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Safe Mercury Amalgam Removal in Encino: SMART Protocol
If you have silver amalgam fillings, you’re carrying mercury in your mouth. While these fillings were once considered the standard of care, we now understand that mercury—a known neurotoxin—poses potential health risks. At Encino Holistic Dentistry, Dr. Linda Makuta is certified in the Safe Mercury Amalgam Removal Technique (SMART) protocol, ensuring that if you choose to have your amalgam fillings removed, it’s done with maximum protection for you, our staff, and the environment.
We are proud members of the International Academy of Oral Medicine and Toxicology (IAOMT) and follow their rigorous protocols for mercury-safe dentistry.
Before and After Mercury Filling Removal
Understanding Amalgam Fillings and Mercury
Why Mercury Matters
Mercury is a potent neurotoxin. According to the IAOMT, mercury vapor is continuously released from amalgam fillings, particularly during:- Brushing teeth
- Chewing food
- Drinking hot beverages
- Teeth grinding or clenching
- Dental cleanings
- Placement, replacement, or removal of amalgam fillings
The Environmental Impact
The EPA has recognized the environmental danger of dental mercury. As of July 2020, all dental offices are required to use amalgam separators to prevent mercury from entering our sewers and eventually reaching the ocean. If mercury is considered too dangerous for our waterways, why would we want it in our mouths?
At Encino Holistic Dentistry, we use amalgam separators at all times and have never placed amalgam fillings. We are a completely mercury-free practice.
Health Effects of Mercury Exposure
According to the EPA, mercury exposure can cause a wide range of health effects. While everyone’s sensitivity differs, it’s important to be aware of potential symptoms:
Symptoms of Acute Mercury Exposure
- Tremors
- Emotional changes (mood swings, irritability, nervousness, excessive shyness)
- Insomnia
- Neuromuscular changes (weakness, muscle atrophy, twitching)
- Headaches
- Disturbances in sensations
- Changes in nerve responses
- Poor performance on tests of mental function
Symptoms of High Mercury Exposure
- Skin rashes and dermatitis
- Mood swings
- Memory loss
- Mental disturbances
- Muscle weakness
- Damage to the gastrointestinal tract
- Damage to the nervous system
- Damage to the kidneys
For a complete list of health effects, visit the EPA’s website.
Should You Replace Your Amalgam Fillings?
At Encino Holistic Dentistry, we believe in informed patient choice. We don’t pressure patients to replace amalgam fillings solely because they contain mercury. However, we do encourage you to become educated about mercury’s potential effects on health.
Reasons to Consider Amalgam Removal
You may want to replace your amalgam fillings if:
- The filling is damaged: Cracked, worn, or loose fillings should be replaced regardless of material
- Decay has developed: Cavities around or under old fillings require treatment
- You’re experiencing symptoms: That you suspect may be related to mercury exposure
- You’re pregnant or planning pregnancy: Mercury can cross the placental barrier
- You’re nursing: Mercury can appear in breast milk
- You have multiple large fillings: Greater surface area means more potential mercury exposure
- You want to eliminate mercury: As a proactive health measure
- You want better aesthetics: Tooth-colored fillings look more natural
- You have metal sensitivities: Or prefer biocompatible materials
When Amalgam Removal May Not Be Urgent
If your amalgam fillings are:
- In good condition with no cracks or wear
- Not causing symptoms
- Small and few in number
You may choose to leave them in place and simply monitor them. The most dangerous time for mercury exposure is actually during removal if proper protocols aren’t followed—which is why the SMART protocol is so critical.
Before Amalgam Removal
During Amalgam Removal
After Amalgam Removal
The SMART Protocol: Maximum Protection During Removal
Dr. Linda Makuta is certified in the Safe Mercury Amalgam Removal Technique (SMART) developed by the International Academy of Oral Medicine and Toxicology (IAOMT). This comprehensive protocol provides maximum protection for patients, dental staff, and the environment during amalgam removal.
Our Complete SMART Protocol Process
Before Removal Begins
- Amalgam separator: Used at all times to capture mercury and prevent environmental contamination
- Room preparation: High-volume HEPA air filtration system activated
- Staff protection: All staff wear respiratory masks with mercury vapor protection
Protecting You During the Procedure
- Full body protection: Protective covering for your body, head, and eyes
- External oxygen: You breathe clean oxygen through a nasal cannula, not the air around the work area
- Rubber dam isolation: Non-latex dental dam completely isolates the tooth, keeping mercury particles and vapor out of your mouth and throat
- High-volume evacuation: Powerful suction (placed 2-4 inches from your mouth) captures mercury vapor and particles before you can inhale them
- Copious water irrigation: Continuous water spray keeps the filling cool and washes away particles
Safe Removal Technique
- Sectioning method: Amalgam is removed in large chunks rather than being ground out, which significantly reduces mercury vapor production
- Minimal drilling: Strategic removal minimizes heat and vapor generation
- Immediate disposal: Removed amalgam is placed directly into a hazardous waste container
After Removal
- Thorough mouth rinse: Your mouth is thoroughly flushed with water to remove any residual particles
- Room decontamination: Complete wipe-down of the treatment area before proceeding with the new filling
- Protective barrier removal: All protective coverings are carefully removed and disposed of properly
- Air filtration continues: HEPA filtration runs throughout and after the procedure
Additional Detoxification Support
To support your body’s natural detoxification processes after amalgam removal, we provide and recommend:
Complimentary Activated Charcoal
We provide activated charcoal to help bind and eliminate any mercury that may have been absorbed during the removal process. Activated charcoal is a powerful natural detoxifier.
Optional Ozone Therapy
Available for an additional fee, ozone therapy offers multiple benefits after amalgam removal:
- Kills bacteria in the tooth structure
- Improves tooth health
- Supports healing
- Enhances the bond between tooth and filling
- Provides additional antimicrobial protection
Professional-Grade Detoxification Supplements
We offer high-quality liposomal supplements to support your body’s detoxification:
Liposomal Glutathione
Glutathione is one of the body’s most powerful detoxifiers. It supports healthy immune function and can neutralize a broad spectrum of free radicals. Our liposomal glutathione offers much more rapid and complete uptake than non-liposomal alternatives.
Best for: Supporting your body’s master detoxification pathway
Liposomal Vitamin C with R-Lipoic Acid
Two of the most powerful and versatile antioxidants—Vitamin C and Lipoic Acid—are paired to support detoxification throughout the body. In addition to functioning as extraordinary antioxidants on their own, both can support increased levels of glutathione in the body.
Best for: Comprehensive antioxidant and detoxification support
Liposomal Vitamin C
Vitamin C is a potent water-soluble antioxidant that, even in small amounts, can protect us from damage by free radicals. It’s vital to immune function and is an essential cofactor in many enzymatic reactions in the body. It is a truly universal antioxidant.
Best for: Immune support and general antioxidant protection
Note: Liposomal delivery systems significantly enhance absorption compared to standard supplements, making these products particularly effective for supporting detoxification.
The Complete Amalgam Removal and Replacement Process
Step 1: Consultation and Planning
Dr. Makuta will:
- Examine all your amalgam fillings
- Assess their condition
- Take X-rays if needed
- Discuss your health history and any symptoms
- Explain the SMART protocol
- Create a treatment plan (if you have multiple fillings, we typically remove them over several appointments)
- Answer all your questions
- Discuss detoxification support options
Step 2: Pre-Removal Preparation
Before your appointment:
- Begin taking antioxidant supplements if recommended
- Stay well-hydrated
- Eat a nutritious diet to support your body
- Get adequate rest
- Follow any specific instructions from Dr. Makuta
Step 3: Safe Amalgam Removal
On the day of your appointment:
- All SMART protocol safety measures are implemented
- You’re made comfortable with anesthesia
- The amalgam filling is carefully removed following SMART guidelines
- The tooth is thoroughly cleaned and prepared
- Optional ozone therapy is applied if selected
- A biocompatible, mercury-free composite filling is placed
- Your bite is checked and adjusted for comfort
Step 4: Post-Removal Support
After your appointment:
- Take activated charcoal as directed
- Use any recommended detoxification supplements
- Drink plenty of water to support elimination
- Eat a clean, nutritious diet
- Get adequate rest to support healing
- Avoid additional mercury exposure (certain fish, etc.)
- Follow up with Dr. Makuta as scheduled
Prioritizing Multiple Filling Removals
If you have several amalgam fillings, we typically remove them over multiple appointments to minimize your mercury exposure at any one time. Dr. Makuta will help prioritize which fillings to remove first based on:
- Condition: Damaged or leaking fillings first
- Size: Larger fillings may release more mercury
- Location: Strategic removal order for comfort and function
- Your symptoms: If certain teeth seem to be causing issues
- Your schedule: Spacing appointments appropriately
What to Expect After Amalgam Removal
Immediate Effects
- Normal post-filling sensitivity is possible
- New composite fillings may feel slightly different than amalgam
- Your bite may need minor adjustment
- You can eat and drink normally once numbness wears off
Long-Term Benefits
Many patients report improvements after amalgam removal, including:
- Increased energy
- Improved mental clarity
- Better sleep
- Reduction in unexplained symptoms
- Peace of mind from eliminating mercury exposure
- Improved appearance of their smile
Note: Individual experiences vary. While many people report feeling better after amalgam removal, we cannot guarantee specific health outcomes.
Why the SMART Protocol Matters
Not all dentists who remove amalgam fillings follow the SMART protocol. Without proper precautions, amalgam removal can actually increase your mercury exposure more than leaving the fillings in place.
The Dangers of Unprotected Removal
When amalgam is drilled out without SMART protocols:
- Mercury vapor is released in high concentrations
- You can inhale this vapor directly
- Mercury particles can be swallowed
- Exposure during removal can exceed years of exposure from intact fillings
SMART Protocol Protection
The SMART protocol dramatically reduces exposure through:
- Keeping you breathing clean oxygen, not mercury vapor
- Isolating the work area so you can’t swallow particles
- Capturing vapor before it can spread
- Using techniques that minimize vapor production
- Protecting everyone in the room
This is why Dr. Makuta invested in certification and the specialized equipment required for SMART protocol—because your safety matters.
Our Commitment to Mercury-Free Dentistry
At Encino Holistic Dentistry, we are committed to mercury-free, mercury-safe dentistry:
- We never place amalgam: All our fillings are mercury-free composite, ceramic, or gold
- We’re IAOMT members: Committed to the highest standards of biological dentistry
- We’re SMART certified: Dr. Makuta has completed rigorous training in safe amalgam removal
- We use amalgam separators: Protecting the environment from mercury contamination
- We offer detoxification support: Helping your body eliminate any absorbed mercury
- We use biocompatible materials: All our dental materials are selected for safety and compatibility
Frequently Asked Questions
Is amalgam removal covered by insurance?
Insurance typically covers amalgam removal if the filling is damaged, broken, or has decay around it—just as they would cover replacement of any failing filling. If you’re removing intact amalgam fillings proactively, insurance may not cover the removal, but will usually cover the new filling at their standard rate. We provide detailed documentation for you to submit to your insurance company.
Does amalgam removal hurt?
The procedure itself is performed under local anesthesia, so you won’t feel pain during removal. Some patients experience typical post-filling sensitivity afterward, which usually resolves within a few days.
How long does amalgam removal take?
Removing and replacing a single amalgam filling typically takes 45-90 minutes, depending on the size and location of the filling. The SMART protocol requires extra time for safety measures, but this investment in your protection is well worth it.
Can I have all my amalgams removed at once?
We typically recommend removing amalgam fillings over several appointments to limit your mercury exposure at any one time. The exact schedule depends on how many fillings you have and their locations.
What will replace my amalgam fillings?
We use biocompatible, tooth-colored composite resin fillings. For larger restorations, we may recommend ceramic inlays or onlays. All materials are mercury-free, BPA-free, and carefully selected for compatibility with your body.
Is the SMART protocol really necessary?
Absolutely. Research shows that amalgam removal without proper protection significantly increases mercury exposure. The SMART protocol provides scientifically-validated protection for you, our staff, and the environment.
Take the Next Step Toward Mercury-Free Dentistry
If you have amalgam fillings and are concerned about mercury exposure, or if your amalgam fillings need replacement due to damage or decay, Dr. Linda Makuta provides the safest possible removal using the SMART protocol.
Your health is our priority. We combine advanced protective protocols with biocompatible replacement materials to give you a smile that’s not only beautiful but supports your overall wellness.
Schedule Your Amalgam Removal Consultation Today
Take the first step toward eliminating mercury from your mouth. Dr. Makuta will evaluate your fillings, explain the SMART protocol in detail, answer all your questions, and create a personalized treatment plan.
Contact Encino Holistic Dentistry:
Call (818) 986-7470
Located at 5400 Balboa Blvd #211, Encino, CA 91316
Serving patients throughout the San Fernando Valley including Encino, Tarzana, Sherman Oaks, Woodland Hills, Reseda, and Van Nuys.
Certified SMART protocol. IAOMT member. Completely mercury-free practice. Your safety is our highest priority.
Holistic Dental Checkups
Comprehensive exams that connect your oral health to overall wellness, using biocompatible materials and preventive care.
Safe Mercury Removal
Mercury-free dentistry with SMART protocol for safe amalgam removal, protecting your health and the environment.
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Safe, customized whitening for a radiant smile. Whitening for Life program available for long-lasting results.
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Discreet clear aligners straighten teeth without metal braces. Comfortable, effective, and virtually invisible.