Displaced waste

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  Posted by: Dental Design      13th October 2024

A dental practice impacts the environment, from the material waste generated by procedures to the consistent use of water and electricity. Its impact is in fact greater than that of general healthcare: across Europe, General Medical Practitioners produce 100kg of waste per year whilst General Dental Practitioners produce 260kg per year, indicating the need for more sustainable solutions to manage waste in dentistry.[1]

One of the products found in dental waste is mercury, which comprises 50% of the dental amalgam used in restorative dentistry.[2] Amalgam waste is generated from overproduction, drilling, and removing old fillings. Disposing of it properly is essential for the safety of the environment, wildlife, staff and patients, making it a legal, ethical and professional duty.[3]

Mercury

In optimal conditions, bacteria can convert mercury waste into methylmercury, a neurotoxin.2 If methylmercury integrates within the natural world – rivers, seas, soils – it is absorbed into the wildlife, potentially affecting the animals that humans may then eat. Methylmercury can cause brain, kidney and lung damage for humans, and it is alarmingly easy for people to reach high levels of exposure to this substance.2

For over 150 years, mercury has been a key component used in dental amalgam, along with other metals such as silver, tin and lead. Amalgam use in primary care is high, especially in the publicly funded sector where the majority of posterior restoration provision lies.[4] Whilst amalgam is being phased out globally,[5] the amount of waste that is, and still will be produced, is high: dental clinics contribute between 3% and 70% of environmental mercury, with spillage, storage issues and a non-adherence to the necessary precautions being the three common explanations for this output.5

Mercury can be released from autoclaving amalgam-filling dental instruments, incinerating amalgam wastes, and the uncontrolled disposal of amalgam extracted teeth.5 The proper management and disposal of dental amalgam can, therefore, minimise the amount of elemental mercury vapour entering the environment.[6]

Careful regulations

It is imperative to be up-to-date with the best practice waste disposal regulations and have an effective strategy within the dental practice setting to follow these. To avoid binning harmful substances into the sludge drum or washing them away into the water supply, practices need to educate their staff on the safe management of mercury waste.

This is necessary to follow The Controlled Waste (England and Wales) Regulations 2012,[7] the Environmental Protection Act 1990[8] and the Regulation (EU) 2017/852 of the European Parliament and of the Council, which dictates that amalgam separators must retain 95% of amalgam particles and these shall not be released directly or indirectly into the environment under any circumstance.[9] For amalgam separators, meeting the British Standard Dental Equipment (BS ISO EN 11143:2000) is also essential for waste safety.1

Resource deficit

Besides harmful substances, the manufacturing and distributing of any object has an environmental impact as it requires raw materials and energy, with the added potential of releasing pollutants into the air, land or water.[10] Research has elucidated that, since the 1970s, humanity has accumulated an ecological debt; more resources are being spent than the planet can reproduce.6 This is especially obvious in economically developed countries, where the amount of waste produced per person is significantly higher.6 By managing our resources in an environmentally friendly way, such as using recyclable products, the imbalance can be changed.

Initial Medical supports sustainable dentistry with their range of recycled dental collector cups. Ideal for capturing amalgam waste and preventing the release of mercury into the environment, the collector cups are thoroughly cleaned and returned to the original standard of a new cup by the Initial Medical service. This reduces single-use plastic consumption in the practice and offers a more cost-effective option compared to purchasing new collector cups. By replacing the collector cup after each use, the build-up of debris that can damage the dental pump is prevented, ensuring a safer workplace. Initial Medical is here to help both your practice and the planet.

As the fight to preserve the natural world becomes more and more important, incorporating sustainable solutions into the dental practice can better manage harmful waste. Controlling amalgam waste and the mercury in it promotes a safer, greener work environment for staff and patients alike.

To find out more, get in touch at 0808 304 7411 or visit the website today www.initial.co.uk/medical

About Initial Medical:
Initial Medical set the standard in healthcare and infectious waste management in the UK, providing a reliable, effective and fully compliant service built around customer needs and delivered by our highly trained local teams.  We are ISO 9001:2015 accredited, with technology fully integrated into our operations, providing full traceability of service delivery, electronic waste documentation and the best customer experience possible. We also offer innovative healthcare waste management services and infection control products, to help break the chain of transmission and prevent cross contamination.  
Initial Medical are a company with a ‘World Class’ Health and Safety record, and ISO 45001:2018 accreditation. We are also accredited to ISO 14001:2015 environmental standards, and pride ourselves on our sustainable approach with a focus on delivering eco-friendly products and operational solutions.

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[1] www.dental-nursing.co.uk. (n.d.). Disposal of waste in the dental practice setting – DentalNursing. [online] Available at: https://www.dental-nursing.co.uk/features/disposal-of-waste-in-the-dental-practice-setting.

[2] Rastogi, V. (2014). Green Dentistry, A Metamorphosis Towards an Eco-Friendly Dentistry: A Short Communication. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. doi:https://doi.org/10.7860/jcdr/2014/8084.4556.

[3] Wilmott, S. and Duane, B. (2023). An update on waste disposal in dentistry. British Dental Journal, [online] 235(6), pp.370–372. doi:https://doi.org/10.1038/s41415-023-6359-7.

[4] Bailey, O., Vernazza, C.R., Stone, S., Ternent, L., Roche, A.-G. . and Lynch, C. (2020). Amalgam Phase-Down Part 1: UK-Based Posterior Restorative Material and Technique Use. JDR clinical and translational research, [online] p.2380084420978653. doi:https://doi.org/10.1177/2380084420978653.

[5] Oluwatosin Makanjuola, J., Idah Ekowmenhenhen, U., Lami Enone, L., Chioma Umesi, D., Mojirayo Ogundana, O. and Toyin Arotiba, G. (2021). Mercury hygiene and biomedical waste management practices among dental health-care personnel in public hospitals in Lagos State, Nigeria. African Health Sciences, 21(1), pp.457–69. doi:https://doi.org/10.4314/ahs.v21i1.56.

[6] Myszograj, Martyna. (2023). Dental Waste – Management and Statistics. Civil and Environmental Engineering Reports. 33. 55-63. 10.59440/ceer/172514. Accessed via: https://www.researchgate.net/publication/374249482_Dental_Waste_-_Management_and_Statistics

[7] Legislation.gov.uk. (2012). The Controlled Waste (England and Wales) Regulations 2012. [online] Available at: https://www.legislation.gov.uk/uksi/2012/811/schedule/1/made.

[8] legislation.gov.uk (1990). Environmental Protection Act 1990. [online] Legislation.gov.uk. Available at: https://www.legislation.gov.uk/ukpga/1990/43/contents.

[9] Legislation.gov.uk. (2017). Regulation (EU) 2017/852 of the European Parliament and of the Council of 17 May 2017 on mercury, and repealing Regulation (EC) No 1102/2008 (Text with EEA relevance). [online] Available at: https://www.legislation.gov.uk/eur/2017/852/article/10.

[10] Centre for Sustainable Healthcare. (2018). Sustainable Dentistry How-to Guide: Equipment and Supplies. [online] Available at: https://sustainablehealthcare.org.uk/dental-guide/equipment.


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