POLICY STATEMENT 5.
15
AUSTRALIAN DENTAL ASSOCIATION INC.
AMALGAM WASTE MANAGEMENT
1 Introduction
1.1 Mercury is bio-accumulative and of particular environmental significance.
1.2 Many countries have strict mandatory limits on the levels of mercury in wastewater.
1.3 Dental clinics are recognised as a source of mercury into the environment.
1.4 Amalgam waste is created in dental clinics during the placement and removal of amalgam
restorations.
1.5 Dental amalgam waste may find its way into wastewater, sedimentation in sewage sludge,
landfills and the atmosphere.
1.6 Chair side traps, suction filters and/or amalgam separators capture most of the amalgam
waste.
2 Principle
2.1 Mercury discharge into the dental clinic and general environment should be minimized.
3 Policy
3.1 Dental staff must be trained so they can adopt best practices to minimize amalgam waste
and ensure that waste is disposed of properly.
3.2 Only precapsulated amalgam alloy should be used in dental clinics.
3.3 Dental clinics must collect, store safely and forward for recycling as much amalgam waste
as possible. Such waste includes:
• used amalgam capsules;
• excess amalgam not placed in restorations;
• amalgam retained in chairs traps, suction filters and amalgam separators; and
• extracted teeth which have been restored with amalgam.
3.4 Amalgam separators, which comply with ISO 11 143, should be installed in all dental
clinics.
Policy Statement 5.15
Adopted by ADA Federal Council, April 12/13, 2007.
Amended by ADA Federal Council, November 15/16, 2007.
ADA Policy Statement 5.15 Page 1 of 5 November 15/16, 2007
AMALGAM WASTE MANAGEMENT — BEST PRACTICE GUIDE
[APPENDIX TO POLICY STATEMENT 5.15]
Dental Amalgam Waste
Dental amalgam waste can be recycled. Following the simple suggestions outlined in this document will
help protect the environment.
Although mercury in the form of dental amalgam is very stable, amalgam should not be disposed of in the
general waste, infectious waste “yellow bag”, pharmaceutical waste or sharps container. Amalgam also
should not be rinsed down the drain. These precautions are important because some communities
incinerate municipal garbage, medical waste, and sludge from wastewater treatment plants. If amalgam
waste ends up in one of these incinerated waste streams, the mercury can be released to the environment
due to the extremely high temperatures used in the incineration process. Increasingly, local communities
are enacting restrictions on the incineration of wastes containing mercury.
The good news is that amalgam waste, kept separate from other waste, can be safely recycled. The
mercury can be recovered from amalgam wastes through a distillation process and reused in new
products. Recycling is best practice for amalgam waste management for dental clinics.
Standards
The appropriate standard for amalgam separation is ISO 11 143, which specifies the use of amalgam
separators that effectively filter 95% of amalgam waste that might otherwise go to into wastewater
streams.
Types of Amalgam Waste
• Non-contact amalgam (scrap) is excess mix leftover at the end of a dental procedure.
Many recyclers will buy this clean scrap.
• Contact amalgam is amalgam that has been in contact with the patient. Examples are
extracted teeth with amalgam restorations, carving scrap collected at chair side, and
amalgam captured by chair side traps, filters, or screens.
• Amalgam separators that comply with ISO 11 143 capture over 95% of amalgam waste
but also trap other treatment debris.
• Chair side traps capture amalgam waste during amalgam placement or removal
procedures (traps from dental units dedicated strictly to hygiene may be placed in the
general waste).
• Vacuum pump filters or traps contain amalgam sludge and water. Some recyclers will
accept whole filters, while others will require special handling of this material.
• Amalgam sludge is the mixture of liquid and solid material collected within vacuum pump
filters or other amalgam capture devices.
• Empty amalgam capsules are the individually dosed containers left over after mixing
precapsulated dental amalgam.
ADA Policy Statement 5.15 Page 2 of 5 November 15/16, 2007
Bulk Elemental Mercury
The use of bulk elemental mercury, also referred to as liquid or raw mercury, is not recommended for use
in dental clinics. Instead, precapsulated amalgam alloy should be used.
If there is still bulk elemental mercury in a dental clinic, it should be recycled. Check with a licensed
recycler to determine whether they will accept bulk elemental mercury. Do not pour bulk elemental
mercury waste into the general waste, infectious waste yellow bag or down the drain.
Steps for Recycling Amalgam Waste
1. Stock amalgam capsules in a variety of sizes to minimize the amount of amalgam waste
generated.
2. Amalgam waste may be mixed with body fluids, such as saliva, or other potentially infectious
material, so use personal protective equipment such as gloves, masks, and protective eyewear
when handling it.
3. Store amalgam waste in a covered plastic container labeled “Amalgam for Recycling” or as
directed by your recycler. Consider keeping different types (e.g., contact and non-contact) of
amalgam wastes in separate containers—talk to your recycler about any advantages in doing so.
4. Arrange for your recycler to collect your amalgam waste on a regular basis.
Amalgam Waste Management — Best Practices
DO DON’T
Do use precapsulated alloys and stock a variety Don’t use bulk mercury
of carpule sizes
Do recycle used disposable amalgam capsules Don’t put used disposable amalgam capsules
in sharps containers, infectious waste containers
(yellow bags) or general waste
Do salvage, store and recycle non-contact Don’t put non-contact amalgam waste in sharps
amalgam (scrap amalgam) containers, infectious waste containers (yellow
bags) or general waste
Do salvage (contact) amalgam pieces from Don’t put contact amalgam waste in sharps
restorations after removal and recycle the containers, infectious waste containers (yellow
amalgam waste bags) or general waste
Do use chair-side traps to retain amalgam and Don’t rinse chair-side traps containing amalgam
recycle the content over drains or sinks
Do recycle contents retained by the vacuum Don’t rinse vacuum pump filters containing
pump filter or other amalgam collection device, amalgam or other amalgam collection devices
if they contain amalgam over drains or sinks
Do recycle teeth that contain amalgam Don’t dispose of extracted teeth that contain
restorations. (Note: Ask your recycler whether amalgam restorations in sharps containers,
or not extracted teeth with amalgam restorations infectious waste containers (yellow bags), sharps
require disinfection) containers or general waste
Do manage amalgam waste through recycling Don’t flush amalgam waste down the drain or
as much as possible toilet
Do use line cleaners that minimize dissolution Don’t use bleach or chlorine-containing cleaners
of amalgam to flush wastewater lines
ADA Policy Statement 5.15 Page 3 of 5 November 15/16, 2007
A Practical Guide to Integrating
Amalgam Waste Management — Best Practices into Dental Clinics
Non-contact (scrap) amalgam
• Place non-contact, scrap amalgam in wide-mouthed, airtight container that is marked “Non-contact
Amalgam Waste for Recycling.”
• Make sure the container lid is well sealed.
Amalgam capsules
• Stock amalgam capsules in a variety of sizes.
• After mixing amalgam, place the empty capsules in a wide-mouthed, airtight container that is marked
“Amalgam Capsule Waste for Recycling.”
• Capsules that cannot be emptied should likewise be placed in a wide-mouthed, airtight container that
is marked “Amalgam Capsule Waste for Recycling.”
• Make sure the container lid is well sealed.
• When the container is full, send it to a recycler.
Amalgam separators
• Check supplier instructions for replacement of waste container (varies from volume guideline to time
cycle e.g. annual replacement).
• Check with supplier re model information against specific conditions in the practice i.e. space,
plumbing, access, workload, regulatory requirements
• Consider capacity (in chairs), maximum flow rate and life cycle.
Disposable chair-side traps
• Open the chair-side unit to expose the trap.
• Remove the trap and place it directly into a wide-mouthed, airtight container that is marked “Contact
Amalgam Waste for Recycling.”
• Make sure the container lid is well sealed.
• When the container is full, send it to a recycler.
• Traps from dental units dedicated strictly to hygiene and non-amalgam related activities may be
placed in with the general waste.
Reusable chair-side traps
• Open the chair-side unit to expose the trap.
• Remove the trap and empty the contents into a wide-mouthed, airtight container that is marked
“Contact Amalgam Waste for Recycling.”
• Make sure the container lid is well sealed.
• When the container is full, send it to a recycler.
• Replace the trap into the chair-side unit (Do not rinse the trap under running water as this could
introduce dental amalgam into the waste stream.
Vacuum pump filters
• Change the filter according to the manufacturer’s recommended schedule. Note: The following
instructions assume that your recycler will accept whole filters; some recyclers require different
handling of this material, so check with your recycler first.
• Remove the filter. While holding the filter over a tray or other container that can catch any spills,
decant as much of the liquid as possible without losing any visible amalgam. The decanted, amalgam-
free liquid can be rinsed down the drain.
• Put the lid on the filter and place the sealed container in the box in which it was originally shipped.
When the box is full, the filters should be recycled.
ADA Policy Statement 5.15 Page 4 of 5 November 15/16, 2007
Line cleaners
• Use non-bleach, non-chlorine-containing line cleaners, which will minimize amalgam dissolution.
Instruments
• Clean scrap amalgam from instruments and matrix bands.
• Place scrap into a wide-mouthed, airtight container that is marked “Contact Amalgam Waste for
Recycling”.
Ultrasonic Cleaning Solution
• Dispose of ultrasonic cleaning solution via the amalgam separator.
Appendix to ADA Policy Statement 5.15
(Copyright © 2004 American Dental Association. All rights reserved.
Adapted 2007 with permission.)
Adopted by ADA Federal Council, April 12/13, 2007.
Amended by ADA Federal Council, November 15/16, 2007.
ADA Policy Statement 5.15 Page 5 of 5 November 15/16, 2007
