The SMART protocol — safe removal of amalgam fillings

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.