Dentistry is a challenging business in so many ways, requiring a nearly unique balance of professional, personal, and business skills. On the business side of the house, staying abreast of the requirements and best practices prescribed by the various entities that regulate dental practice is an ongoing challenge for every dental practice.
In 2017, a significant change in standards from the EPA created a series of new regulations regarding amalgam scrap in the form of a final ruling requiring that all nearly all dental offices in the United States install amalgam separators no later than July 14th, 2020. The ruling further sets two new best practices for dental offices regarding amalgam management:
- Collect and recycle scrap amalgam
- Clean the chairside traps with non-bleach or non-chlorine cleanser so as not to release mercury
This ruling is deceptive in its simplicity—there are a number of popular understandings and misconceptions within the profession as to what they mean. By addressing the truth and the fact so the ruling we can better understand what an amalgam separator does and how it helps your practice.
Per the American Dental Association, the goal of the new regulations is to create “a fair and reasonable approach to the management of dental amalgam waste.” According to Gary L. Roberts, president of the ADA: “The ADA shares the EPA’s goal of ensuring that dental amalgam waste is captured so that it may be recycled. We believe this new rule — which is a federal standard — is preferable to a patchwork of rules and regulations across various states and localities.”
Dental amalgam is a mixture of metals including mercury. While dental amalgam accounts for less than one percent of human-caused environmental mercury contamination, the ADA affirms dentistry has an important role to play in preventing such contamination by capturing and recycling dental amalgam wherever possible.
So what does the new ruling require? As it turns out the new ruling is modeled closely on the existing ADA best practice standards for the disposal of amalgam. Broadly speaking, it requires the following:
- That dental practices use separators to isolate amalgam
- That dental practices are prohibited from flushing waste amalgam from any source down a drain
- That dental practices are prohibited from using chlorine or bleach-containing cleaners while cleaning chair-side traps and vacuum lines, as these may lead to dissolved mercury in the wastewater.
The end goal is to prevent dental amalgam waste from entering the sewer system and causing a myriad of environmental problems associated with heavy metal contamination. By following the standards outlined by the ADA and the EPA, your office will not only be conforming to the best practices within the industry but also playing a part in avoiding long-term environmental and infrastructure issues for both your community and the nation as a whole.
While most offices are required to have dental amalgam separators in place, there are a handful of exceptions. Per the ADA, these include the following:
- Dentists who practice in oral pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics are exempt from the rule.
- Dentists who do not place amalgam and only remove amalgam in unplanned or emergency situations (estimated at less than 5 percent of removals) are also exempt.
- Mobile dental units are exempt.
- Dentists who already have separators are grandfathered for 10 years.
Fortunately for practices required to install amalgam separators, there are a number of options that meet ADA and EPA standards while offering many benefits of their own. The ultimate choice will depend on your individual practices and its needs, but with the variety out there it’s likely a near-perfect option exists, offering out-of-the-box compliance and professional peace of mind.