Dental Services · Holistic Dentistry · West Los Angeles

SMART Mercury Amalgam Removal in West LA

What is mercury amalgam?

Often called “silver fillings,” dental amalgam is approximately 50% elemental mercury by weight, combined with metals such as silver, tin, and copper. An amalgam filling can release low levels of mercury vapor, which can be inhaled and absorbed through the lungs. Removal highly increase that exposure which is why the SMART protocol was created.

Why is mercury a concern?

Mercury is a toxic substance. At sufficiently high exposure levels, mercury vapor can harm the nervous system and kidneys. Risk depends on the dose, form of mercury, and individual susceptibility. The European Union has prohibited routine use of dental amalgam since January 1, 2025.

What is the SMART protocol?

SMART stands for Safe Mercury Amalgam Removal Technique, a set of recommendations developed by the International Academy of Oral Medicine and Toxicology (IAOMT). It focuses on reducing mercury vapor and particle exposure for patients, dental personnel, and the surrounding environment during removal.

SMART recommendations include:

✓ A sealed non-latex dental dam to isolate the tooth
✓ High-volume suction and nearby aerosol capture
✓ Water cooling to limit heat during removal
✓ Sectioning amalgam into larger pieces where possible
✓ Protective barriers, respiratory protection, and patient air/oxygen measures
✓ Air filtration and proper collection of mercury-containing waste
✓ Supplements to aid in detoxification/any exposure

DR. SYRUS’S PERSPECTIVE

One of the most rewarding parts of my work is having a patient who came to me because their bloodwork showed very high mercury levels and then hearing about the retesting showing how the levels significantly dropped after the SMART protocol. For whatever reason the dangers of amalgam fillings is such a polarizing topic in dentistry so its nice to be able to see results showing actual changes.

Dr. Syrus Elicus · Alchemy Dental

What to expect at Alchemy Dental

I examine the filling and surrounding tooth, review imaging when indicated, and discuss your concerns and material preferences. If replacement is appropriate, I explain the SMART precautions and restoration plan before treatment. Once the amalgam is removed, I evaluate the remaining tooth and place or arrange the planned restoration.

Options may include an Admira Fusion tooth-colored filling, a ceramic inlay or onlay, or a porcelain or zirconia crown. The choice depends on the amount of sound tooth remaining and the forces on your bite. Learn about my restorative material choices.

Cost and treatment planning

Your estimate reflects the number and size of fillings, the removal precautions, the replacement restorations, and any additional care needed. I explain the proposed treatment and fees before you decide.

SMART removal: $120 per tooth

Includes SMART protocol precautions and supplementation. The restoration fee is additional.

Restoration fees per tooth

The fees below reflect self-pay pricing. If you have dental insurance, I’ll review your benefits and provide an estimate of your out-of-pocket cost before treatment.

• Small filling — $260

• Medium to large filling — $310–$450

• Ceramic onlay — $1,500

• Porcelain/Zirconia crown — $1,750

• Buildup for crowns, if needed — $350

Frequently asked questions

How do i know if my Amalgam is “leaking” ?

“Leaking” is a misleading term, amalgam fillings release small amounts of mercury vapor even when they appear intact. The amount varies with factors such as the number and age of your fillings, chewing, and teeth grinding.

Does SMART removal detoxify the body?

SMART is designed to reduce mercury exposure during amalgam removal. Removing an amalgam filling eliminates that filling as a source of future exposure, but it does not directly remove mercury already present in your body. Your body’s natural elimination processes handle detoxifies the mercury already in your system over time. We are reducing the input your body takes care of the output.

Can I have amalgam removed while pregnant or breastfeeding?

Elective removal is generally deferred. IAOMT advises against amalgam removal during pregnancy or breastfeeding. If a tooth needs urgent care, I coordinate treatment around the clinical need and your medical circumstances.