Face 
Dentistry 
The short answer: SMART amalgam removal involves assessing the tooth, planning how it will be restored, making you comfortable, putting additional protective measures in place, carefully removing the amalgam and restoring the tooth appropriately afterwards.
If you have never experienced SMART amalgam removal, the setup can sound more complicated than an ordinary filling appointment.
Understanding why each stage is there can make the process much easier to picture.
Here is what you can generally expect at Evolve Dentistry.
Your first appointment is not about immediately taking amalgam fillings out.
Carol or Maggie will first understand why you are considering treatment.
Perhaps:
We then examine the restoration and surrounding tooth.
Where clinically appropriate, dental X-rays may form part of the assessment.
An amalgam filling does not automatically need removing.
If the restoration appears serviceable, monitoring it may be an option.
If treatment is recommended, we will explain why.
If your reason for considering replacement is cosmetic, we will discuss the implications of removing a functioning restoration before you decide.
This stage matters because SMART describes amalgam is removed.
It does not tell us whether it should be removed.
Before removing a filling, we need to consider what the tooth will require afterwards.
For some teeth, a direct tooth-coloured composite restoration may be appropriate.
For others, particularly where a substantial amount of tooth structure has already been lost, a different restoration may be recommended.
Possible options can include:
We will explain the expected approach before treatment begins.
Local anaesthetic can be used to numb the tooth and surrounding area.
The aim is to make treatment comfortable.
You may still be aware of sensations such as:
If you are nervous, tell us before treatment begins.
We can explain what is happening and agree a signal you can use if you want us to pause.
SMART stands for Safe Mercury Amalgam Removal Technique.
The protocol incorporates additional measures intended to reduce exposure to amalgam particles and mercury vapour during removal.
The precise clinical setup depends on the individual treatment, but precautions relate to areas including:
The setup can therefore look more involved than you might expect for an ordinary restorative appointment.
Rubber dam isolation can be used around the tooth being treated.
A rubber dam is a flexible sheet that separates the treatment area from the rest of your mouth.
It helps control debris and provides a more isolated working environment.
You remain able to breathe through your nose.
If you have never experienced a rubber dam before, we can explain how it works before it is placed.
High-volume suction is placed close to the treatment area.
Additional protective and air-management measures associated with the SMART protocol are also used as appropriate.
The existing restoration is carefully removed.
Where clinically appropriate, it can be divided into sections so that pieces can be removed rather than unnecessarily grinding away the entire restoration.
Water cooling and suction are used during this process.
There is an important point patients sometimes overlook:
we cannot always know exactly what lies underneath a large old restoration until it has been removed.
Assessment and X-rays help us plan, but they cannot reveal every detail.
Once the amalgam has been removed, Carol or Maggie can examine the remaining tooth more directly.
Often this confirms what was expected.
Occasionally we may discover:
If that happens, we will explain what we have found and what it means for the restoration.
Once the old filling has been removed and the tooth prepared appropriately, the replacement restoration can be provided according to the treatment plan.
The objective is not simply to make the tooth “white”.
The new restoration needs to function appropriately for that particular tooth.
Once the restoration is in place, we check how it feels when your teeth meet.
A restoration that sits slightly too high can feel uncomfortable once the anaesthetic wears off, so adjustments can be made where required.
Before you leave, we will explain what you may notice once the local anaesthetic wears off.
Some temporary sensitivity or awareness can occur after restorative treatment.
You will also know when to contact us if something does not feel right.
The local anaesthetic is intended to prevent painful sensation from the tooth during treatment.
You may nevertheless notice:
Some patients find the SMART setup reassuring because the treatment area feels more separated from the rest of the mouth.
Others simply need a little time to become accustomed to it.
There is no single SMART appointment length.
Treatment time depends on:
Following assessment, we can give you a much more useful idea of the time required for your own treatment.
Your mouth may remain numb for a period after the appointment.
Take care when eating until normal sensation has returned so that you do not accidentally bite your cheek, lip or tongue.
The tooth may initially feel different.
This can happen simply because the shape and material of the restoration have changed.
If your bite feels wrong, symptoms persist or you are concerned about anything, contact us.
Reality: The tooth still undergoes restorative dental treatment. SMART adds specific precautions to the amalgam-removal stage.
Reality: Examination and X-rays provide valuable information, but sometimes the full condition of the tooth only becomes clear once the existing restoration has been removed.
Reality: The tooth then needs to be restored appropriately.
Reality: No dental procedure is entirely without risk. SMART adds precautions during removal but does not remove the normal considerations associated with restorative treatment.
Local anaesthetic can be used to make the tooth comfortable during treatment. Carol or Maggie will discuss your individual appointment with you.
Yes. The dam isolates the treatment area in the mouth, but you continue breathing through your nose.
Yes. We can agree a signal before treatment so you remain able to communicate if you need us to pause.
This depends on your individual treatment plan and the type of restoration required. We will explain the expected sequence before treatment.
Some temporary sensitivity can occur after restorative treatment. We will explain what to expect and when we would like you to contact us.
For more detail, read:
What is SMART amalgam removal?
Is it safe to remove amalgam fillings?
What can replace an amalgam filling?
How long does amalgam removal take?
Or return to the complete:
Amalgam removal using the SMART protocol
Your guide to SMART amalgam removal explains the full journey from deciding whether treatment is appropriate through to replacement and aftercare.
Carol or Maggie can assess your existing restorations and explain what your individual treatment would involve.
An assessment does not commit you to having anything removed.
Arrange an amalgam consultation
Read more about the SMART protocol from the IAOMT
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
