Cavity hazard: Program teaches dentists to recycle fillings
Read the article in the Missoulian.
By JOHN CRAMER of the Missoulian
Mercury from dental fillings has been targeted for cleanup under a public health initiative launched this week in Missoula.
The pilot program, called WATER, or Waste Amalgam Treatment, Education and Recycling, is to be expanded statewide next year.
“The dental community feels the WATER program is important in helping all dentists become better environmental stewards,” said Dr. Ryan Huckeby, president of the Missoula Second District Dental Society.
More than 1,600 tons of mercury are released nationwide into the soil, air and water each year by mining, coal burning, manufacturing and other sources, according to the U.S. Environmental Protection Agency.
That includes 7.4 tons from dental offices, which are the largest source of mercury emissions into waterways.
Studies show that exposure to high levels of mercury can cause a range of health problems, including brain, heart and kidney damage.
Missoula's WATER program is modeled after the American Dental Association's best management practices, which encourage dentists to recycle the mercury amalgam that goes into “silver” fillings.
The WATER program, which is supported by a coalition of health and environment groups, will provide education, support and incentives to dental practices in the Missoula area.
“It's an important public health issue,” said Jamie Silberberger, a spokeswoman for Women's Voices for the Earth, a Missoula nonprofit group. “We're not suggesting anything radical, just that dentists follow the ADA's best management practices.”
The coalition's other members are the Missoula Wastewater Treatment Plant, the Missoula City-County Health Department, the Montana Dental Association and Montana Department of Environmental Quality.
Dental amalgam is made up of 50 percent liquid mercury and other metals. When amalgam is removed or placed in a patient's mouth, a small amount goes down the drain.
If the mercury isn't captured by an amalgam separator, it goes to the wastewater treatment plant, where bacteria convert elemental mercury into methylmercury, the most toxic form of mercury to humans.
A growing number of state and local governments require dental offices to recycle mercury amalgam.
Montana isn't among them, but WVE would support legislation if the voluntary program fails, Silberberger said.
No data is kept on how many local dentists follow the ADA's mercury recommendations or have amalgam separators, which remove up to 99 percent of mercury particles from the wastewater.
But a 2006 survey of 29 Missoula dental offices found that more than half were not following best management practices for mercury disposal and that few had amalgam separators, meaning much of their mercury waste went down the drain or into the trash.
The ADA adopted best management practices for dental amalgam in the 1990s in response to concerns about hazardous medical waste in the environment.
Jackie Jones, a Missoula dentist, said she thinks most of the 60 to 70 dental offices in the Missoula area try to follow best management practices.
But she said some staff members may not be aware of the mercury guidelines or be properly trained in mercury disposal.
Jones said she saves chunks of mercury, gold and other metals waste and sends them to a refinery every 12 to 18 months for recycling.
Smaller mercury particles that reach the Missoula Wastewater Treatment Plant can't be filtered out before they go into biosolids for composting or into the Clark Fork River.
It hasn't been determined how much of the mercury waste at the plant comes from dental offices.
The plant's permit, which was renewed in 2006, has lowered the allowable levels of 11 heavy metals, including mercury. The plant hasn't exceeded its mercury limits but has had four spikes in mercury levels in recent years.
In addition to best management practices, Missoula dentists are being encouraged to buy amalgam separators.
Jones, who has a separator, said the devices have been around about 10 years, but only in recent years have they become more efficient and affordable.
“We want to be proactive instead of reactive and hopefully make sure everybody in the county is using best management practices,” she said.
Dentists who participate in the WATER program will receive a decal that shows they practice environmentally responsible dentistry.
Reporter John Cramer can be reached at 523-5259 or at johncramer@missoulian.com.