The removal of a tooth is a common dental procedure, and patients are often curious about the fate of the extracted tissue. Once removed, handling is governed by strict health, safety, and legal regulations. Dentists must follow specific protocols for the disposition of this human tissue, which includes standard disposal, returning the tooth to the patient, or specialized paths like donation or banking.
Immediate Handling and Biohazard Classification
A tooth not requested by the patient is immediately categorized as regulated medical waste, also known as biohazard waste. This classification is mandated because the tooth and surrounding tissue are contaminated with blood and other potentially infectious material (OPIM). Dental professionals must follow the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard due to the risk of disease transmission.
The standard protocol requires the extracted tooth to be placed into a designated, secure container, often a sharps container or a labeled biohazard “red bag.” These containers are leak-proof and puncture-resistant to ensure the safety of staff and waste handlers. Specialized, licensed medical waste disposal companies transport and destroy this regulated waste, usually through incineration.
A separate protocol exists for teeth containing amalgam fillings, which include mercury. These teeth must never be disposed of in containers destined for incineration, as burning amalgam releases mercury vapor that contaminates the environment. Instead, teeth with amalgam are managed as hazardous waste and sent to specialized recyclers who safely process the material.
Patient Rights: When the Tooth Goes Home
Patients maintain the right to request and keep their extracted tooth, often for sentimental reasons or for children participating in the Tooth Fairy tradition. When returned to the patient, the tooth is exempt from the federal OSHA Bloodborne Pathogens Standard, but the dental office must prepare the specimen safely before releasing it.
The preparation involves cleaning the tooth to remove all visible blood and debris. The surface is then wiped down with an approved disinfectant to minimize infection transfer. Once disinfected and rinsed with clean water, the tooth is placed in an impervious container or sealed bag for the patient.
Some dental practices may ask the patient to sign a release form acknowledging receipt of the disinfected tooth and taking responsibility for its future handling. This administrative step ensures proper documentation of the transfer.
Paths Other Than Disposal: Research and Donation
Beyond standard disposal, extracted teeth can serve valuable purposes in education and regenerative medicine, though these paths require explicit patient consent. Dental schools and university research institutions rely on donated human teeth for preclinical training, allowing students to practice procedures like fillings, root canals, and crown preparations on natural tissue. This hands-on experience provides a realistic simulation of the texture and anatomy of a living tooth.
Donated teeth are meticulously cleaned and sterilized, often through heat or chemical immersion, before they are used by students or researchers. The demand for these specimens has increased, making patient donation a significant contribution to the education of future dentists. Teeth are also a source for advanced scientific study, specifically in the field of dental pulp stem cells (DPSC).
Dental Stem Cell Banking
Dental stem cell banking is a specialized service where mesenchymal stem cells are isolated from the soft dental pulp inside the tooth. This is typically done with healthy baby teeth or extracted wisdom teeth, which contain viable stem cells with regenerative potential. The process requires advanced planning, as the dentist must place the freshly extracted tooth into a special transport medium provided by a private stem cell bank. Time is a limiting factor, as the tooth must be shipped overnight to a laboratory for processing within a narrow 24- to 48-hour window to maintain cell viability.