Extracted teeth that are being discarded are subject to the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. OSHA considers extracted teeth to be potentially infectious material. Dental healthcare personnel that should dispose of extracted teeth in regulated medical waste containers unless returned to the patient. Do not place extracted teeth containing amalgam in a medical waste container that uses an incinerator for final disposal (e.g., regular garbage, sharps containers, biohazard or red bags). Consult state and local regulations regarding disposal of amalgam. Many metal recycling companies will accept extracted teeth with amalgam. Contact a recycler to ask about its policies and handling instructions. The American Dental Association has digitally published Best Practices for Management of Amalgam Waste that provides additional guidance on the disposal of scrap amalgam.
Yes, you may return extracted teeth to patients upon request. Once an extracted tooth is returned to a patient, it is no longer considered a potential risk to dental health care personnel and is no longer subject to the provisions of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard.
Extracted teeth used for preclinical educational training should be:
- Cleaned so there is no visible blood or debris.
- Kept moist in a simple solution such as water or saline, placed in a container with a secure lid to prevent leaking during transport or storage, and labeled with the biohazard symbol until sterilization.
- Heat-sterilized to allow for safe handling.
Teeth that do not contain amalgam are preferred for educational use because they can be safely autoclaved. Extracted teeth containing amalgam should not be heat-sterilized because of the potential health hazard associated with possible mercury vaporization and exposure. Immersion of extracted teeth with amalgam in 10% formalin solution for 2 weeks has been an effective method of disinfecting both the internal and external structures of the teeth. Formalin is a saturated solution of formaldehyde, a human carcinogen. When using formalin, dental health care personnel should review the manufacturer safety data sheet for occupational health concerns and to ensure compliance with the Occupational Safety and Health Administration (OSHA) Hazard Communication Standard. Review OSHA’s fact sheet on Formaldehyde and consult with an occupational health professional to determine the appropriate measures to take when workers may be exposed to formaldehyde.
American Dental Association. Best Management Practices for Amalgam Waste. Available at: https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/amalgam-separators Accessed February 22, 2023.
CDC. Guidelines for infection control in dental health-care settings – 2003. MMWR 2003; 52(No. RR-17):1–66. Available at: www.cdc.gov/mmwr/PDF/rr/rr5217.pdf [PDF-1.2M]. Accessed February 22, 2023.
US Department of Labor, Occupational Safety and Health Administration. 29 CFR Part 1910.1030. Occupational exposure to bloodborne pathogens; needlestick and other sharps injuries; final rule. Federal Register 2001;66:5317–5325. Updated from and including 29 CFR Part 1910.1030. Occupational exposure to bloodborne pathogens; final rule. Federal Register 1991;56:64003–64182. Available at: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051. February 22, 2023.
US Department of Labor, Occupational Safety and Health Administration. 29 CFR 1910.1200. Hazard communication. Federal Register 1994;59:17479. Available at https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1200. Accessed February 22, 2023.
US Department of Labor, Occupational Safety and Health Administration. OSHA Fact Sheet: Formaldehyde, Available at: https://www.osha.gov/sites/default/files/publications/formaldehyde-factsheet.pdf. Accessed February 22, 2023.
US Department of Labor, Occupational Safety and Health Administration. Hazard Communication. Safety Data Sheets. Available at: https://www.osha.gov/hazcom#HazcomHome_url. Accessed February 22, 2023.