Smart Protocol

Here at Kateri Clinic we follow the IAOMT’s guidelines for the safe removal of amalgam (metal fillings).

Why is following the SMART protocol so important?

Dental amalgam fillings (also known as silver fillings and metal fillings) contain 50% mercury. Exposure to mercury is associated with some very serious health issues including damage to the nervous system, immune system, kidney and liver function.

What does SMART protocol  involve?

• We ask the patient to rinse their mouth with a charcoal based mouthwash before and after the removal of amalgam fillings.
• Covering the patient with drapes to prevent aerosols containing mercury to settle on your clothes or hair.
• Placing and sealing a rubber dam around the tooth/teeth with amalgam to be removed. The rubber dam (as the name suggests) acts as a barrier to protect the patients airway to ensure that no mercury debris can be inhaled or accidentally swallowed.
• We place a cup over the nose that is attached to an oxygen cylinder, this ensures that the patient can breath purified oxygenated air to avoid inhalation of any mercury vapours through the patients nose.
• We use lots of water and a high powered suction unit to prevent dust and clear the old amalgam away as quickly and safely as possible.
• We use tungsten carbide burs to cut the amalgam into chunks rather than grinding it down to produce less harmful vapours.
• All staff involved in the surgery during the procedure will wear special filtration masks.

An few interesting little facts : 

In 2018 NHS England banned the placement of Amalgam fillings in pregnant women and children under 16 years. Because of how toxic it is. It always surprises me how few people outside of dentistry know this.

• From January 2025 The European Parliament have issued a complete ban on the use of amalgam fillings. 
• This is set to send shockwaves through NHS dentistry because silver amalgam is the most common material for NHS permanent fillings across the UK!!!