Mercury Amalgam Removal
Many people are deciding they want to have their silver amalgam (mercury) fillings removed. However, the procedure is not done right, it can cause a tremendous amount of mercury to be absorbed by the body and make one ill. To help prevent this, safety precautions are used by our office so the person won’t swallow or breathe mercury vapor while the fillings are being drilled out.
Mercury vaporizes at room temperature. As soon as the dentist touches the filling with a drill, the temperature soars and the mercury vapor comes pouring off the fillings. Then when you take a breath it goes right into your lungs. To prevent this from happening, we take the following safety precautions:
- Safety glasses are put over your eyes to protect them from settling mercury particles and vapor.
- We have you breathe pure bottled oxygen through a nasal cannula (tube). This will minimize your breathing the air right around your face, which is full of mercury vapor. Your nose will be covered with a dental mask to help keep the mercury vapor from going into your nostrils.
- A rubber dam will be placed over your mouth. This is a sheet of rubber that helps keep the mercury from going down your throat.
- Copious amounts of cold water will be constantly squirted on the filling as it’s being drilled out, to keep the temperature down.
- A Clean-up device will be used when necessary. The Clean-up fits over the tooth and is attached to the suction, so it pulls all particles away from the tooth as the filling is being drilled out.
- A high-volume air evacuator is placed directly in front of your face while the filling is being drilled out. This pulls all the air-borne particles away from your face, to prevent you from breathing/swallowing them.
- Powdered charcoal and chlorella are placed in your mouth under the rubber dam. Both these substances have the ability to absorb mercury particles before they get absorbed into your system.
- The fillings will be taken out with as little drilling as possible, in as large chunks as possible, to minimize the amount of mercury vapor released into the air.
- The dental staff protects themselves by wearing industrial grade gas masks while the mercury is being drilled out. They know that the air around them is full of mercury vapor which could be a liability to both their bodies and to yours.
- An industrial strength ion generator is mounted over the patient’s chair, which electrostatically captures any particles of mercury vapor that are released.
See the amazing story of a patient, Russ Tanner, and his experience in our office.
Cost of Mercury Amalgam Removal
We get many inquiries as to how much it costs to have the mercury fillings replaced. We may cost more than some dental offices, but we take many more safety precautions than most offices take to ensure that the smallest amount of mercury as possible is absorbed by the body during the procedure.
The main factor in cost is what is used to replace the old metal filling. If the metal filling was small, a composite (plastic) filling can be used, which costs around $300. If the amalgam filling was large, it will probably take either an inlay, onlay or crown to restore the tooth.
Onlay vs. Inlay
An inlay is a lab-made restoration (also called “indirect”) that sits inside the cusps of the tooth. Cusps are the four bumps on the corners of each molar. If these are sound, it is best to leave them, and just replace the center of the tooth. Below you can see the cusps, where the corners of the teeth protrude.
Here are 3 onlays, ready to be seated.
An onlay is an indirect restoration that replaces at least one of the four cusps. Again, we feel that it is better to do a “conservative” preparation, and leave as much of the healthy tooth as possible. We definitely do not drill the tooth down into a little teepee.
Below is a picture of the onlays on a model. You can see how the preparation of the teeth are “conservative” (removing as little tooth structure as necessary).
Onlays on model. Notice the amount of good tooth left.
A full-coverage crown is needed when all the cusps are not salvagable, or when a neuromuscular adjustment needs to be made. This can occur if the “bite needs to be opened,” which means the teeth need to be made longer due to their having gotten shorter after years of grinding.