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 Olivia Wann, JD

Nothing can frustrate an employee more than asking them to attend a course on a usual day for them to work and not compensating them.

Is it required by law to pay employees for their time to attend a CE event? The short answer is it depends. 

by Brenda Thornburg

Why is it so important to have a Fire Safety Plan? Just look around.

Common materials used in dentistry, such as gauze packs, cotton rolls, latex gloves, mouth masks and paper drapes are all obvious sources of fuel for a fire. Not to mention, isopropyl alcohol, polymethyl methacrylate, lamps, and Bunsen burners, X-ray films. While not flammable themselves, oxygen and nitrous oxide significantly increase the risk of fire when present with other flammable materials.

Storing flammable materials in designated containers and following proper handling procedures are critical to prevent fire hazards. As is having your Hazard Communication Standard in place to educate and protect team members. Having Safety Data Sheets and proper labeling are an essential part of your Fire Safety Plan. They provide important firefighting measures in case a chemical starts a fire. Dental offices use many different chemicals with fire hazards ranging from explosive and flammable to irritative characteristics.

And let’s not forget all the water lines running in proximity with electrical lines in your dental units and equipment. Regular inspection and maintenance of electrical cords, outlets, and dental equipment to prevent overheating or sparking.

We need to be aware of patient safety as it relates to fire during dental care. A 72-year-old patient received second-degree burns on her face caused by a fire that ignited near the nasal hood supplying a nitrous oxide-oxygen mixture. The ignition source was likely caused by the heat generated during the preparation of a titanium post with a high-speed, irrigated carbide bur. The patient was treated at a local hospital and discharged home with second-degree burns.[1]

Your Fire Safety Plan and training are essential to keep your dental office, team, and patients as safe as possible. All the above, as well as the following:

• Regularly evaluate and maintain all fire alarms and smoke detectors throughout the office.
• Proper placement of fire extinguishers, clearly labeled and regularly inspected. Schedule training for all staff on the proper use of fire extinguishers.
• Backup emergency lighting in case of power outage. Clearly mark all exits and evacuation routes throughout the office.
• Determine who will call 911. Maintain an updated list of emergency contact numbers for local fire department, emergency medical services, and police department in the event the 911 system may be down.
• Establish a designated safety point outside the building where everyone will meet when evacuating. Once everyone is safely out of the building, and the fire department has put out the fire…the real work begins. That’s where your Disaster Recovery Plan will kick in. But that is a separate conversation.

https://www.protectorplan.com/wp-content/uploads/ada_disaster_manual.ashx_-2.pdf

https://journals.lww.com/jdrr/fulltext/2015/02020/fire_safety_in_dental_clinics__basics_for_dentists.13.

https://www.ada.org/resources/practice/practice-management/emergency-planning-and-disaster-recovery-planning-in-the-dental-

[1] https://pubmed.ncbi.nlm.nih.gov/27083777/, accessed on July 8, 2025

by Terri Walker

While most patients and dental team members aim to keep patients comfortable during their visit, the paramount concern remains whether the patient will experience illness from their dental treatment.

by Olivia Wann, JD

As you read through this article, how do you feel? Is your neck, back, or shoulder hurting? Musculoskeletal disorders (MSDs) can result in absenteeism, lost productivity, increased health care disability, and worker’s compensation costs. It also causes difficulty filling vacant positions especially during this labor shortage.

By Brenda Thornburg

The Active Shooter Scenario has become all too common in the news and in our lives. It’s hard to think of ourselves as ever being a part of one of these horrendous events, but we are in fact vulnerable. At church, grocery stores, concerts, and yes, even in our workplaces. We’ve all experienced the wrath of a disgruntled patient. How do we know whether a rude, arrogant patient or family member is going to morph into a dangerous situation?

by Terri Walker

The answer lies in the evolution of security.  From ancient Greece, where “watchwords” were used, to the 1944 military challenge-response methods, the importance of safeguarding information has always been paramount. Fast forward to the 1960s, when the first digital password was created at the Massachusetts Institute of Technology (MIT). As technology advanced, we quickly learned that many password choices are inherently vulnerable. Users often opt for passwords they can easily remember, but this also makes them easy to guess.

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 Terri Walker

Are you relying on a “free” email account for your practice? It’s crucial to unveil the hidden costs associated with these seemingly costless services.