Safe Mercury Removal Protocols

Why Safe Removal Matters

The average amount of mercury vapor released during filling removal far exceeds the maximum safety levels set by government regulatory agencies (including OSHA and the World Health Organization). Once vaporized, 80% of the mercury enters the body by inhalation and absorption through the lungs. It is both odorless and invisible.

To minimize the risk to both patient and dental team members, protocols were developed primarily targeting mercury vapor but also controlling small, easy-to-swallow pieces.

Since the removal process releases vaporized mercury, very careful measures must be taken to prevent inhalation. Particulate matter must be controlled as well.

Strict protocols, as established by the IAOMT, using intra-oral barriers, an external oxygen source, high-speed intra-oral and extra-oral suction, plus building air exchangers, are all part of the process. This is definitely the case at Cahill Dental Care.

Safe Amalgam Filling Removal Protocols

At Cahill Dental Care, the doctors realize that the controversy regarding mercury and amalgam fillings is not going to be resolved in the next several years, so they have adopted a pragmatic mercury-free and safe approach that will protect patients and office staff by instituting the following protocols:

• Per the mercury-free IAOMT protocol, all restorations are removed using the “Cool, Cut and Chunk” technique in a mercury-free and safe environment. Water spray keeps mercury fillings cool during removal to reduce mercury release. Cutting fillings into large chunks speeds removal and limits the quantities of mercury vapor that would be released if the entire filling mass were pulverized.
• High-volume intraoral suction is used immediately adjacent to the tooth.
• A high-capacity extra oral scavenger is used near the patient’s mouth to pull large amounts of air across the work area and away from the patient.
• External air exchangers control ambient air quality by circulating outside air and discharging it outside the building.
• Bio-compatible tooth-colored restorations are used to repair damage caused by decay (cavities) in all children and all adults meeting established criteria.
• CEREC Same-Day porcelain onlays and inlays are available for badly damaged teeth or for patients desiring more permanent restoration than composite materials can provide.

Additional Protocols for Sensitive Patients

• Rubber dam barriers to prevent amalgam particle ingestion.
• High power suction on the patient side of the rubber dam.
• Supplemental oxygen for the patient.
• Surgical drapes to protect the skin.
• HgX: an industrial-strength mercury-binding cream.
• Mercury chelating rinses following mercury removal.