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How Do I Dispose of Bloody Gauze and Extracted Teeth?

Written by web on . Posted in Modern Practice Solutions.

by Brenda Thornburg

When evaluating disposal items such as bloody gauze, cotton rolls, patient bibs and other disposable items, determine whether the item is saturated enough to release blood or other potentially infectious material (OPIM) if compressed.  If so, dispose of this waste as regulated biohazardous waste in the red bag or Isolyser. 

According to OSHA, extracted teeth are subject to their regulations and must be treated as regulated medical waste. It gets tricky here because extracted teeth with amalgam require special handling and disposal requirements. Amalgam is defined as multiple metals that have been bonded together by mercury, which is toxic to the environment especially when incinerated.

However, according to CDC, if the extracted teeth are requested by the patient especially the pediatric patient awaiting the tooth fairy, it is no longer treated as a risk to the clinical dental team and no longer subject to OSHA’s standard. 

If the patient does not request the tooth, the tooth is disposed of in a regulated medical waste container unless the tooth has amalgam.  In this case, consult your waste hauler if they have a special container for this purpose or consult a recycler.  Such waste cannot be incinerated. Mercury can be released into the air during the incinerator process and then end up in our soil and water supply.  EPA fines are certainly not pleasant or cheap.

In line with this thought, the EPA requires all dental offices who generate amalgam waste to have an amalgam separator to contain this metal. This type of waste includes scrap amalgam, vacuum pump filters with amalgam, saliva ejectors, extracted teeth which used amalgam in restoration and other items that contain amalgam. It must be separated from regular waste and go to a licensed facility where the metal is melted and recycled. Improper disposal could allow amalgam to get into the water sources and environment, leaving a negative impact on the environment. 1.

Sharps must be disposed of carefully to avoid an exposure incident and injury. A sharp in a dental office may take many forms. It can be a needle, scalpels, disposable blades, orthodontic wire or even glass and some plastics. Sharps are known as bio-hazardous waste and must be collected in authorized sharps containers that are rigid (puncture proof) and have a locking lid (tamper proof). Most containers already have the biohazard symbol in place.

State and federal regulations lay out safe and proper disposal of dental waste. OSHA and the Environmental Protection Agency (EPA) provide guidelines on the safe handling and disposal of medical waste. Here are best practices for dental waste disposal:

  • Segregation — Proper separation and segregation of dental waste is crucial to ensure that different types of waste are handled properly.
  • Packaging — Waste should be securely packaged in leak-proof and puncture-resistant containers that are clearly labelled with the type of waste and any associated hazards.
  • Storage — Dental waste should be stored in designated areas away from patient treatment, waiting areas and unauthorized individuals. Storage areas should be secure and equipped with appropriate spill containment measures.
  • Transport — You must use licensed waste carriers who are certified to handle this kind of waste. Dental waste should also be accompanied by any relevant paperwork.
  • Disposal — Dental practices can work with a licensed waste management company to ensure the safe and compliant disposal of dental waste, meeting regulatory requirements and minimizing environmental impact. 2.

Dental practices are required to provide training on how to dispose of waste properly, what types of PPE to wear during handling, use of the correct receptacles and recordkeeping. 

References

  1. https://allfloridamedicalwaste.com/dental-waste-disposal/contain the sharps.
  2. https://www.stericycle.ie/en-ie/resource-centre/blog/a-guide-to-dental-waste-disposal
  3. American Dental Association – https://www.ada.org/resources/practice/legal-and-regulatory/07_medical-waste-disposal
  4. https://www.cdc.gov/dental-infection-control/hcp/dental-ipc-faqs/extracted-teeth.html#:~:text=Because%20of%20the%20risk%20of,returned%20to%20patients%20upon%20request.