Removing an old silver filling may seem like a straightforward procedure, but the way it is performed can meaningfully affect how much mercury vapor enters the air around you during treatment. The SMART protocol, which stands for Safe Mercury Amalgam Removal Technique, is a research-backed set of safety measures designed to reduce that exposure. Developed by the International Academy of Oral Medicine and Toxicology (IAOMT), it provides dentists with a clear framework for protecting patients, staff, and the environment during the removal of mercury-containing fillings.
At Smile Design Holistic in Pompano Beach, our restorative dentistry approach reflects a core belief: every aspect of your dental care should work in favor of your health. Dr. Andy Baghaei, DMD, our Clinical Director, is trained in the SMART protocol and leads a practice committed to mercury-free and fluoride-free dentistry as part of a whole-body philosophy of care.
What Are Amalgam Fillings and Why Does Removal Require Care?
Dental amalgam has been one of the most common filling materials in dentistry for over 150 years, valued for its durability and low cost. What many patients do not realize is that amalgam is composed of several metals, with elemental mercury comprising roughly 50% of the material by weight. As the FDA has documented, these fillings can release small amounts of mercury vapor during everyday activities like chewing, and that release can increase during an active removal procedure.
Conventional removal typically involves drilling out the filling at high speed without additional protective safeguards, which generates mercury vapor and fine amalgam particles that both the patient and the dental team can inhale. For individuals who are pregnant, nursing, health-conscious, or managing immune-related conditions, this warrants careful consideration. Our whole-health dentistry approach begins with exactly that kind of attention to what your body may be exposed to during a visit.
How the SMART Protocol Works
The SMART protocol builds upon traditional amalgam removal techniques by adding a comprehensive layer of safeguards informed by scientific research. Rather than relying on standard methods alone, SMART-certified dentists implement protections both for the patient and for the treatment environment throughout the procedure.
Patient Protections During Removal
Before and during a SMART removal, the patient receives a set of specific protective measures. These typically include a non-latex rubber dam placed over the tooth to contain mercury particles, a charcoal or chlorella rinse taken before treatment to help the body process any incidental ingestion, full-body protective coverings, and an alternative air source to reduce vapor inhalation during drilling. Patients are also encouraged to rinse thoroughly once the procedure is complete.
Safeguards Throughout the Operatory
The treatment room is also prepared to minimize mercury in the surrounding air. A SMART removal generally incorporates the following protective standards:
- High-volume evacuation positioned at the drilling site to capture mercury vapor and particles at the source
- Air filtration systems installed in the room, rated to filter mercury vapor from the air
- Sectioning the filling into large chunks rather than grinding it, which reduces the total amount of mercury released
- Amalgam separators in the dental plumbing to prevent mercury waste from entering the water supply
- Protective gear for the entire dental team throughout the procedure
These combined measures create a meaningfully safer removal environment than standard methods provide. Our patient resources page includes additional information to help you prepare for your visit with confidence.
Why Choosing a SMART-Trained Practice Matters
A practice that follows the SMART protocol has made a deliberate choice to go beyond the minimum required by conventional dentistry, and that commitment extends to how the entire team approaches your safety. If you have been putting off amalgam removal because of uncertainty about the process, knowing that a structured, evidence-based protocol exists may make that decision easier. It is always reasonable to ask a dental provider how they handle amalgam removal before you schedule the appointment.
We also offer sedation options for patients who find dental appointments stressful, making even complex procedures more comfortable and approachable from start to finish.
Schedule Your SMART Amalgam Removal at Smile Design Holistic
At Smile Design Holistic, Dr. Andy Baghaei brings over two decades of clinical experience alongside a genuine commitment to biocompatible, mercury-free care for patients in Pompano Beach and the surrounding communities. As a locally owned, multi-specialty practice, we offer a range of holistic dental services under one roof, with flexible financing options through CareCredit, Cherry, and Lending Club to make care more accessible for every patient.
If you have old amalgam fillings and are ready to explore safe removal options, we invite you to contact our office and schedule a consultation with Dr. Baghaei today.
