Why A Rubber Dam?
Many holistic or biologic dentists recommend use of a rubber dam during amalgam removal. The rubber dam is usually a 6×6 square inch sheet of latex, which is held by a clip over the tooth. The dam acts as a barrier, isolating the tooth with the filling to be removed, and preventing debris from getting into the mouth.
We recommend using a rubber dam material that is NOT LATEX due to potential for severe sensitivities or allergic reactions. The most popular material is nitrile.
There is evidence demonstrated by the EPA-approved Jerome mercury detector that the permeability of the rubber dam allows mercury vapors to pass through into the mouth. Therefore, use of the rubber dam may not be as protective as indicated in the literature.
Why A Low Speed Drill?
A low speed drill – 20,000 rpm or less — is extremely important over a high speed drill.
We always use a low speed drill, and here’s why:
- Creates a lower rate of mercury vapor release
- Less traumatic to the tooth pulp, and helps prevent pulp death.
- Less cracking of the tooth structure.
Why Two Vacuum Systems?
We use two different vacuum systems to protect our patients.
Vacuum #1: Clean-Up-Tip, as recommended by the IAMOT (International Academy of
Medicine and Oral Toxicology – www.iamot.org). This device is attached to our office high-vacuum system, and is placed directly over the tooth with the amalgam to be removed. It effectively removes all fumes and amalgam debris.
Vacuum #2: Dr. Cook’s Vacuum System – This is a ¾ HP Shop-Vac, with large piping held at the chin of the patient during amalgam removal, creating a negative airflow. This effectively pulls away all fumes and particles from nose, mouth and face.
Oxygen may be given as an adjunct, but it’s not necessary if there are two vacuum systems functioning effectively.
Why Take An X-Ray After Removing Amalgams?
The x-ray confirms that 100% of the metal is removed from the tooth cavity.