IDA Advice on Dental Amalgam

IDA Advice on Dental Amalgam

(02 Mar 2016)

Dental amalgam has been used on patients for over 150 years. All available world-wide research indicates that amalgam is not harmful to health. This view is endorsed by the International Dental Federation, the International Association for Dental Research, the US Department of Health and Human Services, and many dental associations, including the American, British and Canadian associations. 

No Government or reputable scientific, medical or dental body anywhere in the world accepts, on any published evidence, that dental amalgam is a hazard to health.   Ireland is a signatory to the UN Minamata Convention which commits to reducing rather than abolishing the use of dental amalgam.

Dental research is ongoing in a wide variety of areas, including filling materials, in the search to provide the most up to date and safest treatments to the public at large.

In 2015 the Dental Council, the regulatory body for dentistry charged with protecting the interests of patients, also introduced new standards following which the Association’s Quality and Patient Safety Committee developed new guidance and recommended that all practitioners fit amalgam separators to their suction units.

We also have a large section on our website on Amalgam Separation, under Best Practice, which can be accessed by IDA members. This section outlines the relevant legislative guidelines and EU Directives, and offers practical guidance for dentists as well as information on the different types of amalgam separators available, as follows:

Irish Dental Association – Standards in Practice

  1. Used amalgam capsules should be stored in a labelled container supplied by a registered waste company and used according to manufacturers’ instructions.
  2. Amalgam waste from suction units should be stored in an approved container.  These containers have a sponge in them which is impregnated with a mercury vapour suppressant.
  3. Always ensure that all containers containing amalgam waste are properly sealed and stored in a safe place away from a heat source and not accessible to the public.
  4. Extracted teeth should NOT be disposed of in a sharps box, but in special dedicated containers available from waste management companies.
  5. All dental practices should have a waste management plan and ensure appropriate staff training.
  6. As the generator of this waste the practice principal is required to keep records of its disposal.  C1 forms must be kept for three years.  These forms are required by law when hazardous waste is being transported from one location to another in Ireland.
  7. It is the waste generator’s responsibility to ensure that the company contracted to remove the waste is a registered waste collection company and has a waste collection permit from the appropriate local authority.  The company must also have access to a licensed disposal site approved by the EPA (Environmental Protection Agency).  The company must also have dedicated vehicles for transport of hazardous waste with Hazchem-trained staff and insurance appropriate for employee and public protection.

Conclusions and Recommendations

There is a legal requirement in Ireland to separate amalgam using an amalgam separator (PARCOM recommendation 93/2).  In addition, it is illegal to dispose of amalgam waste down the drain (EU Waste Directive 2008/98/EC). 

Amalgam separators are a legal requirement in 18 European countries out of 28 that took part in a CED survey (Feeney 2012). 

There are a number of other reasons that we should separate amalgam waste from waste water:

  1. It is best practice to separate toxic waste properly. Disposal of waste amalgam without separation through the public water system does contravene the EU Waste Directive.  Mercury in the environment is a serious pollutant and dentistry is one of the main sources of environmental mercury.
  2. As a profession we value amalgam as a filling material and it is important that the dental profession can show that Best Management Practice is employed in dealing with amalgam waste.