Mercury Toxicity & Lyme disease

How to Safely Remove Silver Amalgam Fillings 

Mercury toxicity often accompanies Lyme disease, so I think it’s important not to increase the load of heavy metals in the body. That is why I'm sharing these guidelines for the safe removal of silver amalgam fillings.

Last month, during a dental appointment, my hygienist noticed that I needed to replace two silver amalgam fillings – the ones that have mercury in them. Knowing that mercury and Lyme are bad company, I alerted my dentist that he would need to take additional safety precautions with me because of my Lyme disease. Mind you, I had no idea what those safety precautions might be, but I knew I had to at least give him a heads up until I had some time to look into it. 

Thank goodness for the internet! I googled 'safe removal of silver amalgam fillings' and found a site where I was able to adapt and develop a list of guidelines that I felt were essential to follow. I then took a printed copy to my dentist and we had a discussion about what he could and couldn’t do. Happily, he was able to accomplish everything we discussed!  

For further information on mercury and Lyme disease, there’s a good discussion in the book “The top 10 Lyme Disease Treatments” by Bryan Rosner. An excerpt taken from this book (The importance of mercury detoxification when treating Lyme Disease) can be found on the following website:

Lyme isn't the only reason to be concerned about mercury toxicity; many people are genetically susceptible to its accumulation even from low-level, everyday exposure.  If you’re interested in having your own silver fillings safely removed (and replaced with white fillings), print and discuss the following guidelines with your own dentist.

The guidelines for safe amalgam removal below were adapted from the following website (

Safe Amalgam Filling Removal: Guidelines for Dentist and Staff

During the removal process, several precautions are necessary for the patient, including:

  1. A nose mask for breathing oxygen,
  2. A rubber dam to cover the patient’s mouth,
  3. a) A lot of water coming from the drill,
    b) Sectioning the fillings out in chunks as opposed to grinding it out, to decrease the amount of  vapor,
  4. Special high speed suction, and 
  5. Use of an electric drill: It cuts more efficiently than an air turbine and it turns at slower revolutions per minute, so there is less chance of heating the tooth, and therefore, it is rare that a tooth will die after mercury removal. 

Safe Removal Process:

1.     Provide the patient with an alternative source of air while filings are being removed. This isn’t necessary after the removal process is completed, but during the actual amalgam filling removal, the patient should be provided with a protective mask through which to breathe either compressed air from a tank, air from a source outside the office, or oxygen from a tank. Instruct the patient to breathe through the nose while the fillings are being removed. This is especially important for patients who have existing health issues related to mercury, allergies, or immune system problems.

2.     Use a rubber dam. A rubber dam isolates the tooth being worked on; it can reduce the amount of mercury vapor inhaled through the mouth. Even though mercury vapor can pass through the rubber dam, a rubber dam makes it easier to evacuate the filling material and prevent amalgam particles from being swallowed. As long as the patient breathes through the nose, little if any mercury vapor will pass through the rubber dam. Anyone who is concerned about minimizing mercury exposure should insist on its use. 

3.     Keep the fillings cool during removal. Drilling out an amalgam filling generates a tremendous amount of heat, which causes a dramatic increase in the release of mercury, both as a vapor and in amalgam particles. Cooling the filling with water and air while drilling dramatically reduces the amount of mercury vapor the filling releases. Most mercury free dentists use a removal process that’s commonly referred to as chunking. This involves less drilling, because the dentist only drills enough to cut the filling into chunks, which can then be easily removed by a hand instrument or suction. 

4.     Use a high-volume evacuator. This is one of the most important tools in minimizing the patient’s exposure to mercury vapor and amalgam particles. The evacuator tip should always be kept to within 1⁄2 inch of the filling during the entire time the filling is being removed. This helps capture more of the mercury vapor and particles. 

5.     Immediately dispose of filling particles. It is easier for everyone to have an assistant working with him throughout the removal procedure. This will ensure constant suction and a continuous flow of air and water. 

6.     Remove gloves and clean the patient’s mouth. Once the amalgam filling(s) have been safely removed and replaced, the dentist and the assistant should remove and dispose of their gloves and the rubber dam, and thoroughly rinse and vacuum the patient’s entire mouth for at least 15 seconds. The patient should make every effort not to swallow during this procedure. We also suggest that after the rinsing procedure, the patient use a small amount of water and gargle as far back into her throat as possible. The patient should not swallow this watery residue! Instead, he should spit it into a sink or cup. 

7.     Immediately clean up. After the fillings have been removed and replaced, the dentist or dental assistant should immediately remove and dispose of the patient’s protective covering and thoroughly clean her face and neck. 
About two weeks after having my fillings removed, I decided to do a heavy metal test. I was prepared to have the tests done even before the issue of mercury fillings came up, but decided to wait until after I had my fillings removed. Now I'm really curious to see what my levels are. The test involves taking a provoking agent - DMSA - to help to remove heavy metals from the body and then collecting urine for a period of 6 hours. I just did this test on Sunday and am awaiting results. It will be interesting to see if heavy metals could be contributing to my Lyme symptoms - or might be preventing me from getting better. I'll provide an update on this page once I get results and will likely undergo some chelation therapy to detoxify if the results are positive.

UPDATE: The results are in and surprisingly, my  mercury results are normal BUT lead levels were highly elevated!!!! I'll be posting a new blog on heavy metals and chelating lead shortly.

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