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This is why dentists should follow dental amalgam waste management best practices

This is why dentists should follow dental amalgam waste management best practices

Amalgam waste recycling needs to be top-of-mind for everyone in the dental industry.

With new regulations going into effect next month, dentists in practices and other facilities must all be aware of the best practices for managing and handling dental amalgam.

Keep reading to learn why following these best practices is so critical.

Why proper dental amalgam management is important

Dentists have long used and are very familiar with amalgam, as it is a common material used in dental practices to fill cavities. Many dental patients know amalgam fillings as silver fillings.

There are now other materials that have become more widely used to fill cavities, but amalgam is still a popular option because it is known to be versatile and can often be cost-effective.

However, there have been some concerns raised about the safety of amalgam in dentistry due to one of the materials it is made of – mercury.

Mercury is just one of the materials that make up amalgam. The combination includes silver, mercury, tin and copper. There can sometimes be smaller levels of zinc, indium and palladium in amalgam. Mercury is on the list of ingredients because it makes the material more flexible, easier to apply to teeth and it hardens faster.

Now, the U.S. Food and Drug Administration and the American Dental Association have both stated that the amount of amalgam found in fillings is perfectly safe for adults and children six years and older.

Still, environmental concerns surrounding mercury in amalgam must be addressed.

In fact, those environmental concerns are what led the U.S. Environmental Protection Agency (EPA) to put in place next month a rule regarding amalgam separation and disposal.

EPA rule regarding dental amalgam handling

By now, most dental practices and facilities likely should have amalgam separators in place. This will soon be required by next month per the EPA’s rule on dental amalgam waste separating and recycling.

Professionals in the dental industry must follow specific regulations set through that rule. Those regulations include the following:

  • Scrap amalgam needs to be collected by the facility for recycling through an amalgam separator.
  • Non-chlorinated line cleaners in the 6 to 8 pH range are required.
  • Amalgam waste must remain separate from both regular trash and biohazardous waste.
  • Dental facilities will be required to monitor, report and maintain records of amalgam use, recycling and handling.

Environmental reasons for recycling amalgam

The EPA has determined removing and recycling dental amalgam necessary to make sure mercury is not released into the air or into water sources. There could be serious health risks – to people and the broader environment – if that were to happen.

Large amounts of mercury – far larger than any amount found in silver cavity fillings – can cause serious health problems, especially in unborn and young children.

According to the World Health Organization, mercury can have harmful effects on nervous, digestive and immune systems. It can also cause issues for lungs, kidneys, skin and eyes. There can even be behavioral issues for those exposed to excessively high amounts of mercury.

As for the environment, large amounts of improperly disposed of amalgam can allow mercury to seep into groundwater through sewage treatment facilities and landfills. If the amalgam waste is incinerated, then mercury can also be carried through the air, affecting water, land and vegetation.

Using amalgam waste best practices is critical

This is why using best practices for handling, storing and recycling amalgam waste from dentist offices and other similar facilities is so important.

The ADA has put together its own recommended list of best practices for those in the dental industry to adhere to.

These are the amalgam waste best practices dentists should follow

The ADA has set the following recommendations for best practices regarding amalgam in this guide.

In its “do” sections suggesting what dental facilities should do to safely handle amalgam, the ADA recommends the following:

  • Use precapsuled alloys and keep different capsule sizes in stock.
  • Recycle any used amalgam capsules if they are disposable.
  • Salvate, store and recycle scrap amalgam.
  • Salvage amalgam pieces from restorations once they have been removed, then recycle the amalgam waste.
  • Make sure to use chair-side traps, vacuum pump filters and amalgam separators to hold amalgam. Recycle separators’ contents.
  • Recycle amalgam waste as often as possible.
  • Use line cleaners that minimize amalgam dissolution.

Here is what should be avoided when handling amalgam

The ADA also provides a detailed list of “don'ts” that should be remembered when considering best practices to adopt in dentistry facilities and dental practices.

That list includes the following:

  • Never use bulk amounts of mercury.
  • Do not place used, disposable amalgam capsules in biohazard containers, infectious waste containers or in regular garbage. Keep them separate.
  • The same guidance applies for both contact non-contact amalgam waste. Keep that waste separate from biohazard, infectious and regular garbage containers.
  • Do not rinse devices that have amalgam on them over drains or sinks. This helps avoid amalgam from reaching wastewater systems.
  • Do not discard extracted teeth with silver fillings or other amalgam restorations in other waste or garbage.
  • Never flush amalgam waste down the toilet or down a drain.
  • Don’t flush wastewater lines with bleach or cleaners that contain chlorine.

Best practices for recycling amalgam waste

Employees of dental practices should also take steps to follow best practices when recycling amalgam waste.

According to the ADA, that includes wearing personal protective equipment to protect against infection from handling waste that’s been in contact with potentially infectious materials.

Amalgam waste should also be stored in a clearly labeled container: “Amalgam for Recycling.”

Finally, always find a reputable service for discarding recycled amalgam. It may be prudent to contact your city or municipality for help finding a service provider or guidance on local regulations.

Access your free compliance guide

DRNA is proud to be the chosen waste management and regulatory compliance partner of many in the dental services industry. Our company provides guidance on adhering to the EPA’s amalgam rule – and provides the quality, reliable services that our clients know they can count on.

Ready to learn more about coming into compliance with the EPA rule and follow amalgam waste management best practices? Download a free compliance guide to get started.