Many people are deciding they want to have their silver amalgam (mercury) fillings removed, but this can cause a tremendous amount of mercury to be absorbed by their body and make them ill.  To help prevent this, safety precautions should be used so the person won’t swallow or breathe mercury vapor while the fillings are being drilled out.

Mercury vaporizes at room temperature.  As soon as the dentist touches the filling with a drill, the temperature soars and the mercury vapor comes pouring off the fillings. Then when you take a breath it goes right into your lungs.  To prevent this from happening, we take the following safety precautions:

• Safety glasses are put over your eyes to protect them from settling mercury particles and vapor.

• We have you breathe pure bottled oxygen through a nasal cannula (tube).  This will minimize your breathing the air right around your face, which is full of mercury vapor.  Your nose will be covered with a dental mask to help keep the mercury vapor from going into your nostrils.

•  A rubber dam will be placed over your mouth.  This is a sheet of rubber that helps keep the mercury from going down your throat.

• Copious amounts of cold water will be constantly squirted on the filling as it’s being drilled out, to keep the temperature down.

• A Clean-up device will be used when necessary. T he Clean-up fits over the tooth and is attached to the suction, so it pulls all particles away from the tooth as the filling is being drilled out.

• A high-volume air evacuator is placed directly in front of your face while the filling is being drilled out. This pulls all the air-borne particles away from your face, to prevent you from breathing/swallowing them.

• Powdered charcoal and chlorella are placed in your mouth under the rubber dam. Both these substances have the ability to absorb mercury particles before they get absorbed into your system.

• The fillings will be taken out with as little drilling as possible, in as large chunks as possible, to minimize the amount of mercury vapor released into the air.

• The dental staff protects themselves by wearing industrial grade gas masks while the mercury is being drilled out.  They know that the air around them is full of mercury vapor which could be a liability to both their bodies and to yours.

• Dr. Behm uses 4.5x magnifiers to see minute details in the tooth.  This could include faint cracks and leaking crowns or fillings.  He can also make sure that the new crown or filling fits perfectly.  Trying to do this without magnification makes it harder to get perfect results.  Problems areas in the gums are more visible under magnification than with the naked eye (see below). 

The difference between 4.5 magnification and the naked eye.

The difference between 4.5 magnification and the naked eye.

• An industrial strength ion generator is mounted over the patient’s chair, which electrostatically captures any particles of mercury vapor that are released.

See the amazing story of a patient, Russ Tanner, and his experience in our office.

Here is the IAOMT protocol for mercury removal.

Cost
We get many inquiries as to how much it costs to have the mercury fillings replaced.  We may cost more than some dental offices, but we take many more safety precautions than most offices take. 

The main factor in cost is what is used to replace the old metal filling.  If the metal filling was small, a composite (plastic) filling can be done, which is around $200 to $300.  If the amalgam filling was large, it will probably take either an inlay, onlay or crown to restore the tooth. 

An inlay is a lab-made restoration (also called “indirect”) that sits inside the cusps of the tooth.  Cusps are the four bumps on the corners of each molar.  If these are sound, it is best to leave them, and just replace the center of the tooth.   Below you can see the cusps, where the corners of the teeth protrude. 

Here are 3 onlays, ready to be seated.

Here are 3 onlays, ready to be seated.

An onlay is an indirect restoration that replaces at least one of the four cusps.  Again, we feel that it is better to do a “conservative” preparation, and leave as much of the healthy tooth as possible.  We definitely do not drill the tooth down into a little teepee.  

Below is a picture of the onlays on a model.  You can see how the preparation of the teeth are “conservative” (removing as little tooth structure as necessary). 

Onlays on model.  Notice the amount of good tooth left.

Onlays on model. Notice the amount of good tooth left.

A full-coverage crown is needed when all the cusps are not salvagable, or when a neuromuscular adjustment needs to be made.  This can occur if the “bite needs to be opened,” which means the teeth need to be made longer due to their having gotten shorter after years of grinding. 


8 Responses to “Amalgam Removal”

  • mbehm:

    Hi Stacy,
    We never recommend the removal of healthy teeth. If the fillings are small, it is definitely more cost effective to have them replaced rather than have the teeth pulled (in which case the missing teeth may then need to be replaced, which will cost more).
    Best,
    Dr. Behm

  • mbehm:

    Hi Laura,
    Please call Amy at the office at 727 446-6747, she can answer your questions. Also we do provide financing for the dental work, Amy can tell you about that.
    Best,
    Dr. Behm

  • laura guerrero:

    Hi!
    I am looking at getting my husband into the office for removal of 12 amalgam/ mercury fillings that have been in his mouth approximately 20 years.
    I am a little worried about the costs and was curious if there is a price forgiveness for the amount of work needed to be done.
    Thanks!
    Laura

  • Stacy:

    Is it any cheaper to have a tooth removed because of amalgam filling vs.having filling removed and replaced my husband has 2 small fillings and if it is cheaper would like to have the teeth completely removed (im hoping it is not)

  • mbehm:

    They will usually pay the amount it would cost to replace the filling with another amalgam filling, but only if the existing Hg is broken down, leaking or old.
    Best,
    Dr. Behm

  • mbehm:

    Ms. Jones,
    The Rita Meter can detect electrogalvanism created by metals in the mouth. If you no longer have metals, it probably is not electromagnetism, quite possibly the bite is off. Sometimes metal is left in the tooth, and a white filling placed over that; x-rays would show if that is the case. Also, not all white fillings are biocompatible, were you tested for the material that is in your mouth to ensure it is compatible with your body? But I would say the culprit is most likely the bite. That should be adjusted with fine tuned precision, and can handle a myriad of problems, pains, sensitivities, etc.
    Best,
    Dr. Behm

  • mbehm:

    Hi Jennifer,
    The main expense depends on what is used to replace the fillings. A small filling could be $200 or 300. If the filling is large, it may need to be replaced with an inlay, onlay or crown. I will be posting on the site the difference between these 3. Those 3 are all made in a lab, and run around $1200 each.
    If you need more info, pls call the office at 727 446-6747
    Thanks
    Mercedes

  • Jennifer Keating:

    Hello!
    Please give me an approximate cost for removing three amalgam fillings.
    Thank you!
    Jennifer Keating

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Testimonials
I have been a patient of Dr. Behm’s for about four years now. I’m 57 years old, and have lived in 5 different states, so I’ve seen several dentists over the years. I can say without a doubt that Ray Behm is the best dentist I’ve ever had. More than that, as far as I’m concerned, he sets a new, higher standard for dentists. First of all, Dr. Behm cares for people.
Richard Byrd