Face 
Dentistry 
The short answer: Amalgam fillings can be removed as part of restorative dental treatment, but no dental procedure should be described as completely risk-free. SMART uses additional precautions designed to reduce exposure to amalgam particles and mercury vapour during removal.
Before discussing the removal process, however, there is another question we need to answer:
Does the filling need to be removed at all?
At Evolve Dentistry, we believe those two questions should remain separate.
Dental amalgam contains mercury combined with other metals.
When an existing amalgam restoration is removed using dental instruments, the procedure can produce particles, debris and vapour.
Understandably, patients researching amalgam removal may therefore ask how this is managed during treatment.
This is where SMART becomes relevant.
SMART stands for Safe Mercury Amalgam Removal Technique.
It is a protocol developed by the International Academy of Oral Medicine and Toxicology – IAOMT – incorporating additional precautions during amalgam removal.
These relate to areas such as:
The purpose is to reduce exposure to amalgam particles and vapour during the procedure.
No.
We think it is important to be very clear about this.
SMART uses additional precautions, but it would not be appropriate to claim that any removal method guarantees zero exposure.
Nor should a treatment be described as completely risk-free.
The more accurate description is:
SMART uses additional precautions designed to reduce exposure during amalgam removal.
That is the language we use at Evolve.
Rubber dam isolation can help separate the tooth being treated from the rest of the mouth.
It provides a physical barrier around the treatment area and helps control debris during the procedure.
Some patients find the rubber dam unfamiliar initially, but many adapt quickly.
You remain able to breathe through your nose, and we can agree a signal so you can let us know if you need us to pause.
Suction positioned close to the tooth helps collect material, water and debris produced during treatment.
High-volume suction forms part of the additional measures used to manage the immediate treatment area.
Where appropriate, the restoration can be divided into sections.
This allows pieces to be removed rather than unnecessarily grinding away the entire amalgam restoration.
The considerations are not limited to the filling material.
Removing any established dental restoration involves further treatment of the tooth.
Depending on the individual tooth, possible considerations may include:
This is one reason we do not recommend removing sound restorations casually.
The decision needs to balance the reason for treatment against the implications of carrying it out.
If an amalgam restoration is functioning appropriately and there is no clinical reason to intervene, continuing to monitor it may be reasonable.
We do not recommend removing a sound amalgam restoration on the basis that doing so will improve your general health.
If appearance is your concern, elective replacement can be discussed separately.
That conversation should include the fact that treatment will involve further work on the tooth.
This is a different situation.
If the restoration or surrounding tooth genuinely requires treatment, the question is no longer simply whether to disturb a functioning filling.
Removal becomes part of the restorative treatment that the tooth needs.
At that point, Carol or Maggie can explain the SMART protocol and what is likely to replace the existing restoration.
We need to be precise with the word “safer”.
SMART adds precautions intended to reduce exposure during the procedure.
What we should not do is turn that into an absolute promise that treatment is “safe” in the sense of being risk-free or that every possible exposure is eliminated.
A more useful question is:
“What precautions will be used during my treatment, and what are they designed to do?”
We can answer that clearly.
SMART precautions also consider the treatment environment and dental professionals working within it.
The protocol includes protective and air-management measures in addition to measures focused directly around the tooth.
Before agreeing to amalgam removal, you should understand:
Is there a clinical problem?
Is replacement elective?
Are you mainly concerned about appearance?
Monitoring may be an alternative for some restorations.
Removal is only one part of restorative treatment.
If SMART is being used, you should understand the main elements of the protocol.
No responsible clinician should promise zero risk or zero exposure.
Reality: SMART uses additional precautions designed to reduce exposure, but no dental procedure can be guaranteed risk-free.
Reality: Removing a functioning restoration also involves treating the tooth. Whether intervention is appropriate depends on the individual situation.
Reality: SMART concerns the removal procedure. It does not mean every existing restoration needs treatment.
Reality: The underlying tooth needs to be assessed and restored appropriately.
Yes. Carol or Maggie can provide SMART amalgam removal for adult patients where treatment is appropriate.
Local anaesthetic can be used to numb the tooth. You may still be aware of vibration, water, suction and pressure during treatment.
A tooth-coloured composite restoration may be appropriate, but some teeth require a different restorative approach. This depends on the size and condition of the tooth.
Sometimes. The decision depends on the teeth involved, complexity, appointment length and your comfort.
We do not recommend removing a sound restoration on the basis that removal will improve your general health. If you are worried, an assessment can help you understand the condition of your teeth and your options.
Read:
What is SMART amalgam removal?
Should I have my amalgam fillings removed?
What happens during SMART amalgam removal?
Or visit our complete cornerstone:
Amalgam removal using the SMART protocol
For a calm overview of the entire subject, download:
Your guide to SMART amalgam removal
It covers the decision to treat, the procedure, replacement options and questions to ask before going ahead.
If you have an amalgam restoration and are unsure whether it requires treatment, an assessment can give you much more useful information than trying to make the decision from online information alone.
Arrange an consultation with Carol or Maggie
Read the IAOMT’s information about the SMART protocol
Read our CQC report
Why is my dentist taking photographs of my teeth?
“Why are you taking photographs of my teeth?”
A perfectly reasonable question.
Dental photographs aren`t just for before-and-afters.
They can help us record what we`re seeing, monitor changes, explain things more clearly and involve you in conversations about your own teeth.
Richard explains why you might see a camera appear during an appointment at Evolve.
Because when we`re talking about your mouth, we think it`s rather useful if you can see what we`re talking about too.
There`s more to a smile transformation than two photographs
A before-and-after shows you two moments.
What it doesn`t show is everything that happened between them.
The conversations. The planning. What the patient wanted to change. The different options considered. And the decisions about what not to change.
That`s why we think the story behind a smile is every bit as interesting as the finished result.
Every patient is different - and every treatment plan should be too.
Here`s one of the lovely transformations we`ve had the privilege of being part of at Evolve. 💚
What actually happens during a dental examination?
If it’s been a while since your last dental examination, not knowing what to expect can sometimes make booking that appointment feel like a much bigger deal.
So what actually happens when you come in?
Richard explains what your dentist is looking for during a dental examination - and why it involves much more than simply checking whether you need a filling.
Regular examinations give us an opportunity to keep an eye on your teeth, gums and mouth, talk about anything that has changed and identify anything that may need our attention.
And if you haven’t been for a while? Please don’t feel embarrassed.
We’re simply pleased you’ve decided to come and see us.
🦷 We’re hiring - Dental Nurse | Portishead
We’re looking for a lovely new person to join our award-winning team at Evolve Dentistry.
You could be an experienced or newly qualified Dental Nurse, already in training, or looking for a completely new career - we’re genuinely open to all three. Finding the right person matters most.
If you’re new to dental nursing, we’ll fund and support you through your qualification.
💚 Permanent | Approx. 36 hours per week
💷 Trainee: £13.50-£14.50 per hour
💷 Qualified: £14.50-£16.55 per hour
📍 Portishead
📅 Monday, Thursday, Friday + alternate Saturdays
You’ll join a friendly, supportive team with great benefits, funded training and plenty of opportunities to develop.
Interested? Send your CV and a short covering note to hello@evolve-dentistry.co.uk.
Know someone who might be perfect for Evolve? Please tag them or share this with them. 💚
https://evolve-dentistry.co.uk/recruitment/
A little Evolve refresh 💚
You may have noticed something new if you’ve passed us recently…
Our new external signage is up!
We’ve given the outside of Evolve a refresh, making it even easier to spot us when you’re visiting the practice.
It’s been lovely seeing everything come together, and we think it looks rather smart. 😊
Have you spotted it yet?
#EvolveDentistry #Portishead #PortisheadDentist #LovePortishead #Evolve
Starting orthodontic treatment can feel like a big step.
But once you know what to expect, the whole journey often feels much less daunting.
From your first appointment to the day your braces come off, every stage is carefully planned to help you achieve a healthy, confident smile.
Swipe through our step-by-step guide to see what happens during orthodontic treatment - and how we’ll support you every step of the way.
https://bit.ly/3RTNc22
#AdultBraces #Orthodontics #SmileJourney #SmileConfidence #EvolveDentistry #portishead #nailsea #clevedon #Portisheadmarina
