R evi e w A r tic le

Dental Biomedical Waste Management

Harender Singh1, 2 Year Post Graduate Student, Department of Public Health Dentistry, Teerthanker Mahaveer
1 nd

Dental College, Moradabad, U.P, India, 2MDS, MPH, Professor & Head, Department of Public
DJ Bhaskar2,
Health Dentistry, Teerthanker Mahaveer Dental College, Moradabad, U.P, India, 32nd Year Post
Deepak R Dalai3, Graduate Student, Department of Public Health Dentistry, Teerthanker Mahaveer Dental College,
Rahila Rehman4, Moradabad, U.P, India, 4M.Phil (Psyschology) & Education & Guidance counsellor, Ghaziabad, U.P,
Mohsin Khan5 India, 52nd Year Post Graduate Student, Department of prosthodontics, Teerthanker Mahaveer Dental
College, Moradabad, U.P, India

Corresponding Author: Dr. Harender Singh, Dept. of Public Health Dentistry, Teerthanker Mahaveer
Dental College, Moradabad, U.P. E-mail: [email protected]

Abstract
This review provides information to dentist and dental staff that, they need to properly manage Dental waste and render
suggestions for managing the wastes from the day-to-day activities in Dental practises, such as: Amalgam waste, mercury,
used cleaners for X-ray developer systems, X-ray fixers and developers; shields and aprons, lead foils; chemical sterilant
solutions; cleaners, disinfectants and other chemicals; and general medical waste. Dental healthcare staff should be aware of
the proper handling and the management of dental waste. A lot of biomedical waste (BMW) is generated in dental practices
that can be harmful to the environment and to those who come in contact with the materials, if not dealt with appropriately.
Most of the rules all over the world are not specific for dental BMW management and impede natural understanding by dental
practitioners, due to lack of clear cut guidelines either from Government of India or Indian Dental Association (IDA) or Dental
Council of India on disposal of dental wastes. To prevent the harmful effects on health and the environment it is required to
follow proper segregation protocol. The simplified system provided a good model to be followed in developing countries like
India and improved understanding among dental practitioners and dental staff, due to its self-explanatory nature.

Keywords: Biomedical waste, Dental, Waste management

INTRODUCTION Categories of Waste Generated in Dental Practises4

• Biomedical waste- Non anatomic waste & Anatomic
Definition of biomedical waste “Any solid, fluid or liquid waste, sharps.
waste, including its container and any intermediate product, • Silver containing waste-used fixer solution and unused
which is generated during the diagnosis, treatment or x-ray films.
immunization of human beings or animals, in research • Lead containing wastes-lead aprons and lead foils inside
pertaining thereto, or in the production or testing of the x-ray films.
biological and the animal waste from slaughter houses • Mercury containing wastes-element mercury, scrap
or any other like establishments (Bio-medical waste rules amalgam.
1998 of India).1 Dental practices produce large amounts • Chemicals, disinfectants and sterilizing agents.
of waste such as plastic, latex, cotton, glass and other
materials, most of them can be contaminated with infected Steps in Waste Management5
body fluids. Dental practices also produce tiny amount 1. Waste survey: Quantification and differentiation of
of other types of waste, such as silver amalgam, mercury waste.
and various chemical solvents. The dentist generate only 2. Waste segregation: Placing different wastes in different
3% of total medical waste estimated by US medical waste containers.
tracking system.2 The quantity of waste generated is equally 3. Waste accumulation and storage: Accumulation
important. A lesser amount of biomedical waste means a temporary holding and storage longer holding.
lower burden on waste disposal work, a more efficacious 4. Waste transportation: Wastes are carried in special
waste disposal system and cost-saving.3 containers in vehicles.

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 Singh, et al.: Dental Biomedical Waste Management

5. Waste treatment: A process that modified the waste to Scrap Amalgam

disinfect or decontaminate the waste so that they are For the management of scrap amalgam,
no longer a source of pathogens and can be handled, • MercontainerTM (Sponge type) are appropriate to
transported and stored safely. store the scrap amalgam. Empty amalgam capsules
6. Waste disposal: Incineration, microwave irradiation, can be disposed in the garbage due to non-hazardous
chemical disinfects, wet and dry thermal treatment, in nature.
inertization and land disposal. • Using an ISO 11143 compliant amalgam separator on
7. Waste minimization: Following reduce, reuse and the suction lines is suitable for removing over 95%
recycle methods. of the contact amalgam before diffusing in the sewer
system.
Waste Disposal by Waste Management Practises Anatomic • Disposable suction traps on your dental units should
and Non-Anatomic Waste
be changed weekly. Always use gloves, mask, and
Non-Anatomic waste: When gauze is soaked in blood and
glasses while cleaning the suction traps. Disposable
blood is dripping, it becomes a hazardous waste. Its can be
trap should be placed into a properly labelled container
completely manage by collect the non-anatomical wastes
of MerconvapTM solution for proper disposal. After
in yellow biomedical waste bag, apply double bag for the
waste, by labeling a biohazard symbol with the bag, keep in filling it, a certified waste carrier should be contacted
refrigerator if onsite for more than four days, Once waste for recycling or disposal of it.
is collected, inform to certified biomedical waste carrier
Properly labelled container with mercury vapour
for disposal and soaked cotton and gauzes should not be
thrown into the regular garbage.1 suppressant such as fixer or MerconvapTM solution are
suitable to submerse the amalgam particles. The container
Anatomic waste: excised tissues, organs, tumors, extracted must be labelled “Hazardous Waste: Scrap Amalgam”.
teeths. Separate the material from other wastes and use a Premeasured capsules mixed only as much amalgam
yellow biomedical waste bag to collect the anatomic waste. as is immediately required. Large pieces of amalgam
Double bag the waste and labeled with a bio-hazard symbol should be removed manually which are produced, when
and fill the bag till ¾ level and tie it tightly and contact a removing old fillings and store them in a contact amalgam
certified waste carrier for disposal.5 container. Appropriate use of amalgam substitutes can
be considered.
Mercury Containing Waste
Dental Amalgam particles are a source of mercury which Amalgam separation
is known to be a neurotoxic, nephrotoxic, and bio- Sedimentation units are one of the basic types of amalgam
accumulative element. It can get into the environment separation technologies which decrease the speed of the
through wastewater, scrap amalgam or vapours. Vaporous flux of water with baffles or tanks to allow amalgam
mercury waste management includes: particles to settle. The water out to the sides of the unit is
(1) Stored unused elemental mercury in a sealed containers, spin by Centrifuge units. These units offer good amalgam
(2) Contact to a certified biomedical waste carrier (CWC) removal but cause some foaming with American vacuum
for disposal and recycling, systems. Ion Exchange units use polymers to capture small
(3) Use a “mercury spill kit” in case of a spill of mercury, particles; these are often used in series with sedimentation
(4) Unused elemental mercury reacts with silver alloy to units. Other wastewater treatment technologies such as
form scrap amalgam, electrolysis and chemical additions have been adapted for
(5) Not placing elemental mercury in the garbage, and dental applications.3
(6) Don’t wash elemental mercury in the drain. Scrap
amalgam waste management implicates Silver Containing Wastes
• Using suction traps and disposable amalgam Spent X-ray fixer used in dental clinics to develop X-rays
separators on dental suction units, to prevent is a hazardous material that should not be easily rinsed
amalgam accumulation the trap should be changed in the drain. The fixer with a recovery unit can be mixed
weekly, with water and developer and disposed down the septic
• Required amalgam amount only mixed or use system or sewer after desilvering. Spent developer is
premeasured amalgam capsules, permitted to be discharged in the above systems after
• Do not though extracted teeth filled with amalgam dilution with water. The silver should be handed over
in the regular garbage, to the CWC. Using a digital X-ray system and without
• Use mercury containers to stored all scrap/old chromium X-ray cleaner are another suggested safety
amalgam.6,7 measures.

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 Singh, et al.: Dental Biomedical Waste Management

Undeveloped X-ray films include a high level of silver CONCLUSION

and must be treated as hazardous waste. It is advisable
to accumulate any unused film that needs disposing in an Bio-Medical Waste management programme cannot
approved container for recycling by the disposal company. successfully be implemented without the devotion, self
New X-ray films purchase can be minimized by using a motivation, willingness, cooperation and participation of
digital x-ray unit.8 all sections of employees of any health care establishment.
Therefore, it becomes the responsibility of this group
Lead-Containing Wastes to segregate and manage the waste in such a way that it
The lead foil inside X-ray packets and lead aprons is no longer hazard for them, public and environment.
contain toxin that can result into defilement of soil and Desired attention is needed regarding the proper disposal
groundwater in landfill areas after disposal. of dental waste to rescue the immediate environmental
foul, and to ensure the safety of those who come into
They should only be handed over to CWC. Excessive doses contact with it. It is time that the dental education give due
of lead intake begin to reproductive, neurotoxicity, toxicity, importance to this vital issue. So the academic institutions
carcinogenicity, hypertension, renal function, immunology, and non-governmental organisations could also play an
toxicokinetics etc.9 active role in disseminating information. Keeping in view,
incorrect management of biomedical wastes, the Ministry
Sharps
of Environment and Forests notified the “Bio Medical
Needles, glass, syringes, ortho wires, sharp instruments, Waste (Management and Handling) Rules 1998.” These
files. rules are meant to protect the society, patients and health
• The sharp wastes should be handled with care. care workers. Develop a system and culture through
• Needles should be mutilated by needle destroyer/ training, education and persistent motivation of the dental
cutter, before disposing off syringes. practitioners and dental staff is most imperative component
• Non-mutilated syringes are kept in blue bags, will result of the waste management plans.
in prick injury, puncture of the bags and spillage of
the waste.
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How to cite this article: Singh H, Bhaskar DJ, Dalai DR, Rehman R, Khan M. Dental Biomedical Waste Management. Int J Sci Stud.
2014;2(4):66-68.

Source of Support: Nil, Conflict of Interest: None declared.

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