If you have silver fillings and you’ve been thinking about having them removed, there’s something important you need to know: the removal process itself — if done without the right precautions — can expose you to more mercury than simply leaving those fillings alone.
That’s not a reason to avoid removing them. It’s a reason to make absolutely sure your dentist knows what they’re doing.
At Supremia Dentistry in Wake Forest, we follow the SMART protocol — Safe Mercury Amalgam Removal Technique — developed by the International Academy of Oral Medicine and Toxicology (IAOMT). Here’s what that means, why it matters, and what we do differently to protect you.
WHAT’S ACTUALLY IN A SILVER FILLING?
“Silver filling” is a generous nickname. Dental amalgam is approximately 50% mercury by weight, with the remainder made up of silver, tin, copper, and zinc. Mercury is one of the most toxic non-radioactive elements on earth — a fact that is well established in medicine, environmental science, and regulatory policy.
Here’s the part that has always struck me as an interesting contradiction: the same regulatory agencies that impose serious fines for releasing elemental mercury into the water supply or the ground — the same agencies that require strict handling protocols before amalgam is even mixed, and mandate amalgam separators to prevent it from entering the waste stream after removal — also maintain that once that same mercury is sealed inside a patient’s tooth, it becomes essentially inert.
I’ve never found that argument convincing.
Amalgam fillings don’t just sit quietly. They corrode. They conduct electricity. And they do both of these things continuously, inside an environment — your mouth — that is warm, wet, and full of saliva.
THE PROBLEM WITH METAL IN YOUR MOUTH: CORROSION AND GALVANIC CURRENT
Even setting mercury aside for a moment, the very nature of a metal filling creates problems over time that most patients don’t know about.
Metals corrode in the oral environment. Research confirms that amalgam restorations tarnish and corrode in the mouth, and that this corrosion releases mercury vapor and particles that are absorbed through the oral mucosa and swallowed in saliva.
Metals conduct electricity — and create it. When two different metals are present in the same mouth (for example, an amalgam filling next to a gold crown), they act like a battery. This is called galvanic action. The electrical current generated between dissimilar metals accelerates corrosion of the amalgam specifically, releasing additional mercury vapor and free mercury droplets into the oral environment.
Metal fillings aren’t bonded to teeth — they’re locked in. Unlike modern composite or ceramic restorations, amalgam doesn’t chemically bond to tooth structure. Over years of use, the metal expands and contracts with temperature changes, gradually pulling away from the tooth wall in a process called creep. This creates a microscopic gap at the margin — a direct pathway for bacteria to enter the tooth. When amalgam fillings eventually fail, it’s almost never the filling that breaks. It’s the tooth.
WHY REMOVAL HAS TO BE DONE RIGHT
Research published in the Journal of Occupational Medicine and Toxicology demonstrated that drilling dental amalgam generates particulate that volatilizes significant amounts of mercury vapor — frequently exceeding the safety thresholds of multiple regulatory agencies, even when conventional engineering controls were in place.
In plain terms: heating the filling with a drill releases mercury vapor. Cutting the filling into small fragments releases mercury. Standard suction and standard masks are not adequate protection against this exposure.
This is why the IAOMT developed the SMART protocol — and why following it isn’t optional at our practice.
WHAT SMART LOOKS LIKE AT SUPREMIA DENTISTRY
Before we begin: We review your health history and discuss the procedure and any pre- and post-treatment nutritional or detox support that may be appropriate for you.
During the procedure:
• Rubber dam — a barrier is placed to isolate the tooth and prevent mercury particles from entering the mouth and throat
• Dry Shield — provides additional oral isolation and suction
• Extra-oral suction — a high-volume evacuator positioned outside the mouth captures mercury vapor before it reaches the breathing zone
• Copious water irrigation — constant water flow keeps the filling cool during cutting
• Sectioning the amalgam into large chunks — rather than grinding the filling down, we section it into the largest possible pieces to minimize the amount of mercury that is cut and aerosolized
• Oxygen via nasal cannula — you breathe pure oxygen through a nasal cannula during the procedure so you are not inhaling the air in the oral environment
• Activated charcoal rinse — used before and after the procedure; charcoal binds to mercury and helps prevent absorption
• Full patient barriers — hair and clothing are covered to prevent particle contact with skin
• Mercury-safe masks for the dentist and assistant — standard surgical masks are not rated for mercury vapor
• Mercury wipes to clean the operatory — after the procedure, surfaces are cleaned with wipes specifically designed to bind and remove residual mercury
WILL REMOVING MY AMALGAM FILLINGS FIX MY HEALTH PROBLEMS?
Mercury toxicity is real. Its effects are documented across neurology, immunology, endocrinology, and other systems. And because its symptoms are so broad and so variable — fatigue, brain fog, immune dysregulation, hormonal imbalance, unexplained pain — it’s genuinely difficult to identify mercury as the underlying factor in many of the health struggles people experience.
What I believe, and what the science supports, is this: removing a known toxin that your body is continuously absorbing — one that disrupts immune function and interferes with electrical conduction in the body — has to have some net positive effect. Removing amalgam fillings won’t necessarily cure what ails you. But it eliminates a source of ongoing, low-level mercury exposure, and it allows us to replace your restorations with biocompatible materials that are bonded to your teeth, preserve more tooth structure, and don’t corrode.
That’s a meaningful step in the right direction for anyone committed to supporting their body’s overall function and long-term health.
WHO SHOULD CONSIDER SMART AMALGAM REMOVAL?
SMART removal may be appropriate if you:
• Have existing silver/amalgam fillings and are concerned about mercury exposure
• Are experiencing unexplained symptoms that have not responded to conventional treatment
• Have a history of autoimmune conditions, neurological issues, or chronic fatigue
• Are planning a pregnancy (note: we do not recommend amalgam removal during pregnancy)
• Have mixed metals in your mouth and are experiencing galvanic sensitivity symptoms
• Simply want to transition to a fully biocompatible, metal-free mouth
To schedule, call 919-556-6200 or visit supremiadentistry.com.
Dr. Morgan Herman, DDS, practices holistic, airway-focused, and functional dentistry at Supremia Dentistry in Wake Forest, NC.
