Extracted teeth are not classified as pathological waste in the State of Washington, but because of the contamination with blood and saliva they should be handled as biohazardous material in the dental school.

Extracted teeth should NOT ordinarily be returned to patients and, unless they are to be used for research or educational purposes, the teeth are infectious waste and should be treated prior to disposal. If the patient insists on obtaining his/her extracted tooth, it may only be returned to that patient following a 10-minute soak in a 1:10 solution of sodium hypochlorite (i.e., chlorine bleach). Handle extracted teeth only with forceps or gloved hands.

Teeth to be used for research or educational purposes should be placed in a leak-proof container of 1:10 sodium hypochlorite. The container should be no more than one-third filled with teeth, and all teeth must be completely submerged for at least two weeks before handling. Care should be taken to avoid contamination of the outside of the container. Gloves always must be worn when handling the container. Eyeglasses and gloves must be used to prevent exposure to the sodium hypochlorite when adding sodium hypochlorite to, or when retrieving the teeth from, the container. Teeth should be thoroughly rinsed with water to remove as much residue as possible. (Note: If these procedures render the teeth inadequate for the intended research, contact the Hazard Control Advisory Committee concerning the potential development of alternative methods of sterilization or disinfection.)

Teeth with amalgam restorations must not be heat sterilized to avoid the possibility of mercury vapor release.

Disposable Items Management

Items manufactured for "single use" are not to be reused. Such items include needles, plastic suction tips, prophylaxis points, cups and brushes, examination or surgical gloves, masks, operatory surface covers, and disposable clinic attire. Used disposable items must not be removed from the clinic, and should be discarded in available containers immediately after use.

Chemical Spill Management

The range and quantity of hazardous substances used in the facilitites require preplanning to respond safely to chemical spills. The cleanup of a chemical spill should only be done by knowledgeable and experienced personnel. Spill kits with instructions, absorbents, reactants, and protective equipment should be available to clean up minor spills. A minor chemical spill is one that facility staff are capable of handling with the assistance of safety and emergency personnel. All other chemical spill are considered to be in the major category.

Minor Chemical Spill Protocol

Alert all people in the immediate area of the spill.
Wear protective equipment, including safety goggles, and long-sleeved gown.
Avoid breathing vapors from the spill.
Confine spill to smallest area possible.
Use appropriate kit to neutralize and absorb inorganic acids and bases. Collect residue and place it in a container
and dispose of it as chemical waste.
Clean spill area with water.

Major Chemical Spill Protocol

Attend to any injured, or contaminated persons and remove them from further exposure to the spill.
Alert people in the work area to evacuate.
If spilled material is flammable, turn off ignition and heat sources.
Close doors to affected area.
Have any persons knowledgeable of spill incident and the facility assist emergency personnel.

Mercury

Mercury is considered a hazardous chemical and needs to be disposed of by the Safety Assistant through the Chemical Waste Section of EH&S. A chemical collection request form, as shown in Figure 4-1, must be submitted to EH&S to arrange for a pick-up of chemical waste items.

Small Mercury Spills

In the event of a small mercury spill (under 5 ml of mercury) the following protocol should be followed:
Mark or cordon off the area of the spill to prevent the inadvertent spread of the spilled mercury.
Wear gloves and goggles during clean-up procedures.

Moisten a mercury-absorbent sponge with water and wipe down the area of the spill. Some of the mercury will be absorbed into the sponge and some will be amalgamated on the sponge surface. Rubbing mercury absorbent powder into the surface of the sponge will increase its absorbent capacity. These materials can be obtained from the dispensary.

Repeat as necessary until the entire area has been decontaminated.

Place any broken glass, or other mercury-contaminated material such as gloves in a screw capped plastic container. Contaminated sponges can be placed in a "Ziplock" plastic bag and labeled "Hazardous Waste" and stored under a fume hood, or in a well-ventilated area until it is picked up by the Safety Assistant.

The Safety Assistant will submit a hazardous waste collection request form to EH&S to order the pick up.

Large Mercury Spills In the event of a large mercury spill (over 5 ml of mercury) the following protocol should be followed:
Mark or cordon off the area of the spill to prevent the inadvertent spread of the spilled mercury.

The clean-up should be performed by specially trained personnel. For the dental school clinics, either the Safety Assistant, or the Dental Equipment Repair Technician should be contacted to manage the spill using a mercury vacuum. If both of these persons are unavailable, call EH&S at 543-0467 for clean-up advice or follow up, if needed.

Following the clean-up, the contaminated materials are to be disposed of as described above.

EH&S is to be notified of large spills so that they can perform a post clean-up evaluation prior to the release of the contaminated area into service.

Amalgam Scrap

Amalgam scrap is to be stored in the sealable jars located in each cubicle where amalgam services are provided. The scrap is to be covered by a 1:10 solution of sodium hypochlorite in the jar.

Extracted teeth with amalgam are to be handled in the same manner by storing them in a closed container of 1:10 solution of sodium hypochlorite.

Full containers are to be sent to the Safety Assistant for storage in a larger container with a biohazards label until the waste is collected by the Chemical Waste Section of EH&S for proper disposal. A request form needs to be completed for chemical waste collection.

Amalgam Capsules
Used amalgam capsules are not to be disposed of with normal waste.

Place the capsules in the sealable receptacle provided and close the lid tightly. Clinic staff will empty the jars weekly and consolidate the waste into a larger sealed container to be disposed with amalgam scrap by the Chemical Waste Section of EH&S. Notify the Safety Assistant if the container gets full between scheduled pick-ups.

Lead Foil from Dental X-ray Film Packets

Lead foil from dental film packets are to be deposited in containers labeled "Recyclable Lead Foil Only" which are located at each film processing station. No other waste is to be placed in these containers.

Biohazard containers are to be placed at each film processing station to collect the plastic or paper film wrapping material.

Students, faculty, and staff are to be trained in the proper management of dental film packet disposal.

The Safety Assistant will collect the full containers and consolidate the waste into a sturdy, clear plastic bag for pick up by the Radiation Safety Section of the Department of EH&S.

X-ray Film Developing Solutions

X-ray fixer contains silver salts and is considered a hazardous chemical which must not be poured into the sewer system. It is to be collected by the Dental Equipment Repair Technicians and delivered to the Chemical Waste Section of EH&S for proper disposal.

X-ray fixer which has been processed through a silver scavenging system can be disposed of in the sewer system along with the x-ray developer.

X-ray developing solution is considered a hazardous chemical which must not be poured into the sewer system. It is to be collected in the same manner as fixer.

Source: http://www.dental.washington.edu/hazards/