Waste Management

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WASTE MANAGEMENT
IN
DENTISTRY
Dr. Rajeev Kashyap
B.Sc,B.D.S.,
M.Sc(DPH)UK

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WASTE MANAGEMENT DEFINITION
Waste Management is collection,
transport,processing,recycling of disposal of waste
material.This term usually relates to materials
produced by human activity and is generally
undertaken to reduce effect on health, the environment
and aesthetics.
Practice of waste management may differ in
developing nation to under developing nation, urban to
rural area and residential to industrial setup.

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CATEGORIES OF WASTE
Discarded sharps
Laboratory and associated waste
Human tissue including solutions containing blood
Cytotoxic waste
Pharmaceutical waste
Chemical waste
Radiation waste
General waste

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Containers and identification
Clinical waste
Clinical waste must be placed in yellow bags and containers
identified with the Biohazard symbol and the words “CLINICAL
WASTE” marked prominently and permanently in black.
Cytotoxic waste
Cytotoxic wastes require careful handling and containment. All
cytotoxic waste must be placed into purple bags and containers
that are identified with the cell in telophase symbol and the
wording “CYTOTOXIC WASTE” in white.
Radioactive waste
Radioactive waste must be placed into red bags and containers
that are marked with the
radiation warning symbol and the words “RADIOACTIVE
WASTE” in black. The Radiation

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Waste Management in Dental Office
Regulated by Different Governing Bodies
Federal
Provincial
Local
for infection control, hazardous materials
handling, safety and waste disposal issues.

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Understanding Waste Management
in Dental Clinic
Clinical Personal must be trained to handle
waste.
Trainings provided by Different organizations
under guidelines of OSHA, CDC, ADA and
Environment Protection agencies

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Occupational Health and safety
Administration
Regulations concerning
Blood borne pathogens
Hazardous materials
Safe use of chemicals

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Environmental Protection Agency.
Regulates
Workplace exposure level of chemicals.
Heat
Radiation
Discharge of waste materials
Requirements concerning sterilization,
disinfections and waste management

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Center For Disease Control
In Dental Practice provides
Program for waste management need to be
developed
Personals dealing with waste in practice are
appropriately trained

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American Dental Association
Indicate that staff are knowledgeable about the
rules about waste management

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Types of Waste
Regulated Medical Waste ( Hospital waste and
Infectious medical waste – this require special
care and is nearly 3% of the total waste )
Non regulated medical waste

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Types of regulated waste
Contaminated Waste:
items came in contact
with blood or blood
products
Hazardous waste:posing
a risk to human being or
environment
Infectious waste:capable
of causing an infectious
disease

Medical waste:any solid
waste that is generated
in the diagnosis
treatment or
immunization
Regulated waste :needs
special handling and
disposal
Toxic waste:having a
poisonous effect

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INFECTIOUS WASTE
Bulk blood or blood products
Pathology waste
Sharps
Saliva(CDC consider it to be infectious
because it is often tainted with blood during
treatment.)

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BLOOD
Blood mixed with saliva and other fluids
evacuated in the dental office as waste water
system.
Rinse sink traps and evacuation lines daily with
disinfected solution
Carefully pour blood, suction fluids into the
drain connected to the sewer system(meeting
local regulatory guidelines)in an acceptable
method

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PATHOGENIC WASTE
Teeth and other tissues
Potentially infectious there disposal should be
in a color labeled container (many areas allow
in house neutralization of such items)
Disposal of treated tooth and other tissue are
as to the local guidelines
Pathologic waste is hidden from public and its
disposal is in a secured and receptable.

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ANATOMICAL WASTE (HUMAN TISSUE)
Human tissue waste generation is normally limited to oral
surgeons and periodontists for example in the course of
harvesting of human tissue for treatment.
Collect human tissue in red liners that are marked with a universal
biohazard symbol.
Store anatomical waste in an enclosed storage area that is locked
and separated from other supply areas. Anatomical waste should
be stored at a temperature at or below 4 degrees centigrade. The
storage area must be marked as Biomedical Waste Storage Area
and must display the universal symbol.
Once accumulated contact an approved biomedical waste carrier
for disposal.

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Dental Amalgam
Amalgam restored teeth can be disinfected before
disposal with sterilizing chemical for 30 minutes and
should rinse treated teeth well. Teeth with amalgam
restoration must not be heat sterilized to avoid the
possibility of mercury vapor release during the
sterilization procedure.
Extracted teeth should not ordinarily be returned to
patients, however, the new CDC guideline allows
extracted teeth to be returned to the patient. It should
be soaked first in sodium hypochlorite for 10 minutes
before returning to the patient.

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ADA Best Management Practices for Amalgam Waste
DO
Do use precapsulated alloys and stock a variety of
capsule sizes
Do recycle used disposable amalgam capsules
Do salvage, store and recycle non-contact amalgam
(scrap amalgam)
Do salvage (contact) amalgam pieces from restorations
after removal and recycle the amalgam waste
Do use chair-side traps, vacuum pump filters and
amalgam separators to retain amalgam and recycle
their contents.
Do recycle teeth that contain amalgam restorations.
Do manage amalgam waste through recycling as
much as possible
(Note: Ask your recycler whether or not extracted
teeth with amalgam restorations require disinfection.)
Don’t use bulk mercury
Don’t put used disposable amalgam capsules in
biohazard containers, infectious waste containers
(red bags) or regular garbage.
Don’t put non-contact amalgam waste in biohazard
containers, infectious waste containers (red bags)
or regular garbage
Don’t put contact amalgam waste in biohazard
containers, infectious waste containers (red bags)
or regular garbage
Don’t rinse devices containing amalgam over
drains or sinks
Don’t dispose of extracted teeth that contain amalgam
restorations in biohazard containers, infectious
waste containers (red bags), sharps containers
or regular garbage
Don’t flush amalgam waste down the drain or toilet

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Never dispose of scrap amalgam in the sharps
container, red biohazard bag or the trash.
5

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SHARPS
Sharps waste is in the form of medical waste in
the form of devices or objects used to puncture
or lacerate the skin.
Sharps waste is designated as biohazard and
is to be carefully handled.

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SHARPS
Contaminated sharps are capable of transmitting the
disease from injection needles, orthodontic bands,burs,
scalpel blades, sutures, instruments and broken glass.
Sterilization of sharp containers
Use labeled and specified container
Spore test the sterilizer.
Label the disposable containers as to local regulations.
Keep containers in upright position.
Process containers for 40- 60 minutes.
Leave containers vent open.

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SHARPS

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SHARPS CONTAINERS

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Handling of Sharps
Needles should not be bend, break, or
manipulated for the avoidance of accidents in
clinic
Protective cap holdings devices capping
sheath by scoop technique
Size of sharp container also influence overall
efficacy of sterilization

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X-RAY FIXER AND DEVELOPER
Separate fixer and developer solutions in the
container provided by the approved waste
carrier and supplier.
Label the container.
Once the container is full contact appropriate
waste carrier for disposal.

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CONTAMINATED LAUNDRY
 Contaminated laundry is to be placed and transported in bags
containers that are color coded or labeled with a biohazard
symbol..
If the contaminated laundry is sent off site for cleaning, it must be
placed in bags or containers that are color coded or labeled with a
biohazard symbol, unless the laundry uses universal precautions
in handling all soiled laundry.

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ENVIORNMENT PROTECTION
Environment Protection
Agency approve the
Haulers
Waste disposed off
illegally Dental Practice
is held responsible

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Reference
“Infection Control & Management of Hazardous
Materials for Dental Team” Chris
H.Miller,Charles John Palenik.
“National Guidelines for waste management in
health care industry” Govt. of Australia Guide
lines.
American Dental Council Guidelines.
Handling Dental Waste

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Any Questions