Updated: Nov 20, 2019
What is SMART?
SMART is the Safe Mercury Amalgam Removal Technique, which is a set of safety measures to reduce mercury exposures during dental amalgam filling removal. These safety measures were developed as a result of scientific research collected by the International Academy of Oral Medicine and Toxicology (IAOMT).
Why does SMART matter?
All dental amalgams, also referred to as silver fillings, contain 50% mercury (a neurotoxin) which is constantly released in the form of an invisible vapor. This mercury is absorbed and retained in the body, particularly in the brain, kidney, liver, lung, and gastrointestinal tract. The process of drilling out amalgam filings releases even higher quantities of mercury vapor and fine particulates that can be inhaled and taken into the body. This is potentially harmful to patients, dentists, dental workers, and the fetuses of patients and all dental personnel.
The process of removing amalgam fillings can release dangerous levels of mercury..........
SMART safety measures for patient protection:
Slurry of charcoal, chlorella, or similar adsorbent
Full body, impermeable barrier
Full head/face/neck barrier
External air or oxygen delivered via nasal mask
Dental dam made with non-latex nitrile material
At source oral aerosol vacuum
Clean Up device (non essential but preferred)
Copious amounts of water spray
Conventional high speed evacuation device
Section amalgam into chunks and remove in large pieces
SMART safety measures for dentist and dental staff protection:
Protective gowns and covers
Non-latex nitrile gloves
Face shields and hair/head coverings
Either a properly-sealed, respiratory grade mask related to capture mercury or a positive pressure, properly-sealed mask providing air or oxygen
During the opening and maintenance of suction traps, dental staff should utilize the appropriate personal protection equipment
SMART safety measures for office and environmental protection:
An amalgam separator
High-volume air filtration system
If possible, open windows
Compliance with regulations addressing the proper handling, cleaning, and/or disposal of mercury-contaminated items
How can a dentist become SMART certified?
To obtain SMART certification, the dentist must complete IAOMT coursework related to mercury and the removal of amalgam fillings. The educational programming includes learning about the implementation of the rigorous safety measures, including the utilization of specific equipment. To maintain SMART certification, the dentist enrolls in the IAOMT program annually to review the safety measures. The dentist must also be a member of the IAOMT, which is an organization that promotes awareness of the biocompatibility of dental products and the concepts of biological dentistry.
Where can you learn more about SMART?
To learned more about the International Academy of Oral Medicine and Toxicology (IAOMT)'s Safe Mercury Amalgam Removal Technique, visit www.theSMARTchoice.com.