Mercury Safety Score™
— Explained

A rubber dam is placed in the mouth and secured around the tooth being worked on, creating a physical barrier that prevents mercury particles, vapor, and debris from entering the patient's airway. It is the cornerstone of patient protection during SMART removal. We weight this criterion most heavily because its absence substantially increases patient exposure.

High-volume evacuation is a powerful suction system (over 100 liters per minute) positioned directly adjacent to the tooth during the entire removal procedure. It captures mercury vapor and particles before they can spread into the room or be inhaled. A standard saliva ejector provides insufficient flow — ask specifically for HVE, not just suction.

HEPA air filtration with activated carbon removes airborne mercury vapor from the treatment room during and after the procedure. This protects both the patient (from ambient mercury in the room air) and the dental team (from ongoing occupational exposure). We require this element to be located in the treatment room, not just in a central HVAC system.

Some SMART practitioners provide supplemental oxygen to the patient through a nasal cannula during removal. This ensures the patient is breathing clean oxygen rather than treatment room air, providing an additional layer of protection beyond air filtration. While not universally required, it represents a meaningful additional protective measure.

We award points for providers who offer clear, honest pre-procedure education about what the SMART protocol involves, what mercury exposure during removal looks like, and what the alternatives are. A provider who takes informed consent seriously — presenting both risks and benefits — is one you can trust to be honest throughout your care.