Are you concerned about the mercury in your dental fillings? Many patients have questions about amalgam fillings and want to understand their options. If you decide to have them removed, you deserve a careful removal process that protects your health while it is done.
At Club K Holistic Dental, our team follows the IAOMT’s SMART safety protocol for amalgam removal as part of our broader commitment to holistic dental care. Dr. Knapton is certified in SMART (Safe Mercury Amalgam Removal Technique), which is designed to help protect both patients and our dental team during removal.
Experience comprehensive dental care that considers your overall health and wellness with natural treatment approaches.
Dental amalgam fillings, often called “silver fillings,” are made of a mixture of mercury and a powdered alloy of silver, tin, and copper, and they contain approximately 50% mercury. They have been used for over 150 years because they are durable and affordable. According to the FDA, amalgam releases small amounts of mercury vapor over time, how much can depend on the age of the filling and habits such as teeth grinding, and vapor release may be highest during placement or removal.
The FDA states that low levels of inhaled mercury vapor are generally not harmful to most people. It recommends that certain high-risk groups avoid dental amalgam whenever possible and appropriate, including pregnant women and women planning to become pregnant, nursing women, children (especially those younger than six), people with pre-existing neurological disease or impaired kidney function, and people with a known sensitivity or allergy to mercury or other components of amalgam. The FDA also is not recommending that anyone remove or replace existing amalgam fillings in good condition unless it is considered medically necessary, because removing intact fillings can temporarily increase mercury vapor exposure and can cost healthy tooth structure.
Patients choose to have their amalgam fillings removed for a range of reasons. Some have concerns about long-term mercury exposure, and some have fillings that are cracked, worn, or leaking. Amalgam can also darken over time and cause the surrounding tooth to look gray, and some patients prefer tooth-colored restorations or simply want peace of mind. Common reasons include:
Whatever your reason, removal should be done by a provider who follows careful protocol. Because mercury vapor release may be highest during removal, removing amalgam without adequate precautions can expose you to more vapor than the fillings release otherwise. We would be glad to talk through whether removal makes sense for you.
The SMART protocol is a set of safety measures developed by the IAOMT for removing mercury amalgam fillings. It is designed to reduce mercury exposure for everyone in the treatment room, and not all dentists are trained in it. Dr. Knapton is SMART-certified, which involves completing coursework, scientific readings, and testing through the IAOMT.
Our SMART protocol includes several protective measures working together:
Our dental team wears protective equipment, including masks with mercury vapor filters, hair coverings, and full-body coverings.
Arriving well prepared helps the appointment go smoothly. In the days before your visit, avoid alcohol and processed foods, stay well hydrated, and eat a nutritious meal before you arrive. We may suggest optional nutritional support beforehand, which we will discuss during your consultation. Avoid wearing jewelry, perfumes, or lotions that could interfere with protective barriers. Our team will provide specific pre-treatment instructions based on your health history.
After your appointment, we offer optional guidance on nutrition and timing to support your recovery.
Pre-removal consultation: health history, current filling assessment, and discussion of symptoms and goals
Charcoal or chlorella rinse: used before treatment as part of our protocol
Safety setup: rubber dam, high-volume evacuation, protective equipment, and oxygen delivery for the patient; respirator masks and gowns for clinical staff
Sectional removal: amalgam removed in large pieces rather than ground, to minimize mercury vapor release
Air filtration: four-filter mercury vapor filtration system running throughout the procedure
Biocompatible restoration: ceramic preferred; composite available on request
Nutrition guidance (optional): personalized recommendations to support your recovery after removal
Service / Item | Price |
|---|---|
SMART protocol surcharge | $55 per quadrant |
Ceramic inlay/onlay restoration (per tooth) | Starting at $875 |
Initial consultation / assessment | $160 |
Full-mouth amalgam removal | Contact for custom treatment plan |
Financing available through Sunbit & Cherry Pay
After amalgam is removed, we place a biocompatible restoration. Ceramic is our preferred material, and composite is available on request.
For many amalgam replacements, ceramic inlays and onlays offer excellent durability and a natural appearance. These custom restorations are fabricated with our in-office milling system and bonded to your tooth.
When a tooth needs full coverage, we offer ceramic crowns that restore both function and appearance.
Composite resin is a tooth-colored material made of plastic and fine glass particles that bonds directly to the tooth. It is available on request. Dr. Knapton will discuss which option fits each tooth, based on the size of the restoration, its location, and your preferences.
Dental amalgam fillings contain approximately 50% mercury. The FDA states that amalgam releases small amounts of mercury vapor over time and that low levels of inhaled vapor are generally not harmful to most people. It recommends that certain high-risk groups avoid amalgam whenever possible and appropriate, including pregnant women, children, and people with a known sensitivity to mercury. If you have questions about the mercury in your fillings, we are happy to talk them through during a consultation.
Our SMART protocol begins with an activated charcoal or chlorella rinse before treatment. We then set up a rubber dam, a high-volume evacuation system, and protective equipment, and we deliver oxygen through a nasal mask throughout the procedure. Clinical staff wear respirator masks and full protective gowns. Amalgam is removed in large pieces rather than ground down to minimize mercury vapor release, and a specialized four-filter mercury vapor filtration system runs throughout the procedure. After removal, Dr. Knapton can provide optional nutrition guidance to support your recovery.
The IAOMT does not recommend amalgam filling removal for women who are pregnant or breastfeeding as a safety precaution. If you are planning to become pregnant, we can discuss the best timing for any removal in your specific situation.
The SMART protocol surcharge is $55 per quadrant, in addition to the cost of your restoration. A ceramic inlay or onlay restoration starts at $875 per tooth. Ceramic is our preferred material, though composite is available on request. An initial consultation and assessment is $160. For full-mouth amalgam removal, pricing varies depending on the number of fillings and complexity, so contact us for a custom treatment plan. We are a fee-for-service, out-of-network practice and offer financing through Sunbit and Cherry Pay.
The time required depends on the number and size of fillings being removed. For patients with multiple amalgam fillings, we often plan treatment in phases, usually by quadrant, to make the process more manageable both clinically and financially. During your consultation, we will provide a detailed treatment plan with timing estimates based on your needs.
While it is technically possible to remove multiple fillings in one appointment, we often recommend a phased approach. The number of fillings removed per session depends on their location, size, your overall health, and your comfort level, and Dr. Knapton will recommend a plan during your consultation.
You might consider removal if you have concerns about long-term mercury exposure, are planning a pregnancy, have amalgam fillings that are cracked, worn, or leaking, or simply prefer tooth-colored, biocompatible restorations. Because the FDA is not recommending removal of existing amalgam fillings in good condition unless medically necessary, we will talk through your specific situation during a consultation and help you make an informed decision.
Preparation includes eating a nutritious meal before your appointment, avoiding alcohol and processed foods for several days before treatment, staying well hydrated, and avoiding jewelry, perfumes, or lotions. We may also suggest optional nutritional support beforehand. Our team will provide specific pre-treatment instructions based on your health history.
At Club K Holistic Dental, we prioritize your health and safety during every procedure. Dr. Knapton holds a dual DMD and MBA from Roseman University of Health Sciences, is certified in the SMART protocol, and is an active member of the International Academy of Oral Medicine and Toxicology (IAOMT) and the Academy of General Dentistry (AGD). We combine careful protocol with compassionate care so you are comfortable throughout the removal process.
We are a fee-for-service practice and are out of network with all insurers, though our team can submit documentation for potential out-of-network reimbursement. Financing is available through Sunbit and Cherry Pay. Contact our office to schedule your SMART consultation in Springfield, Missouri.
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