Safe Mercury Removal
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Mercury Amalgam Fillings: Safe Removal Protocol
There are 11 procedures that most mercury sate dentists use to minimize mercury exposure to the patient, the dental staff, and the environmental during amalgam filling removal. They are divided into four categories:
– minimizing the amount of mercury that could be released from the filling
– intercepting the mercury that escapes the filling before the patient breathes it in
– filtering the office air
– cleaning the patient and disposing of contaminated material, such as patient coverings, gloves, and rubber dam
I . Cooling the Fillings
The amount of mercury vapor released from an amalgam filling is directly proportionate to its temperature. Drilling out an amalgam filling generates a tremendous amount of heat. Cooling the filling by using as much water as possible during the process will significantly reduce the amount of mercury vapor released.
2. Chunking Amalgams
Mercury safe dentists use a removal process called “chunking” in which they use a special drill bit to section the filling into large chunks. These chunks can then be easily removed by a hand instrument or suction, which reduces drilling time and therefore the amount of mercury vapor released.
3. Using High-Volume Evacuation
Mercury safe dentists use a powerful suctionlvacuum system. This important piece of equipment minimizes your exposure to mercury vapor because in effect it intercepts the vapor before you can breathe it in. The tip of the suction/vacuum hose will be placed as close to the filling as possible during the entire removal process. This procedure captures most of the mercuryvapor and particles released as the filling is removed.
4. Providing an Alternative Source ofAir
All mercury safe dentists adhere to the first three protocols, but not always this fourth one-giving you an alternative source of air to breathe. Some feel that as long as the first three procedures are strictly followed, this isn’t necessary. But if any one of the first three procedures isn’t followed, you should request an alternative source of air during the entire removal process. If your mercury safe dentist doesn’t provide one, be sure to ask him or her if they’re using a highvolume evacuation system and if the other protective methods listed above are being used. However, if you are in the high risk category, especially if you are pregnant or nursing, I would insist on an alternative source of air. An alternative source of air is provided by a nasal hood, which covers your nose. Through this hood you breathe either compressed air or oxygen from a tank. I don’t believe an alternative source of air is necessary after the fillings have been removed. You should always concentrate on breathing through your nostrils and avoid breathing through your mouth while your mercury fillings are being removed whether you are provided with an alternative source of air or not.
5. Using a Rubber Dam
The rubber dam was designed to isolate the tooth or teeth being worked on, making it easier for the dentist to see and protect the toothlteeth from bacteria, moisture, and the tongue. The rubber dam is made from either latex rubber or silicone for those allergic to latex. It is very thin and flexible, comes in various colors, and can range in size from 5 x 5 inch to 6 x 6 inch squares. Until recently, dentists believed that the rubber dam would protect the patient from inhaling mercuryvapor through the mouth. It’s now known that mercuryvapor can readily pass through a rubber dam made from latex, the most common rubber dam material. (Silicone is more resistant to mercury vapor.) A large percentage of patients believe that the rubber dam offers the greatest protection from mercuryvapor and insist that it be used. But because the rubber dam doesn’t actually protect you from inhaling mercuryvapor, it isn’t absolutely necessary for the safe removal of amalgam fillings. Although the rubber dam
offers little protection against mercury vapor, it does make it easier to evacuate the filling material and prevent amalgam particles from being swallowed. Amalgam particles can’t be absorbed into the body, but it’s always wise to avoid swallowing any dental material. More and more dentists are now using a dental device called the Isolite System that illuminates and isolates the tooth and provides a constant source of suction close to the amalgam. It’s often used in place of the rubber dam, and I believe it’s more effective at protecting the patient from mercuryvapor and amalgam particles. As a rule of thumb, when it comes to choosing between the rubber dam and any alternative, I recommend trusting your mercury safe dentist to decide when and which one is or isn’t necessary-but if in doubt, ask for an explanation.
6. Cleaning Up Immediately
Once the removal process is completed, the dentist and assistant should remove and dispose of their gloves and the rubber dam (if used) and thoroughly rinse and vacuum your entire mouth for at least 10 seconds. This process helps remove amalgam particles and residual mercury captured by the saliva. You should make every effort not to swallow during the short rinsing procedure. When this is finished, take a small amount of water and gargle as far back into your throat as possible. Once you’ve gargled, don’t swallow this watery residue! It should be evacuated by the dental assistant, or spit into a cup. In addition, when the removal procedure is finished, the dentist or dental assistant should remove and dispose of your protective covering and clean your face and neck. All mercury safe dentists should routinely do this, but remind the assistant if she or he forgets. After all, you don’t want to take any mercury home with you.
7. Using Additional Air Purification
Some mercury safe dentists use an additional air filtering system that’s placed as close to the patient’s mouth as is practical. The more popular ones resemble an elephant’s trunk and have an opening about 4 inches in diameter. This filter is helpful, but there are other mercury safe dentists who believe that the patient can be adequately protected without such a system. More and more mercury safe dentists are using this type of office purification system, and while it’s a positive addition to the basic removal protocol, I believe this system is more effective at protecting the dentist and assistant than the patient.
8. Filtering Air in the Dental Operatory
Many mercury safe dental offices filter the office air because they work in it all day and it’s to their benefit to do so. Thus, doing this is more important for the dentist and staff than it is for you. Although mercury safe offices don’t put in amalgam fillings, they certainly remove them. You should be encouraged by the fact that mercury safe dentists also want to take the necessary precautions to protect themselves and their entire staff from excessive exposure to mercury.
9. Using Activated Charcoal
Although definitive studies haven’t been done, there is some evidence that shows that activated charcoal taken 10-15 minutes before amalgam removal can capture swallowed elemental mercury and mercury vapor, allowing it to be harmlessly passed out of the intestine via the feces. I consider this to be optional, as only 0.01percent of swallowed elemental mercury is absorbed through the intestine. But it can’t hurt to add it, especially if you are in the high mercury risk category.
l0. Vitamin C Infusions
Some dentists and health professionals consider vitamin C (ascorbic acid) infusions to be an effective method of protecting the body from mercury vapor during the process of removing amalgam fillings. Based on my evaluation of the available data, who support the vitamin C protocol believe that it can protect the body from mercury vapor when it is in the bloodstream. While I don’t consider this an essential procedure for the majority of patients, if you’re allergic to mercury, have numerous symptoms and diseases related to chronic mercury promised immune system, I would recommend these if available. Since its administered intravenously, a vitamin C infusion needs to be coordinated with your dentist and a qualified health practitioner. To date, few dental offices offer this service. But if you feel vitamin C protection would be beneficial and can’t find a dentist who will arrange an infusion, you can take an oral dose. However, this method is less effective because the blood levels of vitamin C obtained with an infusion would be significantly higher than from an oral dose. Still, oral vitamin C could provide some additional protection from mercury vapor while it’s in the bloodstream. Before doing this, discuss it with your dentist. If you are in agreement, obtain a packet of powdered vitamin C from a health food store and take it with you to the dental office. After the area to be treated has been effectively numbed, dissolve the powdered vitamin C in a glass of water and drink it as soon as possible before the removal procedure begins. Because vitamin C may diminish the effect of the anesthetic in some people, I recommend taking it after the anesthetic has been given and the part of you mouth being worked on is numbed. This method works better on an empty stomach because vitamin C is quickly absorbed from the intestine into the blood stream if no other food is present in the stomach.
I recommend that everyone start a mercury detoxification program before the fillings are removed.