Outlook on Dentistry – Safe Protocol for Amalgam Removal

January 12, 2017
Outlook on Dentistry – Safe Protocol for Amalgam Removal

Dentistry is not exempt from controversy. 

Much time is spent in dental offices examining heavy metals and materials compatibility with patients.  When there are over 300 different materials to choose from when performing repairs to the teeth, it’s important to know which are most suitable.

This is done all the time in nutritional counselling…it’s called menu planning.  Fitting the right foods to meet patient needs and preference makes perfect sense.

So when physicians and scientists scorn heavy metals with special attention paid to the dangers of mercury, how is it that dentistry continues to use mercury-based fillings?

Fortunately, it’s not for us to justify the practice.  We do however go out of our way to recommend to patients that if they have silver mercury fillings they ought to consider having them removed, especially if medical tests reveal a high mercury level.  

And they should be removed following accepted safe protocols.  While in the mouth, these fillings are a potential hazard.  Being removed is a good thing, but there are risks in not performing the removal properly.

Before starting, the patient is seen for an initial exam by the medical doctor or naturopath to evaluate the overall health of the body and the body’s ability to eliminate toxins.  Oral examinations by the dentist will evaluate the wear of the teeth and degree to which the mercury fillings have become worn, corroded, have open margins or possible fractures. 

Some dentists will use an amalgameter to measure the electrical output or voltage being created by the metals.  They note the electrical charge is similar to having an active battery operating in the mouth.

In those cases where high volumes of amalgam absorption have occurred, patients have reported symptoms consistent with depression, lethargy and brain fog – which is verified in the scientific literature as among the health risks associated with mercury.

The following procedures are mindful of the fact mercury vapours can be absorbed quickly through the blood-brain barrier and present an immediate health risk.  Safe protocols for amalgam removal include a multi-barrier approach as follows:

  1. An initial examination and medical and dental health history is completed
  2. Detoxification supplements are helpful and Vitamin C intake is recommended
  3. Chairside procedures involve layers of protective covering including a plastic apron under the dental bib and a dental ‘dam’ constructed inside the mouth around the teeth 
  4. The patient’s face is draped around the dam – including goggles and nasal mask providing oxygen. A mercury vapor ionizer is also turned on
  5. Underneath the dam is an activated charcoal filter to intercept particles and chelate dissolved metals that may seep below
  6. New machining instruments are used with the handpiece in combination with high volume suction and water spray
  7. If possible the amalgam is sectioned and scooped to reduce the mercury vapour release
  8. Once the removal is completed the protective layers are removed, and the tooth can then be restored to a healthy state of form and function
  9. This may or may not include compatibility testing for most-appropriate materials; experience has shown that with the removal of the amalgam, patients’ tolerances for a wider variety of materials increases
  10. Studies have shown successful removals have some important short-term effects to compliment the longer-term health benefits:
    1. The metallic taste in the mouth is gone
    2. Patients feel they have more energy
    3. A ‘lightness of being’ and sense of release from the dread of depression
    4. A greater therapeutic effect from nutritional initiatives and supplements

This is one of our Outlook on Dentistry series and we encourage feedback and questions at any time.

Rosemary Whiteside, CNP