Amalgam fillings are being widely used since a decade. However, research has identified mercury as an environmental hazard responsible for causing various diseases such as the Alzheimer’s disease, Minamata disease, kidney and brain damage and so on. Although the amount of mercury fillings in cavities and their subsequent release of vapor are too small to cause any significant harm. It is being recommended that removal of amalgam fillings must be considered and performed by expert dentists and staff in order to avoid further exposure to mercury vapor.
Amalgam fillings must be removed by cutting it out in large chunks rather than grinding it. This process, called chunking, will reduce exposure to amalgam. The entire process generates a large amount of heat and thereby causes the release of huge quantities of mercury vapor as well as minute amalgam particles. So, the filling must be constantly cooled by air and water during the full procedure. Apart from this, most mercury safe dentists prefer to use a suction system with the evacuator tip pointed towards the filling to absorb and eliminate the mercury vapors.
To protect the patient from breathing in mercury vapor, most dentists make use of a rubber dam. However, the rubber dam cannot be effective in all cases. Some patients find it uncomfortable during the procedure. Also, it takes too much time to incorporate the latex-built rubber dam into the patient’s mouth. Further, it is impossible to use the rubber dam for the third molar or wisdom-teeth. So, it is the dentists who best decide the use of rubber dam. A possible solution to prevent the patient from breathing in the mercury vapor is to provide the patient with an alternative source of air through the nose hood or a ventilation device. For better results, the patient must be instructed to concentrate breathing through the nose.
Additional measures taken to avoid mercury contamination include covering the patient’s eyes, nose and skin with a protective barrier. The dentists and staff should use proper nitrile rubber gloves to prevent exposure to mercury vapors. After the procedure, an immediate clean up and disposal of the gloves, protective covering, rubber dam and other materials should be performed. The patient’s mouth must be carefully rinsed with water followed by gargling. The patient must be instructed not to swallow the water and spit it if required. The operation room must incorporate additional devices such as particulate air filters or evacuator to maintain clean air circulation in the room.
Hence, we recommend all dentists to be extra cautious before performing the removal of amalgam fillings and train their patients adequately to avoid any mishaps, mercury contamination or health hazards. Stay safe and healthy!