Level 17, 111 Elizabeth Street, Sydney NSW 2000
Level 17, 111 Elizabeth Street, Sydney NSW 2000
Holistic Treatment · SMART Certified
SMART-certified mercury amalgam removal in Sydney. Mercury-free since 1987, 32,000+ amalgams replaced. The evidence, the protocol and your choice.
Image of Amalgam Removal
Dental amalgam, the 'silver' filling used for nearly two centuries, is approximately 50% elemental mercury by weight, combined with silver (20–35%), copper, tin and sometimes zinc. It was the workhorse of world dentistry because it is strong, cheap and fast to place. It also releases small amounts of mercury vapour throughout its life, which is why its use has been progressively restricted worldwide.
Safe mercury amalgam removal follows the SMART protocol (Safe Mercury Amalgam Removal Technique), developed by the International Academy of Oral Medicine and Toxicology. At Sydney Holistic Dental Centre, we have not placed mercury amalgam since 1987 and are SMART certified for its safe removal, with more than 32,000 amalgam fillings replaced.
Where the regulators stand in 2026
It is worth seeing the timeline plainly.
1987
SHDC stops placing amalgam, decades ahead of regulation.
2020
US FDA advises seven higher-risk groups — including pregnant and nursing women, children under six, and people with kidney impairment or neurological conditions — to discuss amalgam alternatives with their dentist.
2020
NSW Health guideline GL2020_015: alternative materials should be favoured for pregnant and breastfeeding patients, patients with severe renal disease and children under 15.
2022
Australia's ratification of the Minamata Convention on Mercury takes effect (March 2022).
2024
Amalgam available in capsulated form only in Australia (from 1 January 2024).
2024
WHO's updated fact sheet lists mercury among the ten chemicals of major public health concern.
2025
Minamata COP6 (November) agrees a global phase-out of dental amalgam by 2034.
2026
ADA Policy 6.18 (reviewed February 2026) confirms the phase-out and advises minimising amalgam use in children, pregnant or breastfeeding women and people with kidney disease.
Mercury vapour is released from amalgam surfaces by friction (chewing and grinding), temperature (hot food and drinks) and corrosion, with vapour output elevated for up to 90 minutes after chewing. Around 80% of inhaled mercury vapour is absorbed through the lungs, and the body stores mercury preferentially in the kidneys, liver and brain.
Release rates from intact fillings are small; the debate between the professional bodies is about whether small chronic exposures matter, and we set out both positions honestly on our Why Mercury-Safe Matters page.
Patients whose amalgams are failing anyway: cracked, corroded, leaking or with decay underneath. Most amalgams we replace fall in this category, and the question is not whether to replace but how safely.
Patients in the FDA's higher-risk groups planning new dental work, who are advised to discuss alternatives with their dentist.
Patients who have weighed the evidence on both sides and made an informed personal decision to remove sound amalgams. We support that decision and we will not manufacture urgency around it.
Important: Removal is generally NOT recommended during pregnancy or breastfeeding except where clinically necessary. The FDA, IAOMT and ADA agree on this point.
"The question we hear most is 'should I have my mercury fillings removed?' Our answer never changes: that is a decision you make with your dentist and, where relevant, your GP, after weighing your own health picture and the science on both sides. Our job is to make sure that when a filling does come out, for whatever reason, it comes out to the highest safety standard that exists."
DR LEWIS EHRLICH — PRINCIPAL DENTIST
Image of Lewis
Amalgam fillings age. The average service life is measured in decades, and many fail quietly rather than painfully, which is why they are examined individually at every comprehensive consultation. Signs a filling has reached the end of its road include:
1
Visible cracks in the filling or, more importantly, in the tooth around it. Amalgam expands and contracts with temperature at a different rate to tooth structure, and over years this can crack the surrounding tooth.
2
Dark shadows or staining at the filling margins, which can indicate leakage and decay underneath.
3
Sensitivity to temperature or biting pressure on a previously quiet tooth.
4
Corrosion: a rough, pitted or crumbling surface.
5
Findings on X-ray or 3D imaging that the eye cannot see, which is how most failing amalgams are actually found.
We stopped placing amalgam in 1987, when doing so was considered eccentric, and the decades since have been one long exercise in the profession catching up. Over that time this practice has replaced more than 32,000 amalgam fillings, refined its protocol through SMART certification, and invested in equipment that exceeds the Australian regulatory baseline, including the supplementary at-source filtration our patients affectionately call the elephant.
The same team performs this procedure week in, week out; amalgam removal at SHDC is a routine, rehearsed discipline rather than an occasional service.
Team image
SMART is a set of 19 evidence-informed safety measures published by the IAOMT. At SHDC that means a sealed nitrile rubber dam isolating the tooth, a separate medical air supply so you never breathe over the work site, sectioning the filling into large chunks with copious water cooling, high-volume mercury-rated suction with an at-source aerosol capture unit (our supplementary ‘elephant in the room’ filtration system), full protective equipment for the clinical team, charcoal or chlorella rinses before and after, and disposal of every gram of removed amalgam as regulated toxic waste.
Replacement is chosen for your tooth, your bite and your preferences: BPA-free composite resin for smaller restorations, and ceramic inlays, onlays or crowns where strength is needed, most often milled on site with CEREC technology in a single visit. Material choice, longevity and costs are covered honestly at your consultation and on our cost page.
We do not charge a separate fee for the SMART removal itself; your investment is in the replacement restoration, plus consultation and any imaging your plan requires. One or two small amalgams can often be replaced in a single visit; larger amalgam loads are usually staged quadrant by quadrant across several appointments. Full details, including indicative ranges in Australian dollars, are on the Amalgam Removal Cost & Fees page.
Is removing amalgam fillings safe?
With a proper protocol, yes. The purpose of SMART is to reduce mercury exposure during removal to the practical minimum for you and the dental team. Removal without precautions is where exposure spikes, which is why protocol matters more than promises.
Isn't drilling amalgam out worse than leaving it?
Unprotected drilling produces the highest vapour exposure of an amalgam's life, which is precisely the case for SMART. If a filling is sound and you are comfortable keeping it, that is a legitimate choice too.
Should I have amalgams removed while pregnant or breastfeeding?
No, except where clinically necessary. The FDA, the IAOMT and the ADA all advise against elective removal during pregnancy and breastfeeding. If you are planning a pregnancy, timing is a conversation for your dentist and GP together.
Do you support detox after removal?
Optionally, yes. Some patients choose a nutritional support programme around removal, coordinated with clinic nutritionist Sofie Ehrlich or your own practitioner. It is supportive care, not a medical treatment, and it is never a condition of removal. See the Mercury Detox Support page.
How many appointments will I need?
It depends on how many amalgams you have, their size and position. As a guide: one or two small fillings in one visit; a heavy amalgam load staged over several visits, often quadrant by quadrant. Your written plan will say exactly.
Do private health funds cover this?
Funds rebate the replacement restoration item numbers according to your cover; there is no separate removal fee to claim. HICAPS is available on site.
Book a consultation and we'll assess your fillings and create a personalised removal plan.
BOOK A CONSULTATIONLewis image
Dr Lewis Ehrlich
Principal Dentist — Sydney Holistic Dental Centre
Dr Lewis Ehrlich has led Sydney Holistic Dental Centre since its founding and has overseen the practice's SMART-certified amalgam removal programme for over two decades. Technical answers reviewed by Dr Craig Wilson.
Sources
WHO (2024). Mercury and health fact sheet.
ADA Policy Statement 6.18 — Safety of Dental Amalgam (reviewed February 2026).
ADA (2025). Mercury amalgam global phase-out date set for 2034 (COP6, 7 November 2025).
NSW Health (2020). Dental Amalgam Clinical Use and Disposal Guideline GL2020_015.
DCCEEW. Australia and the Minamata Convention (ratified December 2021, effective March 2022).
