General Dentistry Operative Dentistry

Amalgam removal: when & Important precautions

Updated on: July 11, 2017

Amalgam removal

* When to remove Amalgam filling?

– Replacing of the old silver filling (Amalgam) may be a necessity in some cases, the removal of the amalgam filling depends on some factors including: ( Factors affecting amalgam removal )

1) The presence of cracks in tooth filled with amalgam restoration:
The presence of cracks in your filled tooth means that the silver filling became weak creating a gap between tooth and amalgam filling. This provides a room for bacteria and saliva which could cause a cavity under amalgam filling.

2) The presence of a cavity under tooth filled with amalgam restoration:
The presence of a cavity under amalgam requires removal of filling as soon as possible. The dentist uses x-ray device and Intra-Oral camera to assess the condition of tooth and amalgam filling.

3) The presence of a gap between the tooth and amalgam filling:
Corrosion of the amalgam over time leads to poor fitting of filling inside the tooth. This creates a gap between tooth and amalgam which allows bacteria and saliva to fill this gap and in turn will lead to cavity formation under amalgam filling.
This gap will weaken the tooth and make it more susceptible to fracture.

4) Biting on Hard Objects:
Frequent chewing of hard objects will subject the tooth and amalgam filling to lose some of its structure resulting in poor fitting of amalgam and formation of a gap between the tooth and amalgam. This results in accumulation of saliva and bacteria leading to a formation of a cavity.

5) Clenching and Grinding on Your Tooth:
Clenching of the teeth leads to wear down of the silver filling then formation of a gap between the teeth and amalgam filling.

Precautions expected to be seen during the amalgam removal procedure:

All of the mentioned precautions are based on up-to-date science and research. These precautions include:

1) Amalgam separator: a device used to collect all of the amalgam particles.
2) Air Filtration System: this system must present in the dental room to remove the mercury vapor released during amalgam removal process.
3) Keep dental room windows open during amalgam removal process.
4) The Dentist will wear a protective cover called “Protective Gowns” to protect himself from the amalgam particles during the procedure.
5) The Dentist will usually wear non-latex gloves during the procedure.
6) Face Shield will be worn by the dentist and sometimes he may wear a head covering during amalgam removal procedure.
7) Respiratory Mask for the dentist to capture all of the mercury particles during the procedure.
8) Full Body Barrier is worn by the patient to protect the skin and clothes from amalgam particles (Amalgam Tattoo).
9) Nasal Mask to deliver the oxygen to the patient during the procedure. It is used to prevent the patient from inhaling the mercury vapor that released during amalgam removal procedure.
10) Rubber Dam is used to isolate the rest of the mouth from the tooth being operated.
11) Saliva Ejector: this is a device placed under the rubber dam to ensure that no amalgam particles being swallowed.
12) Evacuation Device is used to capture all of the mercury wastes.