EPA Prods Dentists to Fill Mercury Disposal Gap

For decades, the U.S. EPA thought of mercury in amalgam tooth fillings as too puny to fuss with.

Then scientists did the multiplication.

It’s estimated that each of this country’s 140,000 dental practices—110,000 private and 30,000 public—handle a pound or two of mercury per year. That means up to 280,000 pounds are either going into or coming out of teeth annually. And at least 8,800 of those pounds aren’t trapped or diverted in any fashion. They’re merely flushed away.

Granted, that’s just a drop in a chair-side drain when compared to the tons of mercury emitted each year by coal-fired power plants, boilers and heaters, as well as steel factories and incinerators.

Still, the amount is enough to spur the Environmental Protection Agency into introducing a September 2014 rule designed to keep mercury—a heavy metal that is a neurotoxin and a hazardous waste—out of wastewater treatment facilities. It requires dentists to comply with the Clean Water Act by installing equipment known as amalgam separators. The measure, first scheduled to be made final this fall, has been delayed until next summer.

That postponement hasn’t impeded Dr. Bill Phelps, a family dentist in northwest Iowa since 1975. Even though he hasn’t inserted mercury fillings in patients’ teeth since 1988—he prefers composite resin—he has already purchased an amalgam separator to capture mercury from the fillings he extracts.

In addition to mercury, the separators are designed to remove particles of silver, tin, copper, zinc and other filling metals before water from a dentist’s office is discharged to the sewer system.

Iowa is not among the 12 states that have joined numerous localities in passing laws requiring dentists to install separators. But dentists have a responsibility to be patrons of nature whether or not the EPA puts the hammer down, Phelps says.

“We’ve got to stop polluting our water,” says Phelps, whose practice is near a lake resort region. “You’re either lazy or stupid if you don’t care about the environment.”

While hunting for separator technology, Phelps discovered a New York City-based waste management company called Dental Recycling North America (DRNA) through a professional listserv. Though he was approached by his usual dental equipment suppliers, he settled on DRNA because a company representative installs the separator, checks on it regularly and guarantees the mercury is recycled properly. Plus, the price tag of about $500 a year was right.

Marc Sussman, DRNA president and chief executive, says he based his 17-year-old company on a European model he studied while living overseas. He figured U.S. dentists also would eventually be tasked with removing mercury before it entered the wastewater stream. His company manages the whole gamut of dental waste.

Part of that model, he says, is to form a direct relationship with dentists.

“We make it clear that we are selling compliance, not just equipment,” he explains. “When it’s just an equipment model, it’s a sham. And when it’s a sham, mercury ends up in the wastewater treatment plant.”

Dentists don’t have the expertise to monitor separators, nor do local and state authorities have the personnel to spare to keep watch, Sussman says.

“No amalgam policemen are going to inspect these machines,” he continues. “The EPA has realized this and gotten serious about it. This is a hazardous waste issue. As that paradigm changes, our business will grow. It’s much cheaper to capture mercury at the dental office than it is at the publicly owned treatment works.”

Sussman has duplicated his DRNA prototype globally with a venture he calls Dental Recycling International. For instance, DRI is participating in a pilot project initiated by the United Nations Environmental Programme to install amalgam separators in the African nations of Kenya, Tanzania and Uganda. Piggybacked on that protocol is an effort to ensure that dental waste in Africa is disposed of in an environmentally sound manner.

DRI was spawned in response to an international agreement dedicated to reducing global mercury pollution, the Minamata Convention. It is named after a Japanese city that experienced severe, long-term mercury poisoning after industrial wastewater from a chemical factory was discharged into Minamata Bay. Though the text of the convention was adopted in 2013 after three years of negotiation, its requirements won’t go into effect until 50 countries have signed it.

Recently, Phelps sold his practice in Spencer, Iowa, to a dental service organization that operates 25 dental offices in Iowa, Minnesota, Wisconsin and Illinois. The 66-year-old will continue to work at his own office until he retires.

In the meantime, he’s having conversations with the new owners about investing in DRNA’s amalgam separator technology and service at their string of Midwestern dental offices.

“When I compared it to other products, this one is less expensive and does a better job,” Phelps says. “DRNA is taking all of the roadblocks out. The only knock against it is that nobody has ever heard of it.”