When an amalgam filling is drilled out, it releases mercury vapour and fine particles. So the room matters as much as the drill. This is how my surgery is set up for every amalgam removal.
For you, in the chair
Rubber dam. A thin sheet that isolates the tooth, so particles are kept out of your mouth as far as possible.
A separate air supply. You breathe air delivered through a nasal mask, not the air around the tooth.
Protective covering. For your skin, hair and clothes.
Removing in chunks. The filling is cut out in pieces rather than ground to dust, to keep vapour and particles to a minimum.
Plenty of water and suction to keep the tooth cool and clear.
For the room
High-volume suction at the mouth. A dedicated oral aerosol vacuum sits close to your mouth throughout.
Room air purification. A dedicated air filtration system changes the air in the surgery about 25 times an hour.
An amalgam separator. Waste is captured rather than washed into the drains.
For my team
Protective gowns, gloves, eye protection and respiratory protection, every time.
Why it's done this way
This is the Safe Mercury Amalgam Removal Technique (SMART), set out by the International Academy of Oral Medicine and Toxicology. I'm the only IAOMT SMART Protocol Mentor in the UK, which means I help train other dentists in it. In September 2026 I was also made a Fellow of the Academy.
Ready to talk about your fillings?
How amalgam removal works · What it costs · Your questions answered
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