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Is protection required during the removal of amalgam fillings?

There are two main concerns during the removal process. When the filling is being removed the debris generated can be swallowed and it consists of fine particles of the filling material which is made up of mercury, silver, tin and copper and each has its own level of toxicity. To protect the patient from this fine slurry of mixed metals a rubber dam is used. It acts like a raincoat around the teeth and as a barrier it holds the liquid debris away from the throat allowing it to be vacuumed up thereby preventing swallowing it.


The second concern is that as the drill contacts the filling there is a liberation of mercury vapour and particulate, like sawdust and that is concentrated around the breathing area (nose and mouth). It is similar to someone blowing cigarette smoke in front of your face. The answer to this concern is oxygen, this way you are breathing a separate air source during the removal process. The oxygen is left on for approximately fifteen minutes after, and during this time the mercury and particulate dissipates and because mercury is so heavy it falls to the ground. The office also has special air filters that clean the mercury out of the air. Scientific research shows that by using the above precautions the patient’s potential exposure is dramatically reduced to the point that blood tests do not show an increase in mercury while without the precautions there is a substantial increase in blood mercury levels.

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