Amalgam earned its decades of use by being cheap, durable, and easy to place. Chemistry is the catch: the alloy is roughly half elemental mercury, and mercury off-gasses vapor at mouth temperature, more under the friction and heat of chewing. Millions of mouths still carry it.
Removal is where exposure peaks. Drilling amalgam without controls aerosolizes particulate and vapor inches from the airway, converting a slow leak into a spike. Any removal conversation that skips protocol is having the wrong conversation.
How the SMART protocol protects you
The IAOMT certifies the Safe Mercury Amalgam Removal Technique: nitrile dam isolation, high-volume suction at the source, HEPA filtration with activated carbon capture, supplemental oxygen for the patient, sectioned removal, and full protective equipment on the provider side. Dr. Carlo Litano, DMD holds the certification and runs every removal in a dedicated isolation room in our St. Petersburg office.
What goes in after the amalgam comes out
BPA-free ceramic composite, color-matched and bonded the same visit. Patients with sensitivity concerns can run material biocompatibility testing beforehand, reading reactivity against the exact composite planned. Nothing metal replaces the metal.