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The safe removal protocol is approved by IAOMT and known as the SMART protocol.
Drilling out an amalgam filling generates a tremendous amount of heat, which causes a significant increase in the release of mercury, both as a vapor and in amalgam particles, during the entire removal process.
1. Cooling the filling with water and air while drilling substantially reduces the amount of mercury vapor the filling releases.
2. Cutting the Amalgam into Chunks
When cutting the old filling we use a new bur and place big grooves in the amalgam. This involves less drilling and creates big chunks that can then be easily removed by a hand instrument or suction.
3. Use a high-volume evacuator. Our office is equipped with a powerful suction system that is one of the most important tools in minimizing the patient’s exposure to mercury vapor and amalgam particles. 
4. Provide the patient with an alternative source of air 
We provide our patient with a nasal mask that allows them to breathe 100% oxygen.
5. Use a rubber dam
6. Remove gloves and clean the patient’s mouth
7. We give our patients an activated charcoal rinse to rinse and swallow before the procedure and Chlorella after the removal

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