We help our clients to improve their health.

Mercury Amalgam Removal

Safe Mercury Amalgam Removal Technique (SMART) is a protocol developed by the International Academy of Oral Medicine and Toxicology (IAOMT).

Before the procedure, patients rinse with activated charcoal. Then, a dental dam is used to isolate the tooth and prevent mercury exposure to surrounding oral tissues—both the patient and dental professional wear protective gowns and eyewear.

To prevent inhalation of mercury vapors, a nasal mask delivering oxygen is used, and a saliva ejector is placed under the dental dam. During the procedure, copious amounts of water are used for irrigation to reduce heat. A high-speed evacuation device is used to capture mercury particles, and amalgam is removed in larger chunks by sectioning.

After the safe mercury amalgam removal, the patient’s mouth is thoroughly rinsed with water and charcoal.

Let’s get in touch to talk about your new smile with our holistic dental service.

Safe Mercury Amalgam Removal Process

Smart Protocol

A mercury filter that separates & collects particles to avoid releasing them into the environment. In-office air purifiers are to be installed to remove mercury particles in the background.

Amalgam separator for proper collection of mercury waste. The adequate high-volume air filtration system in the operatory. Check our SMART facilities.

For the SMART dentist & staff– Protective gowns, Sterile non-latex gloves, face protection gear, and properly sealed masks providing oxygen and covers are mandatory.

Utilizing the available scientific evidence, the International Academy of Oral Medicine and Toxicology (IAOMT) has developed extensive safety recommendations for removing existing dental mercury amalgam fillings, including detailed protective measures to be utilized for the procedure.

The IAOMT’s recommendations supplement conventional safety protocols like masks, water irrigation, and high-volume suction with several additional protective measures.

Our Holistic Dentistry system meets all the needs that may arise: First, the patient’s problems are studied in-depth, both in the oral cavity and in the rest of the organism.

Once the causes are found, solutions can be established. At America Dental, we only use biocompatible materials and techniques. Dental treatments are performed so that no physical changes affect the body.

For example, it is done using compatible biological materials that were previously tested on the person. In addition to studying your case, we will make a diagnosis and a complete treatment plan.

Safe Mercury Amalgam Removal Benefits

Safe Mercury Amalgam Removal can reduce the risk of oral health problems and improve overall oral health.

Mercury from amalgam fillings can enter the body and contribute to health problems, so a safe mercury amalgam Removal can improve overall health.

A safe mercury amalgam removal reduces mercury exposure, a toxic heavy metal.

A safe mercury amalgam removal with tooth-colored alternatives can improve the appearance of teeth.

Some people experience discomfort or sensitivity with amalgam fillings, which can be alleviated through safe mercury amalgam removal and replacement.

Newer filling materials last longer and are more durable than mercury amalgam.

Safe Mercury Amalgam Removal Technique: 3 Reasons you Should Consider

Have you ever heard of the Safe Mercury Amalgam Removal Technique (SMART)? Well, if you have not you are going to now.

Dental experts fully recommend the extraction of dental mercury amalgams also silver ones from the teeth of patients. This one of our top holistic dentistry procedures.

Formerly they were placed as a filling to replace a missing tooth or part of it, but it turns out to be a toxic material, and extremely harmful to the health of the patient, besides not being aesthetic if it is insight. For this reason, in American Dental, dental fillings are made of composite and porcelain, a much more aesthetic and safe material.

As we now know, it is not advisable to have a mercury amalgam filling in the mouth. As a patient, you can be poisoned because of the overexposure to varying amounts of this metal in your diet. Intoxication may also be due to the use of silver dental mercury amalgam. All forms of intoxication are cumulative and can contribute to the body’s mercury load.

There are three main reasons why you should consider going SMART:

Because it is safe

In American Dental we carry out the Safe Mercury Amalgam Removal Technique, according to the protocol of action that is internationally known for this procedure; to avoid the inhalation of mercury vapors during its withdrawal, to minimize any additional exposure to our patients.

To perform a safe extraction of mercury amalgams, the specialist, and his assistant perform all work with the disposable material. The double-mask, the safety goggles, and the mask or security screen that can be worn during the operation, are thrown when finished. In addition, the room must have a ventilation pathway to prevent health problems arising from breathing the accumulation of mercury in the air. For his part, the patient will receive nasal goggles to have an alternative oxygen source.

  1. Because it is easy

In our clinic, we have the required experience to perform this intervention. The patient will lie down in the seat, the safest position. For the extraction of mercury amalgams, a rubber dam will be used to isolate the tooth from the rest of the denture, and two high-speed aspirators will be placed: one to suck the saliva and the other to collect the remains of mercury or silver. The dentist will clean the area while performing the extraction so that the patient does not accidentally swallow or leave any remaining mercury in the mouth.

The area where the dental mercury amalgams are removed will be kept cool, and local anesthesia will be applied, except in the palatal and lingual areas, so that the specialist of our dental clinic in Escazú, San José, Costa Rica, can supervise how the patient swallows saliva without a problem.

Because it is affordable

The cost to remove an old mercury amalgam filling and replace it can vary because of the extension of the work and the materials that may be necessary. But you should expect it to fall somewhere between $115 and $250.

When it really comes down to it, the decision as to whether to leave in or switch out amalgam fillings with composite or porcelain is up to your doctor. Your X-rays, the health of your gum tissue, and your teeth and bone structure will inform your dentist as to what’s best for you. After all, your teeth as unique as you are!

Did you know you are being poisoned with Mercury?

Since ancient times, mercury has been extracted and used due to its chemical properties.

Nevertheless, according to the United Nations Environment Programme (UNEP, 2019), the growth of human activities, in the past and today, has increased the total concentration of airborne mercury by approximately 450% above natural levels.

Further, according to the World Health Organization (WHO), mercury is in the list of the 10 most concerning chemicals for public health. The worst is that this heavy metal is not degraded and it accumulates along the food chain.

Ibrahima Sow, an environmental expert in the WWF (World Wildlife Fund) explains that “it is important to understand that mercury is a global pollutant due to its ability to propagate along with great distances”.

By the end of the XVII century, mercury amalgam removal cost was low. The procedure used to repair teeth became popular thanks to its cost. Since around 3000 b.C., odontology began as the Egyptians grafted jewels into their teeth. 150 years after being introduced, the widespread usage of mercury in odontology, and the safety of dental amalgams, is questioned.

Since 1920, in Germany, the safety of this odonatological technique was put into question, as it was associated with the release of mercury vapor into the oral cavity, and therefore affecting the health of the patient.

Putting Dental Fillings Safety into Question: Myths and Truths

Both in the past and now, elemental mercury is used for dental amalgams.

Its usage has been widely debated concerning its safety on the environment and our health. Even, in 2003, a Convention was approved to reduce its detrimental effects, just as in amalgams.

In comparison with antiquity, modern odontology has at its disposal techniques and solutions which are less invasive for the dental structure and us.

“My dentist says mercury fillings are safe”. Myth.

Mercury dental amalgams still have a widespread use in the European Union, nevertheless, their safety is questioned, and they have even been forbidden in some countries.

In June 2018, its usage is prohibited on vulnerable populations, aiming for a complete stop of its use.

Elena Lymberidi-Settimo, director of the “Zero Mercury Campaign”, states that the “European Commission and the Member States of the EU must ensure that odontologists enforce the ban immediately and verify if the use of exemptions is necessary. EU authorities must ensure that citizens are aware of these dispositions.

The European Commission is focused on the visibility of a long-term gradual elimination, preferably by 2030, considering national plans. Have you seen the news about French dentists? Doctors and patients are more conscious and critical about mercury.

Dr. Michèle Panetier, a dentist in Paris, comments she stopped using amalgams fifteen years ago, and she preemptively prefers “not to use them on her patients”.

Not only France, other countries like Sweden, Denmark, the Netherlands, or Norway have but eliminated the use of mercury fillings on people younger than 15, lactating, or pregnant women. Why not the rest?

Mercury amalgam fillings are safe because it is combined with other materials and cannot be released. Myth.

According to data from the Richardson, et.al. (2011) research, it was observed that average tooth surfaces with amalgams go up to 0.5-1 μg/day/tooth, depending on age and other factors. These are estimations higher than those from Health Canada, which claims the value is around 0.2-0.4 μg /day. As reported by scientific evidence, dental amalgams contain mercury and methylmercury, which release a low amount of mercury as vapor.

Despite inconclusive or contradictory results, it is observed that on long periods, high quantities can generate adverse effects.

If mercury fillings were not safe, everyone who has them would be intoxicated. Myth

Dental amalgams containing mercury are a controversial topic worldwide. Studies show vulnerable people possess mercury in their urine, and it was correlated to fillings and sometime after receiving them.

Also, Wael L Mortada, et. al., (2002) observed the possible kidney toxicity of mercury from fillings on men and women.

In another study, it was already observed that fillings that were harmful on health did not differ on the number of mercury amalgam fillings, surfaces, or mercury levels in the organism.

This all requires more studies and research in the dental area since there is controversy regarding chronic toxicity and high levels in the organism.

What we know is that the mercury exposition levels can be personal and affect some or other people.

Since mercury amalgams are toxic, mine can be completely removed from my teeth. Myth.

In 2009, the WHO concluded that a “global ban on the short term would be a problem for public health and the dental health sector, instead the aim should be to gradually eliminate its use, promoting prevention and the use of alternative materials, research and development of mercury amalgam removal cost-effective alternatives, Education of odontology professionals, and a sensibilization of the population”.

It is reasonable that, when manipulating amalgams, both the dental professional and the patient suffer a risk to their health and could be exposed to a higher mercury level.

The use of amalgams, further from the controversial topic, entails an unmovable truth; it contains 50% of mercury, which is historically proven to be toxic and therefore harmful to human health.

It is a “old school” method, which poses great risks to human beings; therefore, America Dental is a pioneer in the Central American region in the removal and change of amalgams for materials, which are bio-compatible with human life and the environment.

Certainly! Mercury amalgam removal cost can vary depending on several factors including the number of amalgam fillings to be removed, the complexity of the procedure, and the dentist’s expertise. It is important to consult with our professionals for an accurate assessment and cost estimate tailored to individual needs.

Our Dental Care Team

Dr. Vargas

Dr. Ignacio Vargas Gould



Higher Education

Doctor in Dental Surgery. Latin American University of Science and Technology, San Jose, Costa Rica. 1999-2004

Division of Periodontics at Hospital Calderón Guardia. August 2002.

Fellowship in Restorative Sciences, University of Costa Rica. 2004.

Fellowship in Cosmetic Dentistry, University of Costa Rica. 2007.

 Master´s Degree in Operative and Dental Aesthetics, University of Costa Rica. 2008-2009

Post-Doctoral Fellowship in Implant Dentistry, Pontificia University Javeriana, 2011.

Digital Course in (Digital Smile Design). 2015

He’s SMART (Safe Mercury Amalgam Removal Technique) Certified by the International Academy of Oral Medicine & Toxicology (IAOMT).

Certified in safe amalgam removal by the International Association of Mercury-Safe Dentists (IAMSD).

Basic Life Support. 2008 – Present

National Dental Boards Examinations.  2004 – Present

Course of Epidemiology and Biostatics for Health Professionals. Dr. Petri, May 2008

Course of Peri-Implant Health and Management Hands – On Workshop.  2018

Course of Implantology All on 4 (Oral Revitalize)

Member of the Dental Surgeons College of Costa Rica. 2004 –Present

Member of American Dental Association. 2011 – Present

In America Dental Clinic, accredited by the Ministry of Health, in San Jose, 2003 a 2020.

Professor of Restorative Clinic (undergraduate) of University of Costa Rica, January 2008 – December 2009.

Professor of Dental Clinic. ULACIT, Latin American University of Science and Technology. 2010

Chief of Operative Dentistry Division, ULACIT, Latin American University of Science and Technology. 2010-2016 

Dr. Francisco Solis



America Dental | Dentist

2013 – Currently

    • • IPRF surgery
    • • All on 4 surgery
    • • Prosthetic surgery
    • • Endodontic surgery
    • • Periodontal and pathology surgery

ULACIT| Professor

2012 – 2014

    • • Attendance at anesthesia techniques and theory course.
    • • Attendance and integrated treatment of patient in the course of oral pathology and third molar surgery and periodontal surgery

FAES| Dentist


    • • Dental surgery
    • • General dental procedures
    •  • Degree in Dentistry with emphasis in prosthodontics / Universidad Latinoamericana de Ciencia y Tecnología. Costa Rica 2010
    •  • Certificate of advanced surgery in prosthetic surgical techniques in implants and oral prosthetic rehabilitation/ Pontificia Universidad Javierana. Colombia 2011
    •  • Certificate in oral surgery/ Pontificia Universidad Javierana. Colombia 2011
    •  • Certificate in Endodontic Surgery/ USC Dental School. United States 2010
    •  • All on 4 and sinus lift internship/ Zimer. United States 2015

Dra. Rebeka Jiménez

DDS, Cosmetic Dentist


America Dental | Dentist

January 1, 2012 – Present

Medical Tourism

Dentist: attention of patients, do different treatments (fillings, cleanings, bridges, crowns, veneers, extractions, restorations over implants, dental scanning, etc.), patient’s coordinator.

Dental Technician: do some dental works

Assistant: assistance in surgical procedures and orthodontic procedures.

Dental Laboratory Novadental 

January 2011 – December 2016


Dental technician

Dental Laboratory Juan Carlos López

January 2008 – December 2010

Dental Technician

Honorific mention Cum Laude Probatus in the degree course in dentistry

Active member of the Dental Surgeons College of Costa Rica

Member of the International Academy of Aesthetics in Beverly Hills, California


Dra. Fernanda Ramírez

DDS, Biological Dentist


Formal Education

    •  • Bachelor of dental surgery (2010-2014)
    •  • Emphasis on dental aesthetics
    •  • MBA program at UCLA (2017-2018)
    •  • Medical investigator program (2018-2020)
    •  • Work Experience
    •  • Cyprosa, sales representative Colgate (2012)
    •  • General Dentist, clínica dental doctora Yahaira Madrigal (2015)
    •  • Ebais Unibe San Pedro CCSS (2017)
    •  • America Dental Clinic full time (2012-2020)

Training Courses Attended

    •  • BLS (2014)
    •  • Course: Oral photographic (2014)
    •  • Course: Novosmile (2017)
    •  • Course: First fit (2017)
    •  • Course: Porcelain Veneers Javier Quiros (2018)
    •  • Course: Digital Smile Design DSD (2016)

Safe mercury amalgam removal for a healthier smile.  We help you with our team of experts, holistic dentistry, advanced technology, and strict safety protocols.