Patient Protection: during removal of mercury fillings

In our opinion, Protection of the patient from additional exposure to amalgam (containing mercury) is of the utmost concern during the removal of mercury fillings. The goal of this procedure is to minimize any additional exposure of the patient, ourselves, or staff to mercury.

In the removal and replacement of mercury fillings, we follow the protocols recommended by the IAOMT (International Academy of Oral Medicine and Toxicology) SMART – (Safe Mercury Amalgam Removal Technique) and the British Society for Mercury Free Dentistry. SMART is a set of recommendations created by the IAOMT based on scientific research.

TheSMART (Safe Mercury Amalgam Removal Technique) includes the following precautions:

• Nutritional support considerations, to support the immune system
• Use of general protective coverings
• Use of a nosepiece, to provide an air source out of the immediate area (Oxygen)
• Isolation of the treatment area, usually by a technique known as 'rubber dam' The rubber dam catches all the pieces of old filling and dust created by the drilling. It also helps to prevent the soft tissues of the mouth absorbing mercury vapour
• Use of high-speed, water-cooled instruments
• An amalgam separator installed to collect amalgam safely, before it enters the environment
• Filtration of air for mercury, using a dedicated scavenger unit –In 2004, we were the first Practice in the country to use the mobile IQ Air mercury filtration system which has undergone extensive clinical trials.
  
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  The air filtration system chosen by the Holistic Dental Centre is the Dental Hg FlexVac from indoor air specialist, Air Science Limited. This mobile source-capture system has a flexible, self-supporting suction arm designed to be positioned ca.30 cm from the patient's head thereby reducing exposure to harmful pollutants before they can be inhaled or dispersed in the ambient air.

The Holistic Dental Centre was the first in the country to install the Air Science unit that comes from the same family of air cleaning equipment recently tested by the Health Protection Agency at Porton Down and is used by the Hong Kong Hospital Authority as a tool for combating the SARS virus. Over 2000 units are currently in use in the Authorities' hospitals and specialist clinics.

The unit's high efficiency is made possible by two main factors. Firstly, a complex three-filter system that has been type-tested in accordance with the world's most stringent HEPA filter test norm (EN1822). Secondly, the integrity of the finely-engineered enclosure and fan assembly ensures that, once filtered, no particles, gases or odours can escape back into the environment.

Unlike less sophisticated air purifiers on the market, each IQAir machine is individually tested and comes with a guaranteed Certificate of Performance.