Welcome to my practice. I am Dr. Bruce Vafa, and for over 25 years, I have been dedicated to providing holistic and cosmetic dental care here in West Hollywood and Los Angeles. If you are reading this, you are likely doing research on your health. You might be looking in the mirror at those dark, silver fillings in your teeth and wondering if they are safe. You are not alone.
Many of my patients come to me because they are concerned about the materials used in their mouths in the past. Specifically, they are worried about mercury. Today, I want to walk you through everything you need to know about mercury removal and why the method we use—the SMART protocol—is absolutely vital for your safety.
Understanding the “Silver” Filling
For decades, standard dentistry relied on “silver” fillings to repair cavities. In the dental world, we call these amalgam fillings. While they look like silver, the name can be misleading. These fillings are actually an alloy, which is a mixture of metals.
Here is a fact that surprises many people: Dental amalgam is approximately 50% mercury by weight. The other 50% is a mix of silver, tin, and copper. Mercury is used to bind these metals together to create a hard, durable filling.
While these fillings have been used for a long time, we now know much more about how materials interact with the human body. As a holistic dentist, my philosophy is simple: what we put in your mouth affects your entire body. This is why I advocate for biocompatible materials that work in harmony with your overall health.
Why “Just Drilling It Out” Is Dangerous
You might think, “Dr. Vafa, if these fillings have mercury, let’s just drill them out right now!” I love your enthusiasm for health, but we have to be very careful. This is the most critical part of the conversation.
When a dentist drills into an amalgam filling using a standard high-speed drill without protection, it generates heat. This heat causes the mercury in the filling to turn into a vapor. It also creates tiny particulate matter (dust). If you do not use specific safety measures, you (the patient), the dentist, and the dental assistants can inhale this mercury vapor. It can also be absorbed through the soft tissues of your mouth.
Removing a mercury filling unsafely can actually expose you to more mercury in a single appointment than leaving the filling alone would over many years. This is why standard removal is not enough. We need a specialized approach.
Enter the SMART Protocol
To ensure your safety, I follow the SMART protocol. This stands for the Safe Mercury Amalgam Removal Technique. It was developed by the International Academy of Oral Medicine and Toxicology (IAOMT). This organization is a high-authority global network of dentists and scientists dedicated to researching the biocompatibility of dental products.
The SMART protocol is a rigorous set of safety recommendations designed to reduce mercury exposure during the removal process significantly. When you come to my Los Angeles office for mercury removal, we don’t cut corners. We treat this procedure with the seriousness it deserves.
Step-by-Step: How I Keep You Safe
When you sit in my chair for this procedure, you will notice it looks a little different than a routine cleaning. Here is exactly what we do and why we do it:
- Activated Charcoal or Adsorbent Rinse: Before we begin, I will have you rinse with a slurry of charcoal or a similar adsorbent. If any tiny mercury particles are swallowed during the procedure, this helps bind to them so they pass through your system without being absorbed.
- Protective Body Draping: We cover your body with an impermeable barrier. This prevents mercury dust from settling on your clothes or skin.
- External Air/Oxygen Supply: This is crucial. We place a nasal mask on you that delivers clean, medical-grade oxygen or air. This ensures that you are breathing pure air, not the air immediately around your mouth where vapor might be present.
- Dental Dam (Rubber Dam): I place a non-latex rubber sheet around the tooth we are working on. This isolates the tooth from the rest of your mouth. It acts as a physical barrier, preventing you from swallowing water or debris from the old filling.
- High-Volume Air Filtration: We use a specialized air filtration system specifically designed for oral aerosol vacuums. This sits close to your face and pulls vapors away from your breathing zone.
The Removal Technique
Once you are fully prepped and protected, I begin the removal. I do not just grind the filling away. I use a technique called “chunking.”
I use a high-speed drill with a generous amount of water to keep the tooth cool (reducing vapor). Instead of grinding the whole filling into dust, I cut the filling into large chunks. This allows me to pop the filling out in big pieces. The fewer pieces we grind, the less vapor is released.
Throughout this process, my assistant uses a high-volume evacuator (a very strong suction) right next to the tooth. This captures the water, spray, and potential vapors at the source.
Data That Drives Our Decisions
I believe in science-based dentistry. Let’s look at why these precautions are necessary based on data.
Data Point 1: Mercury Vapor Release
Studies have indicated that the amount of mercury vapor released during the unsafe removal of an amalgam filling can be significantly higher than the daily safety limits set by occupational health organizations. Without high-volume suction and water spray, vapor levels can spike dangerously high in the immediate breathing zone.
This is why the “chunking” method and high-volume suction are non-negotiable in my practice. We want those levels to remain at zero for your safety.
Data Point 2: Filtration Efficiency
The specialized air filtration systems we use in holistic dentistry are capable of removing over 99% of particles and mercury vapor from the immediate air. Combined with the dental dam, we create a closed environment that protects your biological system.
Visualizing Safety: SMART vs. Standard Removal
It can be hard to visualize the difference between a standard dentist removing a filling and a holistic dentist using the SMART protocol. I have created this simple chart to help you understand the exposure risks.
Patient Exposure Risk During Removal
Standard Removal (No Safety Protocol)
SMART Protocol (Holistic Approach)
Minimal to No Risk
*Representation of potential vapor and particulate exposure based on IAOMT safety standards.
Replacing the Filling: The Cosmetic Advantage
Once the mercury is safely removed, we don’t just leave a hole in your tooth! This is where my passion for cosmetic dentistry comes into play. We replace the old, dark metal with biocompatible, tooth-colored materials.
Usually, we use composite resins or porcelain onlays and inlays. These materials are bonded to your tooth structure. This actually strengthens the tooth. Amalgam fillings do not bond to the tooth; they are just packed in. Over time, amalgam expands and contracts with heat and cold differently than your tooth does, which can cause your natural tooth to crack. The metal-free restorations we use move more naturally with your tooth.
The result? A smile that looks natural. When you laugh or speak, people will see your white teeth, not dark grey patches. It is an instant upgrade to your appearance and your confidence.
Why Choose Holistic Dentistry in Los Angeles?
Los Angeles is a city that values health, wellness, and beauty. Living here, we have access to the best organic food, fitness, and lifestyle options. Your dentistry should match that lifestyle.
In my West Hollywood office, I see the mouth as the gateway to the body. We cannot treat teeth in isolation. If you are detoxing your diet and your home environment, it makes sense to detox your mouth as well. Mercury removal is often the missing piece of the puzzle for patients seeking optimal wellness.
I have invested in the technology and training required for SMART certification because I care about the long-term well-being of my community. It is not just about fixing a cavity; it is about respecting your biology.
What to Expect After the Appointment
Patients often ask me how they will feel after the procedure. Because we use such strict safety protocols, most patients feel just fine, exactly as they would after a normal filling.
However, because many of my patients are removing these fillings for health reasons, we often discuss supporting your body’s natural detoxification pathways. Staying hydrated, eating antioxidant-rich foods, and getting good rest are always recommended. For patients with specific heavy metal concerns, I often collaborate with their functional medicine doctors or naturopaths to ensure they have a full systemic support plan in place.
Frequently Asked Questions (FAQ)
Is the mercury removal process painful?
Not at all. I use local anesthesia to numb the tooth and the surrounding area, just like a regular filling. The safety equipment, like the rubber dam and the nasal mask, might feel a bit different if you aren’t used to them, but the procedure itself is pain-free. My priority is always your comfort.
How long does the appointment take?
A SMART protocol appointment takes a little longer than a standard filling because of the setup time for the safety barriers. Typically, you should plan for about 60 to 90 minutes, depending on the size of the filling and the type of replacement restoration we are placing.
Can I remove all my metal fillings at once?
I generally recommend against removing all mercury fillings in a single sitting, especially if you have many of them. Even with the SMART protocol, it can be stressful for the tooth nerves and the jaw to be open for that long. We usually space them out properly—perhaps doing one quadrant (quarter of the mouth) at a time—to ensure your body and your teeth remain happy.
Does insurance cover SMART mercury removal?
Most dental insurance plans cover the replacement of a filling if the old filling is broken, leaking, or has decay under it. They typically cover the cost of the filling replacement itself. However, they may not specifically cover the “safety” components of the SMART protocol. My office team is expert at maximizing your benefits and can help you understand your specific coverage.
My Commitment to Your Health
Deciding to remove your amalgam fillings is a big decision, and it is a positive step toward a healthier, toxin-free life. I have seen countless patients transform their health and their smiles by taking this step.
You deserve a dentist who listens to your concerns and validates your desire for a cleaner, more holistic approach to health. I am proud to offer safe mercury removal in Los Angeles because I believe it is the gold standard of care.
If you have questions about the fillings in your mouth or want to discuss if the SMART protocol is right for you, please reach out to my office. We can sit down, look at your specific situation, and create a plan that prioritizes your safety and gives you the beautiful smile you deserve.
I look forward to meeting you and helping you on your journey to optimal oral health.
