The dental community is made up of healthcare professionals that care about the environment and with that goal in mind, dental office waste management has become an important aspect of the modern dental practice.

The waste that dental offices generate while delivering dental care includes a variety of materials that present a potential challenge to the environment. Dental practitioners are responsible for proper disposal methods of these materials to ensure both the public’s safety and minimize their effect on the environment.

Examples of such waste items include:

• Dental amalgam containing mercury,
• Silver,
• Lead,
• Biomedical office waste including spent x-ray processing solutions, disinfectants, cotton, plastic, latex, and glass which may be contaminated with bodily fluids and sharps including lancets, needles, and syringes, and
• General office waste.

Amalgam

Dental amalgam is a safe, durable, long-lasting, cost-effective material that has been used as a filling material for more than 150 years. Amalgam contains mercury, which is a toxic and bioaccumlative material, continuing to accumulate in living organisms, thereby posing a threat to plants, animals and humans should it enter the water system. Left uncontained, mercury has the potential to enter our food web, harming birds and fish.

Amalgam that is replaced or removed generates mercury-containing waste when amalgam particles are vacuumed from the mouth. These particles must be effectively collected and maintained. To this end, many dental practitioners have chair-side filtration devices that collect larger particles of dental amalgam removed via suction. Amalgam separators are devices designed to filter finer amalgam particles from the wastewater to reduce the amount of amalgam entering the sewage system.

There are standards and regulations in place in Ontario associated with the quality of the dental practice and amalgam waste disposal. The Royal College of Dental Surgeons of Ontario establishes and maintains a standard of practice under the regulated Health Professions Act, 1991, and the Dentistry Act, 1991.

Silver

Silver is another heavy metal that can be found in dental amalgam. It also occurs as silver thiosulfate in radiographic fixer, a solution used in the processing of dental radiographs (x-rays). The used fixer must not be washed down the drain. Dentists can install in-house recovery units that recover the silver for reuse.

Another common waste product from the dental office is unused film, since they contain unreacted silver that can be toxic in the environment.

Incorporating digital imaging as a replacement means to obtain dental radiographs reduces the amount of silver waste generated by the dental office.

Lead

Lead shields that are contained in each film packet used in traditional radiography are another waste product of the dental industry. Lead, like mercury and silver, is toxic to the environment and accumulates in the environment. These lead packets need to be collected and returned periodically to the supplier for recycling.

Biomedical Office Waste

Biomedical waste is one of the many types of waste regulated by the Ministry of the Environment and Climate Change. Biomedical waste includes any materials capable of causing disease such as blood-soaked gauze, tissues, and syringes.

General Office Waste

Dental offices can also minimize the effect of waste accumulation in the environment by implementing best practices such as:

• Purchasing products with minimal packaging
• Use of reusable plastic containers
• Use of products made from recycled or partly recycled materials
• Use of energy-efficient office lighting
• Conscientious use of paper in the dental office for printing and use of both sides of a sheet of paper

By implementing best practices in the collection and disposal of dental office waste, a dental office can successfully minimize and substantially reduce the effects of dental waste on the environment.