Dental Rule: What it is, and how Virginia dental offices can comply

To help prevent mercury, a neurotoxin, from entering wastewater, a new federal rule requires dental practices that insert or remove amalgam fillings to install an amalgam separator to capture waste amalgam.  The Virginia Dental Rule Compliance Form, which is designed to be filled in electronically, and other resources to help comply are available here. The Dental Rule was developed by EPA, codified at 40 CFR Part 441, and published in the Federal Register on June 14th, 2017.  There were two addendums published June 26th, 2017 and July 5th, 2017 to correct compliance dates in the rule.   Additional information on the development of the rule can be found on the EPA site.

The purpose of the Dental Rule is to reduce the amount of mercury containing amalgam that is discharged by dental offices by having dental offices collect it with amalgam separators or similar amalgam removing devices.  Amalgam is the silver-colored material used to fill teeth.  It is composed of 50% mercury and a metal alloy mixture of silver, tin, copper and other trace metals.  Currently, dental discharges with amalgam travel through the sewers to publicly owned treatment works (POTWs) which treat the wastewater prior to discharge into state waters.  The amalgam waste becomes part of the sewage sludge, which is then disposed of in landfills, by incineration or land application.  Mercury, which is a potent neurotoxin, can be released from the amalgam into the environment and bioaccumulate in fish and shellfish.  Amalgam separators remove 95-99% of the dental amalgam from the dental wastewater before it is discharged to the sewer.  EPA estimates that dentists discharge approximately 5.1 tons of mercury each year to POTWs.  Amalgam collection devices will significantly reduce the amount of mercury discharged, along with dentists using other restorative materials.  The American Dental Association (ADA) has additional information on handling amalgam waste

The Dental Rule requirement to have an amalgam removal device and perform the two Best Management Practices (BMPs) applies to offices where the practice of dentistry is performed, and amalgam is applied or removed.  It includes dental schools and clinics, as well as home offices.  See the “Dental Rule FAQs” link for more details.  The rule does NOT apply to dental offices where the practice of dentistry consists exclusively of one or more of the following dental specialties: oral pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, orthodontics, periodontics, or prosthodontics; dental offices that discharge to a septic system*; or discharges to POTWs from mobile units*.   If the rule does not apply to your dental practice, you are not required to submit the Virginia Dental Rule Compliance Form.  However, even if the Rule does not apply to your office, it would be helpful to submit the first 2 pages of the form so your status can be indicated in our records. Please email DentalRule@deq.virginia.gov if you have questions. 
 
* Note that while the Dental Rule exempts dentists who discharge to a septic system and dentists who operate out of mobile dental clinics from being required to have amalgam separators, the waste from these two practices is usually discharged to a wastewater treatment plant for treatment.  The wastewater treatment plant may have their own restrictions on waste that they will accept, and may not take dental wastewater that could contain amalgam.  It is recommended that the wastewater treatment plant that will receive the dental wastewater be contacted to see if there are restrictions.  If so, then installing an amalgam separator would resolve the issue.

Compliance with the dental rule

Applicability of dental rule for offices that install or remove amalgam Must Install Separator by Must submit compliance form by BMPs for Practices with Amalgam Separators

Dental office in business before July 14, 2017 with no Separator

July 14, 2020 Within 90 days of installation

 1. File Virginia Dental Rule Compliance Form with DEQ, and keep a copy for lifetime of ownership.  Update information on Form and resubmit as necessary.

2. Monitor Amalgam Separator according to manufacturer's recommendations.

3. Replace/repair within 10 business days of discovering problems with operation.  File updated Virginia Dental Rule Compliance Form with Virginia DEQ.

4. Maintain by replacing Amalgam retaining cartridge, canister or units as directed by manufacturer or annually, whichever comes first.

5. No use of oxidizers or acidic cleaners when flushing dental unit water lines, chair-side traps and vacuum lines.  No bleach, chlorine, iodine or peroxide cleaning agents.

Must maintain records (reports filed, visual inspection log, documentation of repair or replacement, Amalgam disposal records, and manufacturer's SOP) on site for 3 years.

Existing office with Amalgam Separator

Separator  meets rule until June 14, 2027 unless replacement is needed October 12, 2020 or within 90 days of replacement if after October 12, 2020

New office that begins operating/discharging on or after July 14, 2017

At opening of office Within 90 days of installation
Transfer ownership of existing office with no Separator July 14, 2020 Within 90 days of transfer of ownership
Transfer ownership of existing office with Separator Separator meets rule until June 14, 2027 unless replacement is needed Within 90 days of transfer of ownership  
Dental office that does not place or remove Amalgam except in limited emergency or unplanned events and who can certify as such (estimated less than 5%) No Separator needed October 12, 2020  
Discharges from mobile dental units No Separator needed* No form needed  
Discharges to private septic system  No Separator needed* No form needed  

* Note that while the dental rule does not apply to dentists who discharge to a septic system and dentists that operate out of mobile dental clinics from being required to have amalgam separators, the waste from these two practices must ultimately be discharged to a wastewater treatment plant for treatment. The wastewater treatment plant may have its own restrictions on waste that it will accept, and it might not take dental wastewater that could contain amalgam. It is recommended that the wastewater treatment plant be contacted to see if there are restrictions.  If so, installing an amalgam separator would resolve the issue.

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Virginia Department of
Environmental Quality
P.O. Box 1105
Richmond, VA 23218
(804) 698-4000


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