Author: Caitlin Denison

by Caitlin Denison, BS, RDH

As dental providers, we are experts at looking out for the well-being of our patients. As providers and responsible citizens, we must also ensure that our activities do not negatively impact the environmental health of our communities.

To help prevent mercury from amalgam waste from contaminating the environment, the EPA has established regulations requiring most dental offices to use an amalgam separator¹.  An amalgam separator ensures that amalgam particles suctioned during a procedure stay out of wastewater. Although there are a few exceptions to this rule, most dental practices must comply.

There are several products available to help practices comply with this requirement. One option is an amalgam separator that filters all suction waste from the practice’s operatories, such as the NXT Hg5 by Solmetex. This device simply filters incoming suction waste before it discharges to the wastewater system. Larger offices with multiple operatories that handle amalgam waste may find this solution to be convenient.

Another option is the Dove Capt-all device. This solution goes straight to the source of the amalgam waste and simply fits onto the dental suction. The device separates out any amalgam waste before it enters the suction tubing. Smaller offices that rarely conduct procedures involving amalgam waste may find this device useful, as it can be attached and used as needed.

As with all dental equipment, these devices do require care when maintaining and disposing of them. With a practice-wide amalgam filter like the Solmetex product, the practice must ensure that the filter is checked and changed as needed to ensure optimal filtration. When the filter is changed, it must be disposed of as amalgam waste and cannot be thrown away in general waste. Having a reminder on the office calendar can help ensure this task is completed. Remember, when it comes to compliance, documentation is key, so, be sure to document all filter checks and changes.

The Capt-all device must also be disposed of as amalgam waste. As with the Solmetex filters, disposal should be documented. Both Solmetex and Capt-all can provide appropriate amalgam waste containers that are compatible with their products.

When applicable, amalgam waste documentation should also include records of inspections of the separator, container replacement, disposal of waste via an appropriate vendor or facility, and documentation of any repairs or replacements².

Oftentimes, offices are doing requirement maintenance and disposal tasks but simply aren’t maintaining adequate documentation. Remember, from a regulatory perspective, you don’t get credit for a task unless it’s documented!

In addition to documenting these tasks, most dental offices (including some that are otherwise exempt from the EPA’s rule) must also submit a one-time compliance report to the office’s Control Authority². The EPA page for dental effluent guidelines has resources to help you find your office’s control authority.  

The other major issue we encounter frequently is improper disposal of amalgam fragments or teeth containing amalgam. Remember, these items must be disposed of through an amalgam recycling service. Amalgam should not be placed in regular trash or biohazard waste³.

By prioritizing proper disposal practices, dental practices can provide excellent care and ensure a healthier future for our patients, our communities, and the planet.

1: U.S. Environmental Protection Agency. (2017). Dental office category: Frequent questions [PDF]. U.S. Environmental Protection Agency. Retrieved March 27, 2025, from https://www.epa.gov/sites/default/files/2017-12/documents/dental-office-category_frequent-questions_nov-2017.pdf

2: Environmental Protection Agency. (2017). Effluent limitations guidelines and standards for the dental category. Federal Register, 82(113), 27154–27187. https://www.federalregister.gov/documents/2017/06/14/2017-12338/effluent-limitations-guidelines-and-standards-for-the-dental-category 3: American Dental Association. (n.d.). Best management practices for amalgam waste [PDF]. American Dental Association. Retrieved March 27, 2025, from https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/library/oral-health-topics/topics_amalgamwaste_brochure.pdf

by Caitlin Denison, BS, RDH

Yes, you can leave a voicemail or message with a family member, but there are some important things to keep in mind to protect the patient’s privacy and comply with HIPAA guidelines.

Leaving a Voicemail

The HIPAA Privacy rule does not prohibit leaving a voicemail. However, the Department of Health and Human Services advises caution when it comes to the amount of information shared.

For example, when leaving a message to confirm an appointment, the office would be wise to include only the minimum amount of information necessary to confirm the appointment. A message might say something like:

“This is Happy Smiles Dental, please call us back at (XXX)XXX-XXX to confirm your appointment.”

As opposed to:

“Hi Ms. Johnson, this is Dr. Daniel calling about your oral thrush infection. Please call us back so we can confirm your appointment to treat this.”

Keeping messages simple and general helps protect the patient’s privacy.

Leaving a Message with a Family Member

If a family member answers the phone, you can share information related to the patient’s care, as long as it’s in the patient’s best interest. For example, if a family member is helping with the patient’s care, you can share necessary details. However, always be cautious about the amount of information you disclose.

Honoring the Patient’s Wishes

As always, we must honor our patient’s wishes for communication. If the patient has requested that the office not communicate via phone, voicemail, or message, the office must use an alternative method if possible.

Conclusion

While leaving voicemails or messages with family members is allowed, it’s important to keep the information minimal and avoid sharing sensitive details. Always respect the patient’s wishes for communication and take extra care to protect their privacy.

Source: https://www.hhs.gov/hipaa/for-professionals/faq/198/may-health-care-providers-leave-messages/index.html

By Gracie Hogue & Caitlin Denison

During our visits to various practices, we often encountered chaotic Safety Data Sheet (SDS) binders—what we call “Frankenbinders.” These are incomplete, cluttered with unrelated materials, and far from OSHA-ready. Here’s how to streamline your SDS binder efficiently:

by Caitlin Denison, BS, RDH

Most dental professionals are aware of the risk of contracting hepatitis B that comes with working in the dental field. Most dental professionals are also aware that the hepatitis B vaccine is a safe and effective way to protect oneself from the virus. Despite this, during training Q & As we often find that employees and employers are not quite sure what their rights and responsibilities are when it comes to the Hep B vaccine. Below are some common questions and answers to help demystify the requirements.  

Q: I am an employer, am I required to have my employees vaccinated for hepatitis B?

A: The OSHA bloodborne pathogens standard requires that employers offer all employees who have occupational exposure the hepatitis B vaccine after the employee has received training and within 10 working days of initial assignment. The employer does not need to require that employees be vaccinated, they only need to offer the vaccine free of charge.

Q: As the employer, do I have to pay for my employees’ vaccines?

A: Yes. The employer is required to provide the vaccine to occupationally exposed employees free of charge. Employees must not be made to pay for their own hepatitis B vaccinations.

Q: I am an employee and I do not want to be vaccinated for hepatitis B, what do I do?

A: Employees may decline the vaccine. Employees who decline the vaccination need to sign the declination form which can be found in appendix A of the bloodborne pathogens standard (29 CFR 1910.1030).

Q: What if an employee initially declines the hepatitis B vaccine and later decides they would like to get vaccinated?

A: If that employee is still covered under the OSHA bloodborne pathogens standard, the employer must make the vaccine available free of charge at that time.

Q: Do employers have to provide employees with hepatitis B booster shots?

A: The OSHA bloodborne pathogens standard states that a routine booster dose of the hepatitis B vaccine must be made available at no cost to the employee if it is recommended by the U.S. Public Health Service. Currently, the CDC does not recommend a booster for most people. In most cases, immunity from the hepatitis B vaccine lasts a lifetime. https://www.cdc.gov/hepatitis-b/vaccination/index.html

Q: Can I require my employees to be screened for immunity prior to offering the hepatitis B vaccine?

A: No. The OSHA bloodborne pathogen standard states that employers “shall not make participation in a prescreening program a prerequisite for receiving hepatitis B vaccination”.

Resources:

1. Centers for Disease Control and Prevention. (2024, November 27). Hepatitis B vaccination. U.S. Department of Health & Human Services. Retrieved December 4, 2024, from https://www.cdc.gov/hepatitis-b/vaccination/index.html

• Occupational Safety and Health Administration. (n.d.). 1910.1030 – Bloodborne pathogens. U.S. Department of Labor. Retrieved December 4, 2024, from https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030

by Caitlin Denison, BS, RDH

1. Failure to Provide Appropriate Training

Dental offices often fail to provide adequate training, including bloodborne pathogens and hazard communication training. This training is essential for ensuring staff understand potential risks and safety protocols.

by Caitlin Denison, BS, RDH

Chemical dependency, or substance abuse disorder, may seem like a condition far removed from the dental operatory. In fact, not only are we likely to encounter patients suffering from this disease, but we are also in a unique position to identify substance abuse in patients, help educate them, and provide them with resources.