Extracted teeth are immediately classified as medical waste because they are contaminated with blood and other potentially infectious material. The handling and disposal of the tooth are governed by strict federal, state, and environmental regulations. The ultimate fate of the tooth depends on its contents, the patient’s wishes, and the intended purpose.
Primary Disposal: Biohazard Procedures
Most extracted teeth that are not requested by the patient and do not contain metal restorations enter the regulated medical waste stream. Contamination with blood and saliva classifies the tooth as “infectious waste,” subject to the OSHA Bloodborne Pathogens Standard. Dental staff must place the tooth in a designated, leak-proof biohazard container, such as a red bag or a non-sharps container, to ensure the safety of clinical personnel and waste handlers.
These containers are collected by licensed medical waste disposal companies. The final destruction process is typically high-heat incineration, which effectively neutralizes any infectious pathogens. Alternatively, some facilities use an autoclave, which sterilizes the material using high-pressure steam, before the treated waste is disposed of as non-infectious refuse.
Handling Teeth Containing Amalgam or Metals
A distinction in the disposal process is made for any extracted tooth containing an amalgam filling (silver filling). Amalgam is composed of a mixture of metals, with mercury being a primary component. The Environmental Protection Agency (EPA) strictly regulates the disposal of mercury-containing waste due to the potential for environmental contamination.
Teeth containing amalgam cannot be placed into the general biohazard waste stream if that waste is destined for incineration. Burning amalgam causes mercury to vaporize and be released into the atmosphere, where it can settle into water bodies and the soil. Instead, these teeth must be segregated into a specialized container designated for amalgam waste only.
This separate collection container is part of the dental office’s required amalgam waste management program, mandated by EPA guidelines. The teeth are collected by a specialized recycler who ensures the safe recovery of metallic components, including mercury, preventing its release into the environment. This process also applies to teeth with gold crowns or other non-amalgam metallic restorations, which are often recycled for their material value.
Patient Requests for Retaining the Tooth
Patients maintain the legal right to request the return of their extracted tooth, which is common, especially with children’s teeth or wisdom teeth. When a patient makes this request, the tooth is no longer considered regulated medical waste under the OSHA standard. However, the dental practice still has a duty of care to ensure the returned item is safe for the patient to handle.
To render the tooth non-infectious, the dental team must first clean it of any visible blood and debris. They then disinfect or sterilize the tooth, often by immersing it in a chemical solution like bleach or alcohol, or sometimes by running it through the practice’s sterilization unit. This step decontaminates the surface of the tooth, minimizing the risk of exposure to any infectious agents.
To formally transfer possession and liability, the patient is typically required to sign a release or waiver acknowledging receipt of the biological material and understanding its potentially infectious nature. The tooth is then placed in a small, sealed container for the patient to take home.
Use in Education and Research
A less common, but valuable, destination for extracted teeth is donation for dental education and scientific research. Teeth are indispensable for dental schools, where students use them for pre-clinical training to practice procedures like drilling, filling, and root canals. Researchers also utilize donated teeth for material science studies, such as testing new filling composites or bonding agents.
The donation process is strictly regulated and requires explicit, informed patient consent before the extraction takes takes place. Teeth intended for educational use must be thoroughly cleaned and sterilized, typically using heat-sterilization methods like autoclaving, to allow for safe handling. Teeth containing amalgam, however, cannot be heat-sterilized due to the mercury and must instead be disinfected through prolonged chemical immersion before they can be safely used.