The amalgam phase down will come into place in the coming months. Some dental professionals have been wary of the move, warning that it will “send shockwaves” across UK dental services.[1] However, as of 1st January 2025, a total phasing-out of dental amalgam, and the cessation of its manufacture and export, will come in, in the EU – five years earlier than initially expected.
While the phase down of dental amalgam will affect nations across the UK differently, one thing is certain: it will not disappear entirely from the workflow. Patients currently with amalgam fillings may need their restorations treated or removed in the future, long after changes are made across the continent.
Practices must be aware of the necessary steps they need to take to ensure this waste material is managed and disposed of properly. Clinicians must follow strict regulations as part of this process. Failure to abide by them may limit your ability to practise dentistry, should sanctions be placed.
Stop the flow
Amalgam has long been an effective restorative solution, but it is composed of approximately 50% mercury, known to adversely affect eco-systems and human health.[2] However, it is generally agreed to be a safe material for dental use,[3]hence its widespread use.
Despite this, the move to phase out amalgam has long been discussed as the potential for damage to the environment is so severe. Mercury in air, soil, and water may end up in the coastal and deep-water sediments, and can then enter the animal and plant food chain. In particular, it is known to contaminate seafood, and can then affect those who consume it. The level of risk is dose-dependent, but there are particular concerns for the health of foetuses and young children, with the ability to impair the development of the brain and nervous system of a baby.[4]
Keeping amalgam out of your wastewater is therefore essential. All practices must be equipped with an amalgam separator on dental water outlets that can retain at least 95% of the waste particles.[5]
With these processes in place, your practice can help to minimise the amount of amalgam waste that will end up in our waterways But your responsibilities don’t end there. You must ensure the collected amalgam – whether residual, particles, fillings, or material still within teeth – is disposed of responsibly.
Environmental obligations
An amalgam separator collects the material within a typically small, circular canister, which must be monitored, removed, and replaced regularly. This will either be once a container is full or every 12 months, whichever comes first. If you remove an amalgam collector cup, it must not be opened and should be stored safely in your practice in a dental amalgam container. This prevents any risk from exposure to mercury vapours to your dental team.
Since mercury waste presents a potential environmental threat, it is your responsibility to manage any affected waste within your practice. You must not, under any circumstances, empty a collector cup down a sink or drain, nor rinse the container after it has been emptied. Even the latter creates the risk of mercury finding its way into wastewater systems.
Clinicians must work with an authorised waste management establishment to handle and collect the containers.5 For dental professionals unsure of their role within the amalgam waste management workflow, speaking to such experts can better inform you of your responsibilities and options.
Consider your collector cups
Effectively managing your amalgam waste is essential for protecting the environment, however, your practice has the opportunity to take further beneficial steps.
Amalgam collector cups themselves are single-use items, generally made from plastics. Some waste management services may not dispose of them in an environmentally responsible manner once contaminated with amalgam.
Choose an effective service from Initial Medical and experience complete and environmentally-focused guidance throughout your waste management workflows. Our experienced team will not only manage the disposal of your amalgam waste, but you could choose Initial Medical’s Back to New – Recycled Collector Cup Package for additional sustainability benefits. A first of its kind, both the amalgam waste and the Durr collector cups are recycled at our specialist dental recycling centre.
The collector cups are thoroughly cleaned, tested, and returned to the original standard of a new collector cup ready to be used again. As part of the service, Initial Medical will collect your waste amalgam material and provide you with new recycled collector cups, and a collector cup drum. This is a more cost-effective option than purchasing the solutions outright, all in one simple package.
The future of amalgam in dentistry in the UK will not halt on the 1st of January 2025, as there is still care to be provided to those with amalgam restorations, and actions to be taken to ensure it affects the environment as minimally as possible.
To find out more, get in touch at 0808 304 7411 or visit the website today
About Initial Medical
Initial Medical set the standard in healthcare and infectious waste management in the UK, providing a reliable, effective and fully compliant service built around customer needs and delivered by our highly trained local teams. We are ISO 9001:2015 accredited, with technology fully integrated into our operations, providing full traceability of service delivery, electronic waste documentation and the best customer experience possible. We also offer innovative healthcare waste management services and infection control products, to help break the chain of transmission and prevent cross contamination.
Initial Medical are a company with a ‘World Class’ Health and Safety record, and ISO 45001:2018 accreditation. We are also accredited to ISO 14001:2015 environmental standards, and pride ourselves on our sustainable approach with a focus on delivering eco-friendly products and operational solutions.
Rebecca Waters, Category Manager, Initial Medical
Rebecca has worked in the Healthcare sector for the past 17years and was a Research Chemist with Bayer Cropscience prior to joining Rentokil Initial in 2003. She keeps up to date on all developments within the clinical waste management industry and is an active member of the CIWM, SMDSA and BDIA.
Media enquiries:
For more information, please contact:
01227 265700
[1] Crouch, E. (2024). Amalgam ban may hasten NHS dentistry’s demise. BRITISH DENTAL JOURNAL, 236(3), 149-149.
[2] Fairbanks, S. D., Pramanik, S. K., Thomas, J. A., Das, A., & Martin, N. (2021). The management of mercury from dental amalgam in wastewater effluent. Environmental Technology Reviews, 10(1), 213-223.
[3] Rathore, M., Singh, A., & Pant, V. A. (2012). The dental amalgam toxicity fear: a myth or actuality. Toxicology international, 19(2), 81.
[4] Spaveras, A., & Antoniadou, M. (2023). Awareness of students and dentists on sustainability issues, safety of use and disposal of dental amalgam. Dentistry Journal, 11(1), 21.
[5] Care Quality Commission, (2023). Dental mythbuster 1: Use and disposal of dental amalgam. (Online) Available at: https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-1-use-disposal-dental-amalgam [Accessed May 2024]
