What is SMART amalgam removal?
SMART stands for Safe Mercury Amalgam Removal Technique. It is a protocol developed by the International Academy of Oral Medicine and Toxicology (IAOMT) that establishes strict protective measures for the safe removal of mercury-containing amalgam fillings.
At ndu Clinic, we follow the SMART protocol because we believe that how a filling is removed matters just as much as the decision to remove it. Mercury amalgam fillings release mercury vapour, particularly when being drilled out. Without proper precautions, both the patient and clinical team can be exposed to elevated levels of this vapour during removal.
How do we protect you during removal?
Our SMART protocol at ndu Clinic includes the following protective measures:
- Rubber dam isolation (or Swedish clean-up system) to prevent amalgam particles from entering the mouth
- High-speed suction positioned close to the tooth to capture mercury vapour and particles at the source
- Swiss-made air filtration system to remove mercury vapour from the treatment room air
- Negative ion generator to further reduce airborne mercury particles
- Medical-grade air supply delivered via a nose-piece so you breathe clean, filtered air throughout the procedure
- Protective goggles and facial covering to shield your skin and eyes
- Water cooling to minimise heat generation and vapour release during drilling
What happens after the amalgam is removed?
Once the amalgam filling has been safely removed, we replace it with a biocompatible, metal-free restoration. Depending on the size and location of the cavity, this may be a BPA-free composite resin filling, a ceramic inlay, or a ceramic crown. We discuss your options before treatment so you know exactly what to expect.
Should I have my amalgam fillings removed?
This is a personal decision, and we respect that every patient's situation is different. Some patients choose removal because they have been diagnosed with metal hypersensitivity. Others want to reduce their toxic metal burden as a precautionary measure. Some are replacing old, failing fillings and prefer a metal-free alternative.
To help inform your decision, we offer two diagnostic tests:
- MELISA test: a clinically validated blood test that identifies hypersensitivity to metals including mercury, nickel, and titanium. It can also flag markers associated with Lyme disease.
- Hair Sample Test: measures levels of over 30 heavy metals and provides mineral-to-toxic ratios. Results typically take around two weeks.
Why choose ndu Clinic for amalgam removal?
Our Harley Street clinic is equipped with specialist air filtration and follows every step of the IAOMT SMART protocol. Dr. Goran Stojanovic and the ndu Clinic team take a thorough, unhurried approach to amalgam removal, ensuring that each patient receives the highest level of protection and care throughout the process.