Safe amalgam filling removal with IAOMT-certified SMART Protocol for maximum protection against mercury vapour exposure.
The SMART Protocol (Safe Mercury Amalgam Removal Technique) is a rigorous set of safety procedures developed by the IAOMT (International Academy of Oral Medicine and Toxicology) to protect patients, clinical staff and the environment during amalgam filling removal. Amalgam fillings contain approximately 50% mercury, a neurotoxic heavy metal that continuously releases vapour. Removal without proper protocol can significantly increase mercury exposure. At our clinic, we follow all IAOMT recommendations to ensure safe removal and replacement with biocompatible materials.
Every single step exists for one reason: to protect you. Here is exactly what we do — and why it matters for your health.
01
Days before your appointment, we start you on an antioxidant protocol — vitamin C, selenium and other supplements that prime your body's detoxification pathways.
02
Protective gown, safety goggles and a nasal mask delivering clean oxygen — so you breathe pure air throughout, not treatment room air.
03
A rubber dam isolates the tooth completely, creating a physical barrier so no mercury fragments or vapour reach the rest of your mouth.
04
A high-volume evacuation system sits right next to the tooth, sucking away mercury vapour the instant it is released — before it can reach you.
05
Continuous cold water irrigation prevents the filling from heating up during removal — heat is what causes mercury to vaporise most aggressively.
06
Instead of grinding the entire filling, we section it into large chunks and lift them out — far less vapour than conventional drilling.
07
A HEPA and activated carbon air purifier runs next to the work area, capturing any mercury particles or vapour that escape into the room.
08
The treatment room is fully ventilated during and after the procedure, ensuring clean air for everyone.
09
All amalgam waste is immediately collected and sealed in certified containers — nothing goes down the drain or into the air.
10
Once all amalgam is out, we clean and disinfect the cavity — often with ozone therapy for an extra layer of natural disinfection.
11
Your tooth is restored with ceramic, BPA-free resin or zirconia — materials that are safe, durable and look completely natural.
12
After the procedure, we continue your supplement protocol to help your body clear any residual mercury and recover optimally.
These are the facts that help you make an informed decision — no fear, no pressure, just honest information.
Despite being called 'silver fillings', amalgam is roughly half mercury by weight — mixed with silver, tin and copper.
Mercury vapour is released continuously from amalgam fillings, and increases every time you chew, drink something hot, grind your teeth or brush.
The WHO recognises mercury as one of the most toxic heavy metals. It has a particular affinity for nerve tissue, kidneys and the brain.
A filling placed 20 years ago has been releasing mercury every single day since. The effects are cumulative — your body stores it over time.
Safe amalgam removal requires specialised equipment that most dental clinics do not have. We invested in every piece because your protection is non-negotiable.
Industrial-strength suction positioned right at the tooth to capture mercury vapour and particles the instant they are released.
Medical-grade air purifiers that remove mercury particles and vapour from the treatment room air in real time.
Rubber dam and additional barriers that create a sealed zone around the tooth — nothing escapes into your mouth.
All mercury waste is captured by a certified separation system — protecting the water supply and the environment.
Every case is different. We take time to understand your situation and create a safe, personalised plan.
01
We examine each amalgam filling, check its condition and review your medical history to understand the full picture.
02
We plan the number of sessions and the order of removal — prioritising the fillings releasing the most mercury, and spacing sessions to let your body recover.
03
A tailored antioxidant and detoxification support plan for before and after each session — so your body is prepared and protected.
“What matters most to me is that patients leave our clinic feeling better — not just in their mouth, but about their health as a whole. When done with the right protocol, amalgam removal is a genuinely positive experience. Patients tell us they feel a real sense of relief knowing that a source of daily mercury exposure is gone, replaced with something clean and biocompatible. It is one of the most meaningful procedures we offer, and we take every layer of protection extremely seriously because our patients deserve nothing less.”
Dr. Carlos Sousa
Clinical Director
Ready to Go Mercury-Free?
Book a consultation and let us show you how we can safely remove your amalgam fillings — protecting your health at every step with the IAOMT-certified SMART Protocol.
This treatment follows the guidelines and recommendations of the Portuguese Dental Association, ensuring the highest standards of safety and quality.
Find answers to the most common questions about this treatment.
SMART stands for Safe Mercury Amalgam Removal Technique. It is a comprehensive set of safety procedures developed by the IAOMT (International Academy of Oral Medicine and Toxicology) specifically to minimise your exposure to mercury during amalgam filling removal. It includes rubber dam isolation, high-volume suction, clean oxygen through a nasal mask, HEPA air filtration, sectional cutting instead of drilling, and supportive supplementation before and after.
Because drilling amalgam without protection can release large amounts of mercury vapour — potentially exposing you to more mercury in one appointment than months of normal daily release from the filling. The heat from drilling increases vaporisation dramatically. The SMART protocol exists precisely to prevent this: every step is designed to capture mercury before it reaches you.
Not at all. It feels very similar to getting a normal filling — we use local anaesthesia just like any other dental procedure. The additional protective equipment (rubber dam, nasal oxygen mask) may feel slightly different from what you are used to, but patients consistently tell us it is comfortable and reassuring, not uncomfortable.
That depends on how many amalgam fillings you have. We typically remove one quadrant (one side of the mouth) per session, with 2-4 weeks between sessions so your body can recover and detoxify. If you have 4-8 fillings, expect 2-4 sessions. We never rush — your safety comes first.
We use biocompatible materials chosen specifically for your situation: BPA-free composite resins for smaller restorations, ceramic inlays or onlays for larger ones, or zirconia crowns when more coverage is needed. All materials are metal-free, non-toxic and look completely natural. We help you choose the best option during your consultation.
Yes, and this is an important part of doing it right. We prescribe a personalised antioxidant protocol in the days before removal — including vitamin C, selenium and activated charcoal — to support your body's detoxification pathways. We also continue supplementation after the procedure. This before-and-after support is what sets a truly safe approach apart.
No. We strongly recommend postponing amalgam removal during pregnancy and breastfeeding. Even with the SMART protocol, we believe zero mercury exposure is the only acceptable standard during these periods. The ideal time is before you start planning a pregnancy.
Yes. It is based on decades of research into mercury toxicology and was developed by the IAOMT, a scientific organisation with over 30 years of expertise. Studies confirm that SMART protective measures significantly reduce mercury exposure during removal compared to conventional approaches. It is the recognised standard of care among biological and integrative dentists worldwide.
That is entirely your decision, and we respect it either way. What we can tell you is that even stable amalgam fillings continuously release mercury vapour — every day, for as long as they are in your mouth. During your consultation, we assess the condition of your fillings, discuss your health goals and give you all the information you need. We never pressure anyone. We believe in informed choice.
Regular removal treats an amalgam filling like any other — just drill it out. No special precautions for mercury. SMART removal adds 12 layers of protection: rubber dam isolation, high-volume suction, nasal oxygen, HEPA filtration, sectional cutting, cold water irrigation, protective equipment, room ventilation, waste containment, and pre- and post-procedure supplementation. The difference in mercury exposure between the two approaches is dramatic.
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