DEEP: Best Management Practices for Mercury Amalgam

Best Management Practices for Mercury Amalgam

Introduction

The following best management practices (BMP’s) replace the October 23, 2003 BMP’s for mercury amalgam and are intended to help dental practitioners comply with the requirements of Sections 22a-616(d) and 22a-622 of the Connecticut General Statutes (CGS) concerning the management of amalgam. In addition to these mercury amalgam BMP’s, dental offices should be familiar with the document entitled The Environmentally Responsible Dental Office: A Guide to Proper Waste Management in Connecticut Dental Offices. This guidance document addresses general environmental waste disposal issues routinely encountered by dental offices.

BEST MANAGEMENT PRACTICES

  1. Amalgam substitutes should be used in dental practices in cases where they are appropriate as determined by the dental professional when determining the best treatment option for the patient.

  2. Each dental office shall make available to patients information about mercury-amalgam fillings and possible alternatives. At a minimum, the brochure Fillings: The Choices You Have, Mercury Amalgam and Other Filling Materials shall be displayed and remain prominently displayed in each office. This brochure is available on the Department website at www.ct.gov/dep or by calling the Department’s Mercury Hotline at 1-877-537-2488.

  3. Single use amalgam capsules should be used in dental practices. Any dental practice using mercury in the formulation of amalgam fillings shall maintain a mercury spill kit on site and train all technical and medical staff on mercury spill clean-up response procedures.

  4. Spilled amalgam must be swept up immediately and placed into an amalgam container. Any mercury spill should be cleaned up in accordance with proper procedures which can be found on the DEP website at: www.ct.gov/dep or the EPA website at: http://www.epa.gov/epawaste/index.htm.

  5. Empty amalgam capsules (after mixing amalgam), that contain no visible amalgam, should be disposed of as a solid waste.

  6. All contact and non-contact scrap amalgam should be salvaged and stored in separate containers. The containers should be structurally sound and labeled as to the contents (example – Hazardous Waste: Contact Amalgam). The containers should be tightly closed except when adding or removing scrap amalgam. The contents of such containers should be recycled and shall be processed through an amalgam recycler or a licensed hazardous waste transporter. Contact and non-contact scrap amalgam shall not be disposed of in the trash or into sinks or drains.

  7. If the amalgam is stored under water, then the water may not be poured down the drain or in the trash. The water must be collected and managed by an amalgam recycler or licensed hazardous waste transporter.

  8. Amalgam separation units must be installed and maintained, and records kept, as described below, for any dental practice that discharges mercury amalgam (e.g. from chair-side sinks, vacuum systems, etc.).

      1. Type/installation of amalgam separators:

  1. Amalgam separation units shall at all times meet the ISO 11143 standard of a minimum of 95% mercury removal.

  2. The separator should be installed centrally so that wastewater from all suction lines pass through it.

  3. Amalgam separators must be operational at all times when dental procedures are being performed.

2. Maintenance:

  1. Spent amalgam collection boxes or cartridges should be recycled whenever possible.

  2. The separator should be inspected and collection boxes or cartridges changed in accordance with manufacturer specifications.

  3. Chair-side traps should be inspected and maintained in accordance with manufacturer specifications. Use traps with the smallest screen size your vendor says will work. One time use amalgam traps are preferable to reusable traps due to the difficulty in effectively removing amalgam particles from the trap without spilling them into the trash or down the drain.

  4. All contact amalgam captured by chair-side traps, filters, or screens shall be managed through an amalgam recycler or a licensed hazardous waste transporter. Contact amalgam shall not be disposed of in the trash or into sinks or drains.

  5. When plumbing parts are removed or cleaned, the sludge inside the piping should be inspected for the presence of mercury amalgam. If amalgam is present, it should be removed and managed along with other amalgam waste.

  6. When cleaning wastewater pipes or vacuum lines, it is extremely important to use proper line cleaning solutions to maintain the proper functioning of amalgam separators. Clean wastewater pipes or vacuum lines with non-oxidizing/biodegradable (non-bleach or non-chlorine containing) cleaners to minimize the dissolution of amalgam.

      3. Records:

      1. Records of amalgam separator and chair-side trap installation, maintenance and servicing records shall be maintained on site.

      2. Such records should include, at a minimum:
    • Date of installation;

    • Date of each inspection/service of each separator/trap

    • A clear indication of which separator/trap is being serviced;

    • Description of routine and non-routine maintenance activities conducted;

    • Records and receipts of all contact and non-contact amalgam sent to recycling or disposal facilities; and

    • Signature of person conducting the activity.
      1. A dental office shall make such records available to the commissioner or his/her designated agent upon request.
Adopted on this 11th day of January, 2006   /s/ GINA McCARTHY
Commissioner

Content Last Updated on December 15, 2006