Proper Disposal of the Plastic Bladders Found Inside Some Amalgam Capsules

Question:What is the proper method for disposing of the plastic mercury “bladders” that are in some amalgam capsules?
mercury-containing pillow

Answer:  This is a very relevant question due to the change in Air Force policy on recycling amalgam waste.
Some manufacturers enclose the mercury within the amalgam capsules using a “pillow pack” to prevent premature mixing of
the mercury and alloy powder before trituration. The pillow pack is a small, clear, plastic envelope that resembles a
bladder (see picture). The kinetic energy generated during trituration ruptures the pillow pack and allows the mercury to
mix with the powder. The used pillow pack appears as a piece of plastic that usually comes out of the capsule with the
mixed amalgam.


In 2003 the American Dental Association (ADA) published Best Management Practices for Amalgam Waste. The ADA has updated
these recommendations in 2004 and 2005. The recommendations included guidelines for recycling disposableclose-up view of
pillow amalgam capsules. The Air Force followed the ADA’s lead and issued a policy letter on amalgam waste recycling
in 2004. The policy letter requires USAF Dental Services to recycle the disposable amalgam capsules. This includes the
plastic pillow. After an amalgam capsule is opened and the triturated amalgam is removed the plastic pillow should be
put back into the used capsule, the capsule recapped, and then stored in a sealed container. An alternative method for
recycling the plastic pillow is to store it with amalgam scrap in a sealed container. The amount of used amalgam capsules
and scrap amalgam stored in the dental treatment room before being placed in a central recycling area in the dental clinic
is determined by local policy. Air Force policy requires that contact amalgam (contacted patient), non-contact amalgam,
disposable traps with amalgam contamination, and extracted teeth with amalgam restorations also be recycled.

References

1. ADA. Best Management Practices For Amalgam Waste
http://www.ada.org/prof/resources/topics/topics_amalgamwaste.pdf

2. USAF Best Management Practices for Amalgam Waste, Policy Letter 2004.

(Col Miniotis)