Scott Silver DDS Discusses Safe Amalgam Removal 

Silver Dental was established in 1948 and though they are still in their original Haddon Township location, many of their patients are now more holistic-minded than ever before. The practice offers traditional and biologic dentistry including safe amalgam removal, and Dr. Scott Silver says that the office has seen an influx of patients requesting this procedure over the past years. Reasons for this trend include health concerns, deteriorated fillings and the desire to change over to more modern materials.

A Conservative Approach

Not everyone is a candidate for amalgam removal, and Silver believes in a conservative approach that does not present risk to the patient. He is a certified member of The International Academy of Oral Medicine and Toxicology (IAOMT) and follows its protocols for removing fillings as safely as possible. 

He explains that an amalgam is a mixture of materials, and for tooth fillings this refers to a blend of mercury with various metals such as silver. Mercury is a major component of these fillings and contrary to what some believe, it does not release when the mouth is stationary. This can instead happen during eating and brushing when the filling is disturbed. It is the mercury gas that is the dangerous element.

Careful, Thorough Preparation

A safe amalgam removal appointment can be fairly quick or as long as 90 minutes. “It depends on how complicated it is,” Silver explained. “We look at X-rays to see how many surfaces there are and how deep the filling is.” Safety is paramount for patients and staff, and every patient must wear a bonnet to protect their hair and a plastic apron from the neck to knees. Silver and his assistants dress in disposable surgical gowns and protective masks.   

Once preparations are complete the patient rinses with a mercury binder, which helps pull the mercury gas into a more solid state to rinse it away. Straight oxygen is administered to the patient via a nose piece the whole time, and a rubber dam is put in place. Also called a “raincoat”, this surrounds the tooth, protecting the rest of mouth. Behind the dam, a suction tip is placed for the patient to control the flows of ozonated water and saliva.

Silver also described “the elephant”, a suction tube that looks like an elephant trunk. It is placed under the patient’s chin and is used to pull in the vapors. There are also fans in the office to pull in vapors which makes the office environment safer for everyone.

Removal Now… and Then

Silver uses a thin instrument to cut around the edges of the filling to pop it out whole if possible; otherwise, it can be taken out in sections. Since fillings were designed to lock underneath the tooth, it can take effort to get them out. 

Once the filling is removed, an X-ray is taken to ensure there are no small particles left. If it is indeed all out, the patient does a second binding rinse. The equipment, materials and tools are then disposed of or thoroughly cleaned. Depending on the type, a new filling can be placed immediately or made in a laboratory. In the latter case, a temporary is placed until the new materials are ready. 

Safe amalgam removal provides patients with much less exposure to toxic materials than the old way, which involved using a drill and melting the filling away “into a slush until it was gone,” according to  Silver. Today, routine fillings or crowns are completed with more holistic materials like composites, porcelain or zirconium.

Biological Dentists of NJ is located at 621 White Horse Pike in Haddon Township. For more information or to schedule an appointment, call 856-854-4354 or visit BiologicalDentistsOfNJ.com.