If you own or work in a dental practice you know what a variety of waste materials are routinely generated during the provision of oral healthcare.

Most of these by-products are non-hazardous and can be managed in the same way as household waste.

However, some materials used in dental practices can pose a risk to humans or the environment if not discarded properly.

Clinical waste needs correct handling and special care and there is a strict legislation in place to prevent harm being caused to the environment and to human health by any type of hazardous waste.

It is vital that every dental practice is aware of their responsibilities and adheres to the current legislation.

All waste produced by a dental practice falls in one of these 2 categories:

Hazardous – this includes bagged or ‘infectious’ clinical waste, sharps, dental amalgam, chemicals, x-ray by-products, refrigerators, computer monitors, fluorescent tubes, etc. Even though the use of amalgam for dentistry in the UK has decreased considerably in the last years, small amounts are still being used when, for example, old amalgam fillings are removed (normally, fine amalgam particles are produced by the drill when removing the fillings and these are captured by the amalgam separator units attached to the suction systems).

Non-hazardous – this includes bagged hygiene wastes such as gloves, face-masks, paper towels, detergent wipes and other items from the surgeries that are not contaminated; out-of-date pharmaceuticals (non-cytotoxic and non-cytostatic); partially discharged LA cartridges; gypsum; precious metal waste (from old bridges and crowns); batteries and ‘domestic’ or ‘municipal’ waste (such as food packaging, empty coffee jars, disposable paper towels that haven’t been used in the surgeries, etc.)

The primary responsibility for the proper disposal of these wastes lies with the employees of the practice (i.e. dentists, hygienists and dental nurses). All team members should be properly educated and they must be aware of the different waste types produced so as to ensure correct disposal. For example, it is important that anyone can recognise wastes that have been placed in the wrong container.

Here are the top 3 things every dental practice should be doing with regards to managing their hazardous or clinical waste.

Identify your waste stream

Proper segregation is critical to safe management. The mixing of waste streams is prohibited by law in England and Wales. It also helps support waste minimisation and reduces the risk of exposure and injury to your staff.

All containers used for the disposal of clinical waste must be labelled in accordance with the details of the legal requirements for transporting and packaging. Your container labels should clearly identify what is inside and it should always be signed by the producer before correct disposal.

The Environment Agency issued a memorandum with the best practice guidelines for healthcare waste segregation. The Safe Management of Healthcare Waste Memorandum[i] recommends to use colour coded bins, sacks and receptacles to enable easy identification. These containers should be placed as close to the point of waste creation as possible. The colours used are:

Yellow: Infectious waste for disposal by incineration

Orange: Infectious waste for disposal by treatment or incineration

Yellow/Black (Tiger): Offensive/hygiene waste for disposal by deep landfill

Blue: Medicinal waste for disposal by incineration

Purple: containing cytotoxic or cytostatic waste for disposal by incineration

Red: Anatomical waste for disposal by incineration

White: Amalgam waste for recycling

Safely manage sharps to prevent injuries

The safe handling and disposal of needles and other sharp instruments should form part of an overall strategy of clinical waste disposal to protect staff, patients and visitors from exposure to blood borne pathogens. Dental practice employees generating sharps waste should have access to sharps containers that conform to current standards. It is proven that the likelihood of needlestick injury is greatly reduced by the immediate disposal of sharps into an appropriate container.

The Health and Safety (Sharps Instruments in Healthcare) Regulations[ii] provide practical advice on the safe use and disposal of sharps, on staff training requirements and on the procedures for responding to a sharps injury. Some key tips to make sure you comply with the new regulations are:

Implement safe procedures for using and disposing of sharp medical instruments and contaminated waste;

Eliminate the unnecessary use of sharps by implementing changes and providing medical devices with incorporated safety-engineered protection mechanisms;

Sharps disposal equipment should be kept as close as possible to the assessed areas where sharps are being used or found;

Ban the practice of recapping;

Use personal protective equipment;

Train your practice staff on the correct use of sharps devices and the disposal of sharps waste.

Choose the right hazardous waste disposal service

When choosing the right partner to take care of your hazardous or clinical waste disposal, the first and most important thing to check is that the company is a Registered Waste Carrier. It’s a good idea to ask for a copy of their licences. These are some other important things you should consider:

Check if the disposal service is licenced to take away the types of waste you are producing;

Make sure the technicians and the drivers of the vehicle carrying dangerous goods hold an ADR licence, which is the European Agreement concerning the International Carriage of Dangerous Goods by Road. This is a legal requirement for every vehicle carrying dangerous goods;

Ask what documentation you will receive to cover your transfer and make sure your waste will be fully traceable from leaving your premises through to end disposal;

Check that the containers provided by your supplier meet all legal requirements;

Make sure that your waste will be fully segregated on-site and during transportation to meet the current regulations;

Ask for any hidden charges and make sure your chosen provider can guarantee on time pick up and deliveries.

At All Waste Matters we can offer a complete hazardous waste management service, from collection to disposal. We have over 50 years of experience and you can rest assured that your waste is being handled safely and in-keeping with the latest legislation.

We are a fully licensed hazardous waste disposal company and operate our own collection vehicles and fully licensed recycling facility. This ensures your waste collection is carried out with minimum impact to the environment and has full traceability as to its final disposal.

[i] https://www.gov.uk/government/publications/guidance-on-the-safe-management-of-healthcare-waste

[ii] http://www.hse.gov.uk/pubns/hsis7.htm