Types of Hazardous Waste at the Dental Office

Despite the complexity of waste management, dental offices must evaluate the types of wastes generated and dispose of such waste properly.  Dental practices should first determine if the waste is a hazardous waste regulated by Resource Conservation and Recovery Act’s (RCRA) or just simply general waste. Here are the different types of hazardous waste at the dental office.


According to the EPA, dental offices are the single largest source of mercury at sewage treatment plants. Dentists should employ the use of amalgam separators, which takes the excess dental amalgam waste and prevents it from entering water systems.

It is imperative for dental practices to ensure the safety of their patients, staff, and community by properly disposing of amalgam waste in accordance with all state and federal laws.

Fast amalgam disposal facts:

  • Amalgam cannot be disposed of in the regular trash. It has the potential to contaminate ground water and air.
  • Amalgam should not be incinerated. The mercury can be released into the air.
  • Amalgam should not be treated as medical waste. It is a hazardous waste.
  • Amalgam cannot be autoclaved. The volatilized mercury will escape from the autoclave, presenting an immediate health hazard to dental office staff.

X-ray Fixer

While many dental offices use digital x-rays, some still rely on analog x-rays and are therefore subject to the proper disposal of all x-ray related wastes. For example, x-ray fixer, or x-ray fixer solution neutralizes any developer remaining on the film, removes undeveloped silver halides, and hardens the emulsion. What makes it dangerous is its chemical makeup: it contains high concentrations of silver, typically 3,000 to 8,000 mg/l of silver. Because of this silver content, used x-ray fixer must be managed as a hazardous waste. Used fixer cannot be poured down the drain or disposed of as regular solid waste.

Hazardous waste generators must follow strict protocol before disposing of x-ray fixer waste, which includes tracking the volume of hazardous materials produced in a month, using proper forms and reports for disposing of x-ray fixer, and handling toxic waste and determining if it can be recycled, treated, or disposed of. In this case, x-ray fixer may not be “land disposed.”  It is the responsibility of the generator — in this case, dental offices — to ensure that dental fixer is disposed of in a compliant and safe way.

X-ray Developer

Like x-ray fixer, x-ray developer is highly toxic. To develop the x-rays, a series of solvents are used, which amplify and stabilize the x-ray films.  The solvents, while necessary, are actually quite hazardous, and contain chemicals such as gluteraldehyde, hydroquinone, potassium hydroxide, potassium sulphite, sodium, formaldehyde, thiosulphate, acetic acid, aluminum sulphate, ammonium thiosulphate, among others.

Hydroquinone, in particular, is a highly toxic substance. It is a skin irritant, and when exposed improperly, persons can develop symptoms such as dizziness, headache, nausea, vomiting, lack of oxygen in the blood, and any dust that gets in the eyes can lead to impaired vision, among other injuries. Only UNUSED developer is toxic; once it has been used, it is safe to dispose of in the sink or toilet.

Extracted Teeth

According to the CDC, extracted teeth that will be discarded are “…subject to the containerization and labeling provisions of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard.” This means that extracted teeth are considered “potentially hazardous” and must be treated as such.  This differs, however, at the state level. In North Dakota, extracted teeth are considered regulated medical waste, whereas in Pennsylvania, the regulated medical waste designation doesn’t apply.

Sharps Waste

Dentists rely on needles to administer anesthetics and other injectable medications. This results in sharps waste. Sharps waste is classified as biohazardous waste and must be carefully handled, and disposed of through the use of sharps containers. Sharps containers are specially made containers used to contain hazardous piercing instruments to reduce the risk of injury and spread of infection. In a dental setting, a sharps container should be placed in each operatory, with additional containers placed in labs, or wherever contaminated sharps waste is generated.

Dental Waste – A Hazard Or Not?

Before disposing of any waste, dental practices should determine:

  • Whether the waste is a “solid waste,”
  • If the waste is specifically excluded from the RCRA regulations,
  • Is the waste is a “listed” hazardous waste and,
  • If the waste exhibits a characteristic of hazardous waste.

Need assistance with your dental hazardous waste? Contact Red Bags today.

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