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Amalgam Removal Protocol

Dr. Sharp, his associates, and dental staff comply with the International Academy of Oral Medicine and Toxicology (IAOMT) safety guidelines for amalgam removal when removing those fillings. This procedure is done in order to minimize exposure to mercury vapor and particles.

Amalgam Removal Protocol Guidelines We Follow:

1. Working area should be isolated with a rubber dam. A rubber dam isolates the tooth or teeth being worked on.

2. Suction: High volume evacuation system should be used to remove amalgam. The evacuator tip should be kept to within 1⁄2 inch of the filling during the entire time the filling is being removed. This helps capture more of the mercury vapor and particles.

3. Remove amalgam restorations in big chunks to aerosolize less of the mercury contents. This is commonly referred to as chunking. This involves less drilling because the dentist only drills enough to cut the filling into chunks, which can then be easily removed by a hand instrument or suction.

4. Keep it cool! Drilling out an amalgam filling generates a great amount of heat, which causes a dramatic increase in the release of mercury, both as a vapor and in amalgam particles, during the entire removal process. Cooling the filling with water and air while drilling dramatically reduces the amount of mercury vapor the filling releases.

5. Cover patient skin with a moist towel.

6. Protect patient eyes with protective glasses.

7. Cover hair with a disposable cap.

8. Controlling breathing space with a nasal mask with oxygen from a tank (nitrous oxide is optional) so they do not have to breathe the air directly over the mouth during amalgam removal.

9. Right after removing amalgam restoration, remove the dam and thoroughly rinse the patient’s mouth before placing the new restoration (about 60 seconds). The patient should sit up and rinse any particle from the back of the tongue out.


If you are interested in learning more about our mercury-free removal protocol please call (305) 857-0990 for an appointment with Dr. Sharp and Dr. Ravazzi.


Dr Bruno Sharp is an active member of the International Academy of Oral Medicine & Toxicology, the top association in the country and international that conducts research on the mercury & amalgam for more than 50 years. For more information and studies on Mercury & Amalgam please visit the International Academy of Oral Medicine & Toxicology web site at www.iaomt.org and search for “Mercury.”