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We
have been asked on many occasions by concerned patients how we go about
removing dental amalgams for individuals who are concerned about the
release of mercury vapour during this process. This page outlines what
we do, again this area is controversial but we have based our amalgam
removal protocol on the best available evidence.
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An
activated charcoal solution is available before the procedure
starts
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Ventilation – the surgeries are kept well ventilated with a good supply
of fresh air
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Dampened eye patches and safety glasses to
protect you from debris and mercury vapour
while we work.
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Keeping fillings cool- it is known that if you heat an amalgam
restoration then the level of mercury vapour released will increase-
for that reason we use lots of water and air to
create a "cooling mist" around the
tooth while we work
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Special burs- most dental drills grind teeth or fillings away.
If you are concerned about mercury and dental amalgam this
approach is not ideal as it generates heat
which increases the release of mercury vapour. the
Grinding approach also creates lots of very small amalgam
particles which are harder to vacuum away
and are more likely to be swallowed, something that we want
to avoid. The solution is to use special
burs designed to cut the filling cleanly as well as a protocol called
chunking to remove the old filling in as few
(large) pieces as possible.
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High
volume suction is used to remove mercury vapour, and debris as the
filling is removed. Our practice has 2 of the
most moderns suction units available to ensure that the maximum
amount of amalgam debris is safely removed as we work.
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Rubber
dam – a rubber shield is used to catch any debris that is not
immediately caught by the suction unit, meaning that far less amalgam
debris will come into contact with the soft tissues of your mouth. This
stage is controversial as some think that the
rubber dam may allow mercury vapour to build up behind it. Studies
however show that treatment with rubber dam reduces total mercury
exposure during amalgam replacement and plasma
levels of mercury are lower following treatment with rubber dam than
without it.
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After
removal of the old filling/s
we replace the rubber dam with a new one to eliminate any traces of the
old filling material and also wipe down your face thoroughly to get rid
of any small particles that have landed there.
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Finally a new white filling can be placed on an impression taken for a
porcelain inlay or crown. Information on alternatives
to amalgam fillings....more
Environmental Issues With Amalgam Removal
It is
known that heavy metals build up in the food chain so in essence waste
products that we wash down the drain can eventually end up back in our
food supply. The mercury in our environment is converted to methyl
mercury in the sea and absorbed / consumed as part of feeding by fish
and shellfish. This is the reason that certain fish species depending
on their feeding patterns are known to have higher mercury levels in
their tissues than others. Indeed in America the Environmental
Protection Agency advise pregnant women to
limit their consumption certain types of fish during
pregnancy.
As we
remove many amalgam fillings every week we take our environmental
responsibility seriously and do everything we can to protect the
environment. We cutting old amalgam fillings out in as few pieces as
possible ( a process called chunking ) to reduce the volume of
small amalgam particles that we produce. The large chunks are collected
in our first stage filtration. The smaller particles enter a high speed
centrifugal separator that is highly efficient ant removing amalgam
particles from our waste water. In all we filter, separate and remove
remove nearly 99% of all of our amalgam waste by weight from our
waste water before it leaves the building. By choosing new mercury free
restorations you are reducing the volume of mercury waste that will
need to be dealt with in future.
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