Amalgam Removal INFO

[Guest guest]

Much on my webpage -

http://www.nccn.net/~wwithin/amalgam.htm

(which I need to update)

Here is one link where you can search for mercury-free dentists.

MUCH HERE

http://www.talkinternational.com/

http://www.talkinternational.com/health/checklist.htm

Checklist for safe dental care

(I didn't do #2 - compatibility testing - I think it is expensive, but

don't know)

http://www.holisticdental.org/

Holistic Dental Association

http://emporium.turnpike.net/P/PDHA/mercury/dentist.htm

How To Find A Dentist

To Remove Mercury Amalgams Safely

Amalgam Removal Protocol

http://emporium.turnpike.net/P/PDHA/mercury/iaomt.htm

International Academy of Oral Medicine and Toxicology

Protocol for Mercury/Silver Filling Removal 1

PATIENT PROTECTION

First in every concerned doctor's mind is the protection of the patient

from additional exposure to mercury. This is especially true of the mercury

toxic patient. The mercury toxic patient may have been exposed to varying

amounts of mercury from diet, environment, employment or from

mercury/silver dental fillings. All forms are cumulative and can contribute

to the body burden. The goal of this preferred procedure is to minimize any

additional exposure of the patient, ourselves, or staff to mercury.

During chewing the patient is exposed to intraoral levels which are several

times the EPA allowable air concentration. 2 During the removal or

placement of amalgam the patient can be exposed to amounts which are a

thousand times greater than the EPA allowable concentration.3 Once the

drill touches the filling temperature increases immediately vaporizing the

mercury component of the alloy. There are 8 steps to greatly reducing

everyone's exposure.

1. Keep the fillings cool

All removal must be done under cold water spray with copious amounts of water.

Once the removal has begun, the mercury vapor will be continuously released

from the tooth.

2. Use a high volume evacuator

Therefore, a high volume evacuator tip should be kept near the tooth (1/2

inch) at all times to evacuate this vapor from the area of the patient.

Polishing amalgam can create very dangerous levels of mercury and should be

avoided especially for the mercury toxic patient.

3. Provide an alternative air source

All patients having amalgam removed or placed should be provided with an

alternative air source and instructed to not breathe through their mouth

during treatment. A nasal hood such as is used with the nitrous oxide

analgesia equipment is excellent. Air is best and oxygen is acceptable

although not required. If just air is used it should be clean and free of

mercury vapor preferably from outside the dental office.

4. Immediately dispose of the mercury alloy

Particles of mercury alloy should be washed and vacuumed away as soon as

they are generated. The filling should be sectioned and removed in large

pieces to reduce exposure.

At present the International Academy of Oral Medicine and Toxicology

(IAOMT) has approved removal both with and without the use of a rubber dam.

Some evidence exist to support both views since high levels of mercury and

amalgam particles can be found under the dam. All members are agreed that

whether or not a rubber dam is used the patient should be instructed to not

breathe through their mouth or swallow the particles. Some experts feel

that it is better to remove the amalgam first and then apply the dam if

needed for restorative procedures.

5. Lavage, and change gloves

After the fillings have been removed, take off the rubber dam if one was

used and lavage the patients mouth for at least 30 seconds with cold water

and vacuum. Remove your gloves and replace them with a new pair. If a

restorative procedure is next then reapply a new dam and proceed.

6. Immediately clean patient

Immediately change patient's protective wear and clean their face.

7. Consider nutritional support

Consider appropriate nutritional support before, during and after removal.

8. Keep room air pure

Install room air purifiers or ionizers and fans for everyone's well being.

STAFF PROTECTION

OSHA4 5 requires that employees be given written informed consent before

the use of any toxic chemicals of which mercury is one. Elemental mercury

vapor is one of the most toxic forms of mercury and should not breathed.

Women of child bearing age should be exposed to no more than 10% of the

OSHA MAC6. Women who are pregnant should be exposed to no mercury.7 If you

use mercury or remove mercury in any form the National Institute of

Occupational Safety and Health (NIOSH) has recommended that your employees

be medically monitored annually.

ANY MERCURY EXPOSURE REQUIRES THAT THE EMPLOYEE WEAR AN APPROVED MERCURY

FILTER MASK.

An approved mask is appropriate for wearing during all dental procedures

which will expose you or your staff to mercury.8

The manner in which dentists operate their equipment dramatically affects

the amount of mercury released. Never drill on mercury high dry. It is

hazardous to you, your staff, and your patient. Levels as high as 4000 m

g/M3 have been measured 18 " from the drill when used high dry. Levels over

1000 m g/M3 are measurable upon opening an amalgam mixing capsule.

One out of 7 California dental offices tested over the OSHA TWA of 50 m g/M

3 . 100% of the vacuum cleaner exhaust tested over 100 m g/M 3 . Any office

where mercury is used should be tested regularly and staff should be

monitored for exposure. Testing services are available and a mercury sensor

badge is available for personnel monitoring. They should test inside

storage areas and along baseboards where mercury might have dropped. Office

spills can go undetected for years and are extremely hazardous.

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REFERENCES

1 IAOMT Standards of Care Preferred Procedure Approved 9/27/92

2 EPA United States Environmental Protection Agency Office of Health and

Environment Assessment Mercury health effects update Final Report

EPA-600/8-84-019F 1971 EPA

3 Cooley RL, Barkmeier WW: Mercury vapor emitted during ultraspeed cutting

of amalgam. J Indiana Dent Assoc 57:28-31, 1978

4 OSHA Job Health Series: Mercury.(2234)8/1975

5 Hazard Communication Program Federal Register/ Vol. 52. No. 163 / Monday,

August 24, 1987

6 OSHA MAC is Threshold Limit Value of 100 micrograms/ cubic meter or 100

PPM This is a never to be exceeded standard.

7 Koos BJ and Lango LD , Mercury Toxicity in the pregnant woman, fetus, and

newborn infant. A review Am J Obstetrics and Gynecology 126(3):390-409, 1976

8 Mine Safety Association high levels and 3M mercury dust mask lower levels

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Sheri Nakken, former R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

Vaccines - http://www.wellwithin1.com/vaccine.htm Email classes start in

January