Traditional amalgam fillings contain approximately 50% mercury. During the removal of these fillings using standard methods without any precautions, the high heat generated by the bur releases a very high concentration of toxic mercury vapor, which can be inhaled by both the patient and the surgeon, leading to acute toxicity. The SMART protocol (Safe Mercury Amalgam Removal Technique) is a strict safety chain developed by IAOMT. According to this protocol: A leak-proof rubber dam is placed over the patient’s mouth during the procedure; the patient is connected to a medical oxygen/air mask from an external source to prevent inhalation of mercury vapor; high-vacuum special mercury-absorbing air filters (clean-up devices) are operated in the room; the filling is removed in large pieces using special carbide burs under continuous cold water, without breaking it. Additionally, special chelating (binding) mouthwashes are administered to the patient before and after the procedure to completely block systemic absorption.
