Final rule closely follows ADA best management practices

December 15, 2016 Washington — The U.S. Environmental Protection Agency released a final rule Dec. 15 requiring dental practices nationwide to install amalgam separators.

"EPA has concluded that requiring dental offices to remove mercury through relatively low-cost and readily available amalgam separators and BMPs makes sense," said the EPA in its executive summary of the final rule.

The rule closely follows ADA's own best management practices and incorporates three of those BMPs: one, requiring use of separators; two, prohibiting providers from flushing down a drain waste amalgam (such as from traps or filters); and, three, prohibiting the use of bleach or chlorine-containing cleaners that may lead to the dissolution of solid mercury when cleaning chair-side traps and vacuum lines.

The ADA, which has worked with the EPA on the rule for several years, commended the EPA for its response to ADA input. The new rule meets the nine principles established by the ADA House of Delegates as a condition for ADA support for a national rule.  

"The ADA believes the Environmental Protection Agency's new federal regulation represents a fair and reasonable approach to the management of dental amalgam waste," said Dr. Gary L. Roberts, ADA president, in a statement. "We believe this new rule — which is a federal standard — is preferable to a patchwork of rules and regulations across various states and localities." 

The rule is effective 30 days after publication in the Federal Register. The date for compliance for most dentists will be three years from now, at the end of 2019. 

Additional highlights of the rule include:

• Dentists who practice in oral pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, orthodontics, periodontics, and prosthodontics are exempt from the rule;
• Dentists who do not place amalgam and only remove amalgam in unplanned or emergency situations (estimated at less than 5 percent of removals) are also exempt;
• Mobile dental units are exempt;
• Dentists who already have separators are grandfathered for 10 years.

Although less than one percent of mercury released to the environment from man-made sources comes from dentistry, the ADA has encouraged dental offices to follow its Best Management Practices for Amalgam Waste to help reduce discharges of used amalgam into dental office wastewater. In 2007, the Association amended its BMPs to include the use of amalgam separators that comply with ISO Standard 11143, part of the International Organization for Standardization, a worldwide federation of national standards bodies.

The ADA will develop practical resources to aid member dentists with questions they may have regarding compliance. In addition, ADA's Business Resources has partnered with HealthFirst, a vendor that offers ADA member dentists special pricing on an amalgam separator device that will meet the federal regulatory requirements along with recycling services.

For more information, visit ADA.org/RecycleAmalgam.