Littleton, CO dentist Dr. Guy Grabiak and team celebrate case study award for long-term healthy results with their patient.
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Mercury Removal (Smart Protocol)

Mercury Removal

What is Safe Mercury Removal?

New research about the dangers of mercury filling removal has brought to light some alarming facts about the process and its effects on patients, dentists, dental workers, and the environment. In order to minimize the risks of mercury vapor and particulate inhalation during treatment the International Academy of Oral Medicine and Toxicology (IAOMT) created the SMART (Safe Mercury Amalgam Removal Technique) protocol.

SMART is a specific set of safety measures used to reduce mercury exposures during dental amalgam filling removal. Once the mercury restoration is safely removed, we can then replace it with a more biocompatible material to restore the tooth. The SMART protocol uses detailed scientifically proven protective measures to safely remove amalgam fillings while capturing mercury vapors, and reducing exposure to toxins in the air and particle matter significantly. If you are looking for ways to reduce risks during your dental care, it is essential to find out if your dentist uses SMART mercury removal in their office. Did you know that less than 1% of dentists have this certification?

Why is Safe Mercury Removal needed?

Dental amalgam fillings are made with a mixture of mercury, silver, copper, tin, and sometimes zinc. Often called “silver fillings,” all dental amalgams are 45-55% elemental mercury. Mercury is toxic, and this poison is recognized by the World Health Organization as one of the top ten chemicals or groups of chemicals of major public health concern. Mercury accumulates in the body, and any amount of mercury taken into the body should be considered hazardous.

This mercury can leak over time with regular brushing, flossing, clenching or even eating and drinking. Mercury vapor that is caused by these activities can be harmful to the patient, and can even be detrimental to the health of the fetus of pregnant patients. For this reason, we often recommend to our patients that they have their old amalgam fillings removed and replaced as soon as possible.

Who is a candidate for Safe Mercury Removal?

If you have amalgam fillings in your mouth right now, you’re already a good candidate to have them removed. We believe mercury (a neurotoxin) is not safe for any individual. The FDA states amalgam fillings may pose a greater health risk to certain populations.

The typical removal method involves drilling out each filling, piece by piece—meaning that large amounts of mercury vapor are expelled into the immediate area around you during the procedure. This not only puts you at risk; it also poses a significant risk to Dr. Grabiak and his staff. Exposure to mercury may pose a greater health risk in certain groups of people, who may be more susceptible to potential adverse effects generally associated with mercury. These high-risk populations include:

  • Pregnant women and their developing fetuses;
  • Women who are planning to become pregnant;
  • Nursing women and their newborns and infants;
  • Children, especially those younger than six years of age;
  • People with pre-existing neurological disease;
  • People with impaired kidney function;
  • People with known heightened sensitivity (allergy) to mercury or other components (silver, copper, tin) of dental amalgam.

What happens during the Safe Mercury Removal process?

Prior to the removal process Dr. Grabiak will discuss with you a one week, two-step protocol designed to support the body in detoxifying and removing mercury and other heavy metals during the removal of dental amalgams. The appointment begins with a charcoal rinse and vitals. In order to protect our patient’s skin and clothing from potential exposure, a full body, impermeable barrier, as well as a full head/face/neck barrier and non-latex dental dam will be utilized. Medical grade oxygen delivered by a nasal mask will be utilized to assure the patient does not inhale any mercury vapor or amalgam debri during the procedure. A saliva ejector will be placed under the dental dam to reduce mercury exposure to the patient.

During the amalgam filling removal, Dr. Grabaik will utilize an at source oral aerosol vacuum in close proximity to the operating field. (i.e., two to four inches from the patient’s mouth) to mitigate mercury exposure. Copious amounts of ozone water to reduce heat along with a high speed evacuation device to capture mercury discharges are required to reduce ambient mercury levels.

The amalgam will be sectioned into chunks and removed in as large of pieces as possible. This practice minimizes excess potential for mercury exposure. Once the removal process is complete, the patient’s mouth is thoroughly flushed with water and then rinsed out with a slurry of charcoal, chlorella or similar adsorbent.

To ensure safe disposal of mercury for our environment an amalgam separator is properly installed, utilized, and maintained to collect mercury amalgam waste so that it is not released into the effluent from the dental office. Additionally each room where mercury fillings are removed adequate filtration is in place, which requires a high-volume air filtration system capable of removing mercury vapor and amalgam particles generated during the removal of one or more mercury fillings.

If you have amalgam (metal) fillings and would like to have them removed, call our office today so that we can help schedule you with an appointment.

lizmar thurber

Noelle Jones

Office Manager

With a robust career spanning over 20 years in the dental sector, Noelle Jones has developed a profound expertise that blends technical proficiency with visionary leadership. Starting her journey as a dental assistant, Noelle has continually expanded her skill set and knowledge base. She pursued higher education at Georgia Perimeter College, where she completed programs in dental lab technology, chairside assisting, and business management. In 2024, Noelle found her perfect match in the professional world at Denver Dentistry, a practice that embraces the principles of biological dentistry. This role not only marks a significant step in her career but also profoundly shifts her perspective on the impact dental health has on the rest of the body. Beyond her professional endeavors, Noelle is an avid adventurer who loves exploring the natural beauty of Colorado. She is on a quest to hike all the "14ers" in the state. When not scaling peaks, she enjoys traveling and cherishing moments with her husband and their three beloved dogs. Noelle's dedication to dental excellence and her commitment to a holistic approach in her field make her a pivotal member of the Denver Dentistry team.

The foundation of providing safe and personalized holistic care begins by getting to know you and your goals for your oral health and overall health, both short term and long term. Dr. Grabiak will then learn about your family’s dental and medical history, along with your dental and medical history. Afterwards, we begin your exam by taking a sample of your saliva (Sillha), checking for seven different biomarkers. That same day, we will send you home with a report showing how you scored in those different biomarker categories.

The head and neck examination is often overlooked by busy clinicians but it is as crucial as an element of the oral cancer examination. Dr. Grabiak begins his exam outside of the mouth by starting with a soft tissue check of the neck and the jaw. A thorough head and neck examination is essential for detecting early skin cancers, any overdeveloped jaw muscles that may be contributing towards bruxism, and enlarged lymph nodes that may indicate an active virus or infection.

After the extraoral exam, Dr. Grabiak begins his extensive intraoral exam. During Dr. Grabiak’s exam he is evaluating the teeth, uvula, mucosal tissues, tongue, floor of the mouth, hard and soft palate, and the oropharynx. Part of this exam includes taking high-definition photos of the mouth, all at different angles so you can see exactly what he is seeing. Our hygienist will then come in and complete a comprehensive periodontal assessment. In some cases, Dr. Grabiak and your hygienist may recommend additional testing to get to the root cause of the evidence of symptoms they are seeing in your mouth. This entire process takes roughly an hour. In some cases, depending on what Dr. Grabiak and your hygienist had found during their exam we will invite you back for a follow-up appointment called review of findings.

In preparation for the review of findings, Dr. Grabiak and your hygienist will take the time to evaluate all of the data that was collected from your examination and testing to determine your specific needs. At your review of findings appointment Dr. Grabiak will sit down with you one on one to review the data that was collected from your appointment, along with any recommendations. This allows you the time to ask Dr. Grabiak any questions that you may have about your treatment recommendations and expectations from treatment.

Jeromy Mulkey

Jeromy Mulkey

Operations Manager

Jeromy earned his Bachelor of Science in Finance from New Mexico State University in Las Cruces, New Mexico. His journey in the dental field began when he moved to Colorado in 2015 from Hannibal, New York, a small town outside of Syracuse. Starting as a patient coordinator in corporate dental, Jeromy quickly advanced to office manager and eventually managed multiple offices for a DSO, including specialty practices over the next 4 years. In 2019, his transition to holistic dentistry at Denver Dentistry began. This transition brought new challenges and a renewed passion for learning about the latest sciences and technologies integrated into their practice. Since starting at Denver Dentistry, Jeromy has enjoyed learning about safe mercury removal (SMART Protocol), airway management, ozone, salivary testing, biocompatibility testing for materials, heavy metals testing, and the systemic and oral health connection. Jeromy currently resides in Littleton, enjoying the proximity to the mountains. Outside of work, he cherishes time spent with his wife and daughter and enjoys activities such as snowboarding, bouldering, paintball, soccer, basketball, camping, and hiking. Jeromy's dedication to delivering exceptional customer service and contributing to the team's mission of bringing more healthy smiles to satisfied patients is at the core of his professional ethos.
Chelsea White

Jazmin Contreras

Dental Hygiene Assistant

A native of Guatemala and raised in Carbondale, Colorado, Jazmin Contreras embarked on her medical journey with a degree in Kinesiology from Colorado Mesa University, where she graduated at the top of her class in 2020. Her early professional life included a significant role in a chiropractic office, where she gained an appreciation for the interconnectedness of whole-body health. This experience laid the groundwork for her holistic view of healthcare. Fluent in both English and Spanish, Jazmin leveraged her linguistic skills as a medical interpreter, greatly enhancing her communication capabilities and deepening her understanding of patient needs and concerns. This role proved essential in her development as a healthcare provider, enabling her to effectively bridge cultural and linguistic barriers in medical settings. Jazmin's career trajectory took a definitive turn when she joined Denver Dentistry. Under the guidance of Dr. Grabiak, she was introduced to an innovative holistic approach to dental care that aligned with her own values and aspirations. It was here that Jazmin found her calling, thriving in an environment that embraced both traditional and alternative medical philosophies. Known for her robust critical thinking and problem-solving skills, Jazmin is passionate about educating her patients on the nuances of holistic dentistry. She is dedicated to demystifying dental care, ensuring her patients not only receive top-notch treatment but also understand the broader implications of oral health on overall well-being. When not at the clinic, Jazmin and her husband indulge in the great outdoors, pursuing activities such as hiking, camping, and kayaking. These adventures not only satisfy their love for nature but also provide Jazmin with a refreshed perspective and renewed energy, which she brings back to her patients and her practice.
lizmar thurber

Lizmar Thurber

Expanded Duties Dental Assistant

Lizmar Thurber is a highly experienced Expanded Duties Dental Assistant, distinguished by her extensive background in both traditional and holistic dental practices. Her educational journey began at the University of Florida, College of Dentistry’s Division of Continuing Education, where she specialized in Expanded Duties of Dental Auxiliary Personnel, Radiological Health, and Safety in 2002. She further enhanced her credentials by earning a Bachelor of Science in Biology with an emphasis in Pre-Medicine from Grand Canyon University in Phoenix, Arizona, in 2015. In her role, Lizmar leverages a robust skill set tailored to holistic dental care. She has a profound understanding of holistic health practices and is skilled in using biocompatible materials for dental procedures, such as fillings and crowns, to reduce toxicity. Her empathetic demeanor and excellent interpersonal skills are pivotal in alleviating patient fears, thereby creating a comforting and reassuring environment. Known for her bilingual proficiency in English and Spanish, Lizmar effectively communicates with a diverse patient base, providing clear explanations of holistic dental treatments and procedures. Lizmar's exceptional communication abilities and her capacity to adapt to various treatment modalities are essential in navigating the unique aspects of holistic dental care. Her versatility and adaptability make her an invaluable asset to any dental team, enhancing patient care with a comprehensive, patient-centered approach. Beyond her professional endeavors, Lizmar cherishes the time spent with her family. Together with her husband, and their sons, she actively participates in various sports activities. They frequently travel for the Colorado Prospects baseball club and engage in other sports like basketball and soccer. Additionally, Lizmar serves her community as a worship pastor, where she shares her passion for music and guides others in their spiritual journey with Christ.

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