Oral Health Topics
Amalgam Separators and Waste Best Management
- Dentists are encouraged to follow dental best management practices for amalgam waste handling and disposal.
- Use of ISO 11143-compliant amalgam separators is recommended.
- EPA final rule on amalgam separators is in development.
Prepared by: Center for Scientific Information, ADA Science Institute
Current estimates indicate that less than 2% of the mercury released into the environment comes from dental preparations and uses.1, 2 The majority of mercury from dentistry-related origin is in the form of elemental mercury in amalgam and not methylmercury, which is the form of mercury of particular environmental concern. Notwithstanding, following are insights about stewardship efforts with respect to dental amalgam in the waste stream.
American National Standards Institute/American Dental Association (ANSI/ADA) Standard No. 109 defines amalgam waste as including amalgam (scrap), chair-side trap filters containing amalgam, vacuum pump filters containing, amalgam, saliva ejectors if used in dental procedures involving amalgam, used amalgam capsules, extracted teeth with amalgam restorations, and waste items that are contaminated with amalgam.3
Amalgam Waste Best Management
Dental best management practices for amalgam waste handling and disposal4
include use of chair-side traps, use of ISO 11143-compliant5
amalgam separators, regular inspection and cleaning of traps, and use of appropriate commercial waste service to recycle and/or dispose of collected amalgam (Table).
Table. Best Management Practices for Amalgam Waste4
| Do use precapsulated alloys and stock a variety of capsule sizes
|Don't use bulk mercury
| Do recycle used disposable amalgam capsules
| Don't put used disposable amalgam capsules in biohazard containers
| Do salvage, store, and recycle non-contact (scrap) amalgam
| Don't put non-contact amalgam waste in biohazard containers, infectious waste containers (red bags), or regular garbage
| Do salvage (contact) amalgam pieces from restorations after removal and recycle their contents
| Don't put contact amalgam waste in biohazard containers, infectious waste containers (red bags), or regular garbage
| Do use chair-side traps, vacuum pump filters, and amalgam separators to retain amalgam and recycle their contents
| Don't rinse devices containing amalgam over drains or sinks
| Do recycle teeth that contain amalgam restorations (Note: Ask your recycler whether or not extracted teet with amalgam restorations require disinfection)
| Don't dispose of extracted teeth that contain amalgam restorations in biohazard containers, infectious waste containers (red bags), sharps containers, or regular garbage
| Do manage amalgam waste through recycling as much as possible
| Don't flush amalgam waste down the drain or toilet
| Do use line cleaners that minimize dissolution of amalgam
| Don't use bleach or chlorine-containing cleaners to flush wastewater lines
Amalgam separators remove amalgam particles from the wastewater to reduce the amount of amalgam entering the sewage system. Amalgam separators are devices designed to capture amalgam particles from dental office wastewater through sedimentation, filtration, centrifugation, or a combination of these mechanisms.6
Some separators may also use ion exchange technology to remove mercury from wastewater.6
Whenever there is need for plumbing work or other activities that might dislodge amalgam waste adhering to the inside of the pipes, it is recommended that steps be taken to minimize potential health or environmental issues.
While the Environmental Protection Agency (EPA) regulation on the use of amalgam separators is in development,7
there is currently no national regulation requiring the installation of amalgam separators. However state and local requirements exist in some areas. Check with your state or local dental society
to determine what, if any, requirements may apply to your practice.
- Graham J, Amar P, Irvine M, et al. Inventory of anthropogenic mercury emissions in the Northeast. Northeast States for Coordinated Air Use Management (NESCAUM) 2005. Accessed September 12, 2016.
- U.S. Environmental Protection Agency. Mercury in dental amalgam. Accessed September 12, 2016.
- American National Standards Institute/American Dental Association. Procedures for Storing Dental Amalgam Waste and Requirements for Amalgam Waste Storage/Shipment Containers. Chicago, IL; 2006 (reaffirmed 2012).
- American Dental Association. Best management practices for amalgam waste. October 2007. Accessed September 12, 2016.
- International Organization for Standardization. ISO 11143:2008: Dentistry — Amalgam Separators; 2008 (last reviewed and confirmed 2011).
- Chou HN, Anglen J. An evaluation of amalgam separators. J Am Dent Assoc 2012;143(8):920-21.
- ADA News. EPA pushes final ruling on amalgam separators to December. American Dental Association April 27, 2016. Accessed September 12, 2016.
Last Updated: September 14, 2016
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