Removal of old mercury-amalgam fillings under isolation, suction and filtration protocols designed to limit mercury vapour exposure during the procedure.
Drilling out an amalgam filling releases mercury vapour. Safe removal protocols — the best known is SMART, taught by the IAOMT — combine a rubber dam, high-volume suction, a separate air source for the patient, room air filtration, copious water cooling to keep the filling cool, and protective covering for patient and staff. The aim is to contain the vapour and particulate generated during removal rather than to treat mercury already in the body.