Safe Amalgam Removal in London:
Meta description: Thinking about having your amalgam fillings removed? Here's what safe amalgam removal actually looks like.From The Bespoke Dentist, Harley Street, London.
Dental amalgam is roughly fifty per cent mercury by weight, bound up with silver, tin and copper. Drill into it and you release mercury vapour and fine particulate directly into the air your patient, and everyone else in the room, is breathing. That's the bit that matters. The removal.
This is why the SMART protocol, Safe Mercury Amalgam Removal Technique, exists. It was developed by the International Academy of Oral Medicine and Toxicology, and it's a set of physical barriers and workflow changes designed to stop that vapour and particulate reaching you, your dentist, or the wider practice, rather than a treatment that changes what amalgam is or what it does sitting in your tooth.
What Actually Happens During Safe Removal
A SMART removal. It's a stack of precautions, each one closing off a route the mercury could otherwise take.
A rubber dam, a thin sheet of latex or nitrile clamped around the tooth, isolates it from the rest of your mouth. You're not swallowing or inhaling fragments that come off during drilling, because there's a physical barrier between the tooth and your airway.
High volume suction, positioned close to the tooth, pulls vapour and debris away as it's created rather than letting it drift into the room.
An external air supply, a nasal mask delivering clean air, means you're not breathing the same air as the immediate treatment zone.
Copious water cooling keeps the amalgam from overheating, since heat is what drives mercury vapour off a solid filling in the first place. Cool, wet cutting, in small sections rather than one continuous grind, keeps that vapour release to a minimum.
Immediate cleanup, a change of gloves, a rinse, sometimes an alginate or charcoal mouth rinse, deals with anything that made it past the dam.
The dentist and nurse wear protective equipment too, because the room air matters for the whole team, not only the patient.
None of this is exotic. It's disciplined, repeatable process. But it's exactly the sort of process that gets skipped when a practice is drilling out an amalgam the same way it would any other filling, at speed, without the dam, without the suction positioned correctly.
Why People Choose to Have Amalgam Removed
The reasons I hear are varied, and I don't think any of them need a grand unifying theory to be valid.
Some patients simply don't want mercury in their mouths any longer than necessary, and that preference alone is reason enough. Some are replacing failing, cracked, or leaking fillings and want a composite replacement rather than another amalgam. Some are following the advice of a doctor or naturopath investigating a broader health picture, where amalgam removal is one part of a wider plan. Whatever brings someone to that decision, my job is the same, do it as safely as the protocol allows, and be honest about what removal can and can't be expected to change.
What to Ask Before You Book Amalgam Removal Anywhere
If you're looking into this, whether with me or elsewhere, a short list of questions will tell you a great deal about whether a practice takes the protocol seriously.
Do you use a rubber dam for every amalgam removal, without exception. Is high volume suction positioned at the tooth itself, not just in the general area. Is there a dedicated external air supply for the patient. Is the amalgam sectioned and removed with water cooling, rather than drilled out in one continuous pass. Is the team also protected, masks, glasses, positioning, not just the patient.
If the answer to any of those is a vague one, that's worth pausing on.
Your Next Step
At The Bespoke Dentist on Harley Street, every amalgam removal follows the full SMART protocol, and I'm currently the only IAOMT SMART Protocol Mentor in the UK, which means I also train other dentists in this technique. If you'd like to talk through whether removal is right for you, or simply want your questions answered honestly before deciding anything, message Liv on WhatsApp at 07545 908174, or call the practice on 0207 099 6651.
Frequently Asked Questions
Is it safe to remove amalgam fillings?
Removal carried out using the SMART protocol, rubber dam isolation, high volume suction, external air supply and water cooling, is designed specifically to minimise mercury exposure during the procedure.
What is the SMART protocol?
SMART stands for Safe Mercury Amalgam Removal Technique, a set of physical precautions developed by the International Academy of Oral Medicine and Toxicology to reduce mercury vapour and particulate exposure during amalgam removal, for both patient and dental team.
How long does SMART amalgam removal take?
It varies by the size and number of fillings, but a single SMART removal appointment is typically comparable to any other filling appointment, generally thirty to sixty minutes, done in careful, cooled, sectioned stages rather than rushed.
What replaces the amalgam once it's removed?
Most patients choose a tooth-coloured composite resin, matched to the surrounding tooth, though the right material depends on the size and location of the cavity and is worth discussing at consultation.
Where can I have SMART amalgam removal done in London?
The Bespoke Dentist, 28 Harley Place, Harley Street, London W1G 8LZ, offers SMART protocol amalgam removal as a core part of the practice, led by the UK's only IAOMT SMART Protocol Mentor.
Safe amalgam removal with the SMART protocol, explained plainly. What actually happens, and how to vet any practice for safety.
At The Bespoke Dentist, we pride ourselves on providing personalised dental care tailored to your needs. Please fill out the contact form below to get in touch. Whether you have a question or want to book an appointment, we're here to help.
