SMART CERTIFIED BIOLOGICAL DENTISTRY
Safe Mercury & Metal Removal in Ohio
A careful, protocol-driven approach designed to reduce unnecessary exposure during mercury amalgam and dental metal removal.
Dr. Johnson has completed IAOMT requirements for SMART certification and incorporates the protocol when removing mercury amalgam restorations.
SMART uses multiple protective measures designed to reduce exposure to mercury vapor and amalgam particles during removal.
Protective barriers, isolation, air filtration, and evacuation techniques are incorporated throughout the removal process.
SMART includes specific measures designed to reduce occupational exposure for the dental professionals performing and assisting with amalgam removal.
Patients have the opportunity to understand the procedure, discuss their concerns, and make informed decisions about their dental care.
BIOLOGICAL DENTISTRY & DENTAL MATERIALS
What Is Safe Mercury & Metal Removal?
Safe mercury and metal removal is a careful approach to removing existing dental materials while taking specific measures to reduce unnecessary exposure during the procedure.
Dental amalgam restorations contain a mixture of metals that includes elemental mercury. When an amalgam restoration needs to be removed, cutting or drilling the material can release mercury vapor and small particles. For this reason, Midwest BioHealth approaches amalgam removal differently from routine restorative removal.
Dr. John W. Johnson, DDS follows the Safe Mercury Amalgam Removal Technique (SMART), developed by the International Academy of Oral Medicine and Toxicology (IAOMT), as part of a broader biological approach to dental care.
The objective is not simply to remove a filling. It is to evaluate why treatment is needed, perform the removal carefully, and thoughtfully consider the material that will replace it.
THE SMART PROTOCOL
A Higher Standard for Mercury Amalgam Removal
SMART stands for Safe Mercury Amalgam Removal Technique, a protocol developed by the International Academy of Oral Medicine and Toxicology (IAOMT) to reduce mercury exposure during the removal of dental amalgam fillings.
When amalgam is cut or drilled, mercury vapor and small particles can be released. SMART brings together multiple protective measures designed to reduce exposure for the patient, dental team, and treatment environment throughout the removal procedure.
At Midwest BioHealth, Dr. John W. Johnson, DDS incorporates the SMART protocol when removing mercury amalgam restorations as part of the practice's broader biological approach to dental care.
SMART precautions include:
Protective equipment and coverings for the patient and dental team
Dental isolation of the treatment area
High-volume evacuation near the restoration
Air filtration and aerosol management
Water irrigation during removal
Sectioning techniques intended to reduce unnecessary grinding
Careful collection and disposal of amalgam waste
The result is a more controlled approach to a procedure that deserves careful planning and attention.
WHY IT MATTERS
The Removal Process Deserves Careful Attention
At Midwest BioHealth, Dr. Johnson favors replacing mercury amalgam fillings with suitable mercury-free alternatives. That treatment philosophy begins with an individual evaluation and a discussion of the benefits, risks, and timing of treatment. When removal proceeds, the SMART protocol provides additional protective measures designed to reduce exposure for the patient, dental team, and treatment environment.
While mercury amalgam removal is an important area of focus at Midwest BioHealth, biological dentistry also considers the other dental materials that may be present in a patient's mouth.
When an existing restoration or dental appliance requires replacement, Dr. Johnson evaluates the material, its condition, the surrounding tooth structure, and the patient's individual needs before recommending treatment.
Mercury Amalgam Fillings
Existing silver-colored amalgam restorations may be removed using SMART protocols when treatment or replacement is appropriate.
Metal Crowns & Restorations
Older crowns, bridges, and restorations containing metal may be evaluated for replacement when clinically indicated or as part of a broader restorative treatment plan.
Metal Dental Components
Certain posts, cores, and other restorative components may contain metal. Their condition and role in the existing restoration should be carefully evaluated before treatment.
Other Dental Materials
Patients sometimes come to Midwest BioHealth with questions about materials already present in their mouths. Dr. Johnson can help identify existing restorations and discuss appropriate options when treatment is needed.
The presence of a dental material alone does not automatically mean it should be removed. Treatment decisions begin with evaluation, conversation, and an understanding of the individual patient.
BEYOND AMALGAM
What We Safely Remove
AFTER REMOVAL
Thoughtful, Biocompatible Alternatives
Removing an existing dental restoration is only part of the treatment decision. What replaces it matters, too.
At Midwest BioHealth, restorative materials are selected with consideration for the individual patient, the location and function of the tooth, durability, aesthetics, and biological compatibility. When appropriate, Dr. Johnson favors modern, metal-free restorative options that can provide both natural appearance and long-term function.
Depending on the clinical situation, options may include:
Ceramic Restorations
Modern ceramic materials can provide durable, natural-looking alternatives for many crowns and restorations.
Composite Restorations
Tooth-colored composite materials may be appropriate for certain fillings and restorative applications.
Zirconia
Zirconia is a strong ceramic material used in biological dentistry for certain crowns, restorations, and dental implant applications.
The goal isn't simply to replace metal with something different. It's to select the right material for the individual patient and the clinical situation.
Zirconia ceramic implant technology from Swiss Dental Solutions (SDS), one of the metal-free treatment options available at Midwest BioHealth.
Dr. John W. Johnson, DDS has spent decades studying biological dentistry, dental materials, airway health, and whole-body approaches to oral care.
As a SMART-certified dentist through the International Academy of Oral Medicine and Toxicology (IAOMT), Dr. Johnson has completed education in the Safe Mercury Amalgam Removal Technique and incorporates SMART protocols when removing mercury amalgam restorations at Midwest BioHealth.
For Dr. Johnson, safe amalgam removal is not an isolated procedure. It is part of a broader biological philosophy that considers the materials used in dentistry, the condition of the existing restoration, the patient's individual needs, and the long-term plan for restoring the tooth.
Patients travel to Midwest BioHealth in New Albany from throughout Columbus, Ohio, and the surrounding Midwest seeking biological dentistry and a more considered approach to mercury amalgam and dental metal removal.
EXPERIENCE & TRAINING
SMART Certified Care at Midwest BioHealth
YOUR VISIT
What to Expect During Your Appointment
Questions about existing dental materials deserve time and attention. At Midwest BioHealth, we begin by understanding your concerns, evaluating your oral health, and discussing how removal and restoration may fit into your treatment plan. The initial evaluation establishes a clear direction before treatment begins.
Evaluation
Dr. Johnson evaluates your existing restorations, the condition of the surrounding teeth, and your individual needs. Your medical and dental history provides important context, including any known material sensitivities or concerns you would like to discuss.
Conversation
Understanding your options is part of the appointment. This is an opportunity to ask why a treatment is being recommended, how removal would be performed, and what materials might be used afterward. The discussion should address both the potential benefits and the limitations of treatment.
Treatment Planning
Removal and replacement are considered together. Planning considers each tooth's condition, the type of restoration needed, and the sequence of care. The aim is to understand not only what will be removed, but how the tooth will be restored and supported afterward.
Careful Removal & Restoration
During treatment, mercury amalgam removal follows the SMART precautions described above. Restoration is guided by the tooth's needs and the individual patient's needs, with attention to function, appearance, and material selection.
CONTINUE LEARNING
Metal Reactions in the Body
Patients sometimes wonder how dental materials relate to the rest of the body. Our Metal Reactions resource features a presentation by Dr. Scott Schroeder that explores metal sensitivities and concerns about implanted materials. It offers another perspective for patients interested in the subject and a starting point for questions to discuss with their dental and medical providers.
This presentation is an educational resource, not a diagnosis or an individual recommendation to remove a dental restoration or implant.
Questions About Mercury & Metal Removal
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SMART stands for Safe Mercury Amalgam Removal Technique. Developed by the International Academy of Oral Medicine and Toxicology, it brings together protective recommendations intended to reduce mercury exposure during amalgam removal. These measures address the patient, dental team, and treatment environment; they should not be understood as a guarantee that a procedure is entirely risk-free.
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Depending on the condition of the tooth, replacement options may include a tooth-colored composite filling or a ceramic restoration. Dr. Johnson considers the location and function of the tooth, the remaining tooth structure, appearance, and material compatibility when discussing the available options. The replacement is part of the treatment plan, not an afterthought.
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The number of appointments is determined during treatment planning. It depends on which teeth are being treated, the condition of the existing restorations, and the type of replacement required. Your consultation is the time to discuss the proposed sequence of care and how it will fit your circumstances.
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Elective amalgam removal is generally deferred during pregnancy and breastfeeding. The IAOMT recommends against amalgam removal during these periods as a precaution. Tell the team before planning treatment if you are pregnant, breastfeeding, or planning a pregnancy. An urgent dental problem requires an individual assessment rather than an automatic delay in necessary care.
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We need an individual treatment plan before we can establish the cost. Fees depend on the teeth involved, the extent of treatment, and any required restorations. The Midwest BioHealth team can discuss treatment fees, insurance questions, and available financing options as part of planning your care.
Schedule a Consultation
Whether you have questions about an existing mercury filling, a metal restoration, or the materials that may replace it, a consultation is the place to begin. Meet with Dr. Johnson to discuss your concerns, assess your oral health, and review your options.
Midwest BioHealth
New Albany, Ohio