Dentistry is Entering the Amalgam-Free Era. Is your DSO or Emerging Group Ready?

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As the deadline for compliance with the new EPA amalgam ruling draws ever closer, group practices must start addressing how to tackle the pending regulation before running afoul of it.

The Backstory
With up to 50% of mercury discharges in our wastewaters traceable back to dental amalgam waste, in 2017 the Environmental Protection Agency (EPA) settled on a two-part response as the most effective measure to prevent its contaminating the environment: amalgam separators and an amalgam recycling program.

This means that in order to comply with the federal body’s new regulation, a majority of dental practices will now have to make sure they have an ISO 11143-certified amalgam separator and have a system to properly dispose of solid amalgam waste by July 2020.

The Regulations
With an overabundance of possible ways to address the law (not all of them equal in measure), practices should consider all of the regulation’s moving parts. The new rule has more than one stipulation, which is where dental practitioners can get lost without proper guidance.

First, the EPA mandates that amalgam separators must achieve at least a 95% removal efficiency. Chair-side traps and vacuum pump filters reportedly only remove anywhere from 40 to 80% of amalgam particles, but amalgam separators are devices that boast a much higher rate of success.

Second, the separated amalgam waste can’t simply be discarded in the trash—it must be sent to a facility that specializes in melting the metals and recycling the mercury contained. If not disposed of properly, amalgam waste runs the risk of being introduced to the waterways and environment, where it can impact the community.

The Confusion
As with all regulation, the devil is in the details. The very definition of “amalgam,” and therefore what needs recycling, can trigger further confusion.

The offending material includes everything from amalgam (scrap), to chair-side trap filters containing amalgam pump filters, to saliva ejectors used in dental procedures involving amalgam, to used amalgam capsules and any extracted teeth with amalgam restorations, as well as any waste items contaminated with it. With all of those complexities at play, a comprehensive approach to compliance is vital.

In response to this new and clear demand for compliance solutions, a slew of programs and separators have cropped up—although not all prove comprehensive enough for the challenges presented. How does a DSO or dental group, encumbered by larger numbers of overall patients and therefore more amalgam generation, handle all the potential pitfalls and challenges?

One of those challenges is locating a proper amalgam waste facility, which consumes time and can leave room for mistakes if the correct facility isn’t chosen, or if the used packages aren’t sent to the correct address or are not on-schedule. In that instance, choosing an amalgam recycling ship-back system removes all those risks. But how does a busy DSO or group practice track that shipment, and verify its disposal?

Moreover, after continuous use, amalgam separators do fill up and lose their effectiveness, and can even lead to health hazards to the staff. How do you keep track of the best time to request a replacement canister, with everything else going on at your DSO or group practice?

The Solutions
New software solutions lead the pack of potential answers to those questions, offering combined separation and recycling to address each part of the regulation. In these types of programs, complete compliance can be made simple and swift.

The best software solutions enable emerging groups and DSOs to both simplify and automate compliance tasks, not just set by the EPA, but OSHA and other organizations. When supported by problem-solving experts, real-time visibility for actionable and efficient compliance management permits these programs to assess individual needs, assuring a cost-effective, compliant medical waste management solution for every practice, no matter how big.

One example that combines all the above solutions is PureWay’s compliance management software. Their “all-in-one-place” program allows group practices of all sizes to not only track shipments of used separators and recycled amalgam waste and automatically store all orders, but also auto-reorder and print e-certificates upon recycling completion.

Their compliance status dashboards also allows your DSO or group to set up e-mail notifications of all kinds (be it for shipment, tracking number, returns, or recycle certificate), while also offering multi-site monitoring and reporting. Solutions such as these remove the risk of oversight and allow dentists to focus on dentistry, not convoluted compliance concerns.

By its own nature, amalgam is a complicated subject. But while compliance complexities can be daunting, options to streamline and simplify the process exist. With the help of automated compliance tasks, multi-site reporting, non-compliance notifications and more, compliance software solutions empower group practice dentists to attain total compliance and total peace of mind all at once, as dentistry enters an increasingly amalgam-free era.

To learn more about PureWay’s compliance management software or to schedule a demo, contact Jeffery Miglicco at For larger implementations, and for a limited time only, PureWay is offering up to 100 hours of free software customization services.

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