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SMART®
Safe Mercury Amalgam Removal
Mercury Amalgam Fillings and Whole-Body Health
Dental amalgam fillings—commonly referred to as “silver fillings”—are composed of a combination of metals, including silver, tin, copper, zinc, and elemental mercury. Mercury typically makes up approximately 50% of the filling by weight and serves as the binding agent that holds the metals together.
Elemental mercury is a biologically active substance that can release mercury vapor, particularly during chewing, grinding, or exposure to heat. Scientific literature has demonstrated that inhaled mercury vapor is readily absorbed through the lungs and can cross both the blood–brain barrier and the placental barrier, where it may accumulate in tissues over time. Research has examined mercury’s potential effects on the central nervous system, immune regulation, and oxidative stress pathways, contributing to ongoing evaluation of material biocompatibility in dental care.
In addition to material considerations, amalgam restorations may expand and contract differently than natural tooth structure. Over time, this mechanical mismatch can contribute to microfractures, marginal breakdown, and structural compromise of the tooth, which may increase the risk of leakage or fracture.
For these reasons, more and more patients choose to discuss replacement of existing amalgam fillings due to material compatibility concerns, structural integrity of the tooth, esthetic changes, or a desire to minimize long-term exposure to certain metals. When amalgam removal is considered, the process itself requires careful handling to reduce exposure.
At Spring Smiles, we approach these conversations through an informed, whole-body perspective, emphasizing patient education, material safety, and evidence-based protocols.
Amalgam Filling Removal
Regardless of the reason a patient may choose to explore removal of existing amalgam fillings—whether related to tooth integrity, material compatibility, esthetics, or overall health considerations—the manner in which removal is performed is critical. Improper removal techniques may increase exposure to mercury vapor and metal particulates.
For this reason, Dr. Duncan follows SMART-certified protocols established by the International Academy of Oral Medicine and Toxicology (IAOMT) when amalgam removal is indicated. These evidence-based protocols are designed to reduce exposure to mercury vapor and particulate matter for patients, clinical staff, and the surrounding environment through the use of protective measures before, during, and after the procedure.
As part of this process, we also offer individualized pre- and post-treatment nutraceutical guidance intended to support the body’s natural detoxification and recovery processes. For convenience, recommended products are available through our in-office dispensary, allowing patients to access supportive supplements easily and consistently when undergoing treatment.
At Spring Smiles, decisions regarding amalgam removal are approached thoughtfully and individually, with an emphasis on patient education, safety, and informed decision-making within a whole-body health framework.
Expertise in SMART®-Certified Amalgam Removal
Dr. Duncan has extensive experience in the safe removal of mercury amalgam fillings and the restoration of teeth using high-quality, biocompatible materials designed to support strength, function, and natural esthetics. When an existing metal restoration is removed, careful planning and precision are essential to ensure the tooth is properly restored and able to function comfortably and predictably.
With many years of experience in restorative dentistry and advanced training through Spear Education in Arizona, Dr. Duncan brings a high level of expertise to the restorative phase of care following amalgam removal. This training supports a thoughtful approach to rebuilding tooth structure using materials selected for durability, compatibility, and long-term performance.
At Spring Smiles, our clinical team is specially trained to support patient safety throughout the amalgam removal process. Dr. Duncan is certified and accredited in the SMART® Protocol through the International Academy of Oral Medicine and Toxicology (IAOMT). These protocols are designed to reduce exposure to mercury vapor and particulate matter for patients, staff, and the surrounding environment by using evidence-based protective measures during removal.
As part of a whole-body, collaborative approach, Dr. Duncan and the Spring Smiles team maintain professional relationships with medical providers both locally and nationally. When appropriate, patients may choose to consult with these providers regarding supportive care before or after amalgam removal, based on individual health goals and preferences.
For more information about the SMART® Protocol standards followed by Dr. Duncan and the Spring Smiles team, visit:
https://iaomt.org/for-patients/safe-amalgam-removal/
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