Amalgam Removal Concerns

Dentist in Chicago Loop

Dentist Chicago Loop

Clearly we want safe amalgam removal. We also want you to know the truth about some of the talk out there.

 

CUT IN CHUNKS AND KEEP IT COOL
Most dentists will do this naturally. It is faster to remove a filling if it comes out in chunks, but traditionally minded dentists do not know how beneficial this is to you, the patient. When you remove it in chunks, you will aerosolize less of the contents. All dentists will use a water spray as well, which traditionally speaking is meant to cool the tooth so as not to cause it harm. An added benefit is that there will be less mercury vapor.

SUCTION!
All dentists use HVE. It is the suction next to every dental chair that an assistant uses to keep you from drowning. Now we know it is also your best tool for keeping the mercury from mixing into your system. Our assistants are instructed to use it as close as possible to the source to be sure to collect as much as possible. But check to see where in your office it discharges! If the vacuum pump discharges into an open trap or through its own base, you could be pumping mercury vapor into your utility room or lab.

OUR GLOVES
Nitrile material is an effective diffusion barrier than more commonly used vinyl or latex gloves. Again, this is a benefit for the staff, and we have them available.

USE OF A RUBBER DAM
The beneficial use of a rubber dam is debated. The debate is in the effectiveness of what the rubber dam is made of. All rubber dams are made of either vinyl or latex, both of which are not as effective as nitrile in preventing mercury vapors from passing through. Despite this truth, it feels like we are doing more if we use one, so we have them. If you want one, let us know. If you’ve never had a rubber dam on, you’ll learn that some patients hate them, and others love them. Same thing from our vantage point: sometimes they help us do a better job, other times they are purely a hindrance.

RINSE A LOT
As soon as the amalgams are out, remove the dam and rinse thoroughly. This may take time. Sometimes as much as 60 seconds of rinsing to fully remove the mercury vapor. Search for gray particles. If there are particles on the back of the tongue, sit up and gargle them out. Consider rinsing with an antioxidant.

COVER THE SKIN
If you are more comfortable with your facial skin covered, it is as simple as placing a moist paper towel or cloth over your face to act as a barrier to any spattered amalgam particles.

VITAMIN C
This falls under the category of “ask your health care practitioner.” We know that high doses of vitamin C can cause an upset stomach and we are not sure if that is right for you. It is up to you if you want to add this protocol to your regimen. If so, the following protocol is most reasonable, and preferably it is taken on an empty stomach.

If the patient is not used to taking Vitamin C, too much at once can cause an upset stomach. It is recommended to be given as follows:

  • Day 1: One 500mg tablet (total 500mg)
  • Day 2: Two 500mg tablets ( total 1,000mg)
  • Day 3-10: Three 500mg tablets (total 1,500mg)

Dr. Gilleran does do a round of metal chelating annually to remove the residual heavy metals in her system as she is exposed daily. If you want the added security of taking a chelating agent too, let us know. What we are learning is that we are the most at risk for continued amalgam removal. We breathe the air everyday. A patient is exposed briefly.

THE AIR
There are two ways to look at the air in this respect. The air you are breathing while we remove your amalgams, and then the air in the office. Supplemental air is something that is forcibly piped into your nose while an amalgam is being removed. We think the exposure is primarily coming from the slurry on your gums and soft tissue, so this added precaution is not currently part of our protocol, but that may change. As far as the air in our office, we do think it is a great idea to keep it clean so we are currently looking into the proper system for filtering mercury vapors from our office air. Although this is clearly a benefit for the patients, this is mostly beneficial to the staff who work in this environment daily.