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 that should be disposed of in medical waste containers. Extracted teeth containing amalgam should not be placed 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.
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. 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) Bloodborne Pathogens Standard.
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 icon[PDF-1.2M]. Accessed March 17, 2016.
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=10051external icon. Accessed March 17, 2016.
US Department of Labor, Occupational Safety and Health Administration. Enforcement procedures for the occupational exposure to bloodborne pathogens. Washington, DC: US Department of Labor, Occupational Safety and Health Administration, 2001; Directive Number. CPL 02–02–069. Available at: www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=2570external icon. Accessed March 17, 2016.