling and the materials used.

Where can I get safe mercury amalgam removal?

IAOMT-certified dental offices are the best place to look! Like Rejuvenation Dentistry in NY, these practices will consider your overall health during the removal process.

Experience Safe, Expert Amalgam Removal With Our Team

Removing amalgam fillings helps prevent exposure to mercury, a known neurotoxin. Dr. Gerry Curatola and his team provide safe, biological dentistry at Rejuvenation Dentistry in New York, NY.

Rejuvenation Dentistry’s founder, Dr. Curatola, has been featured on The Dr. Oz Show to discuss the dangers of mercury fillings. The International Academy of Oral Medicine and Toxicology (IAOMT) also recognizes him as a trusted leader in safe mercury removal.

With advanced training, state-of-the-art technology, and a commitment to individualized care, our team makes your safety the highest priority.

Schedule an appointment with Rejuvenation Dentistry to support your oral health with safe, evidence-based biologic dental procedures.

Sources

Beltrán-Aguilar, E. D., Thornton-Evans, G., Wei, L., & Bernal, J. (2023). Prevalence and mean number of teeth with amalgam and nonamalgam restorations, United States, 2015 through 2018. Journal of the American Dental Association (1939), 154(5), 417–426. Abstract: https://jada.ada.org/article/S0002-8177(23)00112-5/abstract
Mutter, J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. J Occupational Medicine and Toxicology 6, 2 (2011). Full text: https://doi.org/10.1186/1745-6673-6-2
Bártová, J., Procházková, J., Krátká, Z., Benetková, K., Venclíková, Z., & Sterzl, I. (2003). Dental amalgam as one of the risk factors in autoimmune diseases. Neuro endocrinology letters, 24(1-2), 65–67. Abstract: https://pubmed.ncbi.nlm.nih.gov/12743535/
Jirau-Colón, H., González-Parrilla, L., Martinez-Jiménez, J., Adam, W., & Jiménez-Velez, B. (2019). Rethinking the Dental Amalgam Dilemma: An Integrated Toxicological Approach. International journal of environmental research and public health, 16(6), 1036. Full text: https://www.mdpi.com/1660-4601/16/6/1036
Geier, D. A., Kern, J. K., & Geier, M. R. (2009). A prospective study of prenatal mercury exposure from maternal dental amalgams and autism severity. Acta neurobiologiae experimentalis, 69(2), 189–197. Abstract: https://ane.pl/index.php/ane/article/view/1744
Genchi, G., Sinicropi, M. S., Carocci, A., Lauria, G., & Catalano, A. (2017). Mercury exposure and heart diseases. International journal of environmental research and public health, 14(1), 74. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC5295325/
Reinhardt J. W. (1992). Side-effects: mercury contribution to body burden from dental amalgam. Advances in dental research, 6, 110–113. Abstract: https://doi.org/10.1177/08959374920060010201
U.S. Environmental Protection Agency. (2024, December 5). Health effects of exposures to mercury. Full text: https://www.epa.gov/mercury/health-effects-exposures-mercury
Björkman, L., Lygre, G. B., Haug, K., & Skjærven, R. (2018). Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort. PloS one, 13(12), e0208803. Full text: https://doi.org/10.1371/journal.pone.0208803

Fisher, J., Varenne, B., Narvaez, D., & Vickers, C. (2018). The Minamata Convention and the phase down of dental amalgam. Bulletin of the World Health Organization, 96(6), 436. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC5996207/