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Dental Office Chemicals
Tom Barron • Civil EngineerSushma Dhulipala • SF Environment
Dental Industry Overview
Dental Office Injuries
Chemicals Used
Wastes Generated
Waste Management Issues
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Dental Industry Overview
General Dentistry
Pediatrics
Endodontics
Periodontics
Prosthedonics
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Dental Office Sizes
5 - 927%
10 - 199%
1 - 462%
20 - 492%
50 - 990.1%
100 - 2490.02%
Source: US Census - California (Late 1990s)
Number of People
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Dental Office Layout
Front OfficeOperatoriesBack Office
Lab AreasBreak RoomStorageUtility Closet
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Lab / Work Areas
Chemical StorageUltrasonic CleanerSterilizerX-Ray ProcessorMedical WastesAmalgam & Other Chemical Wastes
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Utility Closet
Air CompressorHot WaterVacuum System
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Dental Office Injuries
-100200300400500600700800900
1995 1996 1997 1998 1999 2000 2001 2002
GlovesFixturesChemicalInstruments / Other DevicesOther / MultipleInstruments / Sharps
Source: State of Washington
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Chemical Injuries
Fumes13%
Other25%
Ingested1%
Eyes46%
Skin15%
Source: State of Washington
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Health & Safety Information
Material Safety Data Sheet (MSDS)
Product Labels & Use Instructions
Professional Literature (CDA, ADA, etc.)
Vendor Training Materials
Loss Prevention Specialists
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Chemicals Dentists Use • 1
PhotographyInfection ControlHygiene WorkRestoration WorkLab WorkPharmaceuticalsCleaning & Maint.
HydroquinoneSilverGlutaraldehydePotassium HydroxidePotassium SulfiteSodium ThiosulfateAcetic Acid
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Chemicals Dentists Use • 2
PhotographyInfection ControlHygiene WorkRestoration WorkLab WorkPharmaceuticalsCleaning & Maint.
SanitizersEthyl AlcoholTriclosan
DisinfectantsAlcohols (Ethyl, Isopropyl)Quat. Ammonium ChlorideOxidizers (Bleach, H2O2)Phenylphenol
SterilizersGlutaraldehydeOrthophthaldehyde (OPA)Formaldehyde
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Chemicals Dentists Use • 3
PhotographyInfection ControlHygiene WorkRestoration WorkLab WorkPharmaceuticalsCleaning & Maint.
Amalgam (Hg, Ag, Cu)Glass IonomerResin CompositeGoldPorcelainTooth WhitenerAdhesivesDisinfectantsAntibiotics
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Chemicals Dentists Use • 4
PhotographyInfection ControlHygiene WorkRestoration WorkLab WorkPharmaceuticalsCleaning & Maint.
Typical Cleaners With:DetergentsSurfactantspH AdjustersBuildersDisinfectants
Concerns About :Endocrine ModifiersLow & High pHBleach
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These Chemicals Generate Wastes …
Hazardous WastesPhoto processing wastesChemical sterilantsLine cleaners
Universal WastesAmalgam wastesHg lampsComputers etc.
Medical WastesSharpsBiohazardousPharmaceuticals
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Photo Processing Wastes - 1
Lead Foils & Lead Aprons
Hazardous? Yes! Contain lead
Disposal: Should be recycled
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Photo Processing Wastes - 2
Fixer and Developer must NOT be mixed !!
X‐Ray Developer
Hazardous? May contain hydroquinone & glutaraldehyde
Disposal: Used developer can go down the drain. But unused developer is a hazardous waste.
Less‐toxic tip: Switch to digital
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Photo Processing Wastes - 3
Fixer and Developer must NOT be mixed!!
Used X‐Ray Fixer
Hazardous? Yes! Contains Silver
Disposal: Recycle to reclaim silver
Less‐toxic tip: Switch to digital
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Photo Processing Wastes - 4
X‐Ray Cleaner
Hazardous? May contain Chromium
Disposal: Treat as hazardous waste
Less‐toxic tip: Switch to digital
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Photo Processing Wastes - 5
X‐Ray Film
Hazardous? Yes! Contains Silver
Disposal: Recycle to reclaim silver
Less‐toxic tip: Switch to digital
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Hazardous? Yes! Contains glutaraldehyde
Disposal: Treat on‐site & discharge to sewer
Less‐toxic tip: Autoclave or Dry heat oven
Ultrasonic Cleaners ‐ ??
Cleaning & Sterilization Wastes
Chemiclave ~ Chemical based
Autoclave ~ Steam based
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Disinfectants
Bleach must NOT be used to clean vacuum lines!!
Hazardous?: Contain a variety of toxics (see MSDS)
Disposal: Treat as hazardous waste
Less‐toxic tip: Fully use up product, removing need for disposal.
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Scrap amalgam“Empty” capsulesExtracted teethChairside trapsVacuum screen
____________________Gloves & gauze?Air filters?Instrument cleaning?Carpets?
Amalgam Wastes
Cuspidor
Most amalgam goes here
Vacuum Suction
Vacuum Trap
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Amalgam Separators
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Universal WastesCommonly found hazardous wastes that are generally less toxic and therefore, less regulated. E.g. -
Fluorescent Lamps
Batteries
Aerosol Cans
Mercury Thermometers
Computers
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Medical Wastes
Recycle extracted teeth with amalgam. Do NOTplace in the Biohazard (RED) bin.
Sharps
Biohazardous
Pharmaceutical
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Surviving Inspections
StrategiesSchedule AppointmentConfirm Day BeforeAsk for ChecklistFocus on Key Points
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Acknowledgements
This presentation is the product of a team effort involving a number of organizations and individuals.
Today’s presenters wish to acknowledge the important technical contributions this team made, as well as the persistence with which individual members expressed their views.
California Dental AssociationBay Area Pollution Prevention GroupPalo Alto RWQCPCity of San FranciscoMid-Peninsula Dental SocietySouthern Alameda Co. Dental SocietyUnion Sanitary DistrictBetsy Elzufon, LWAKeith Linn, NEORSDDr. Mark Stone, DDS, US NavyDr. Jim Stevens, DDSDr. Bryan Scott, DDS
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THE END
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Tom BarronCivil Engineer3351 Beechwood DriveLafayette, CA 94549(925) [email protected]
Today’s Presenters
Sushma DhulipalaSan Francisco Environment11 Grove StreetSan Francisco, CA 94102(415) [email protected]
