When a tooth is extracted, patients often wonder what happens to it afterward. Although the tooth belongs to the patient, the dental professional typically retains it following the procedure. This standard practice is governed by two significant factors: the need for potential medical investigation and strict public health regulations for handling biological material. Understanding these reasons reveals why the dentist’s office is the initial destination for the extracted tooth.
Retention for Diagnostic Purposes
A primary reason a dental office retains an extracted tooth is the potential necessity for pathological examination. When a tooth is removed due to a chronic infection, an unexplained lesion, or a suspected mass, the tooth and the surrounding soft tissue function as a biopsy specimen. This biological material may hold the evidence needed to confirm a proper diagnosis, which is an important step in ensuring the patient receives the correct follow-up care.
The extracted tooth may be sent to a specialized histopathology laboratory for analysis. Technicians will process the tissue, often fixing it in a solution like formalin, and then embed it in paraffin wax to create thin slices for microscopic study. This allows pathologists to look for cellular changes indicative of serious conditions, such as cysts, granulomas, or tumors, which may not have been fully diagnosed from X-rays alone. Evaluating the tooth’s internal structure can also reveal the extent of complex issues like internal root resorption.
Teeth as Regulated Biohazardous Waste
Beyond the medical need for diagnosis, the most frequent reason dentists keep extracted teeth is the stringent legal framework governing biohazardous waste. Any extracted tooth, regardless of its apparent health, is considered a potentially infectious material (PIM) because it is contaminated with blood, saliva, and other soft tissues. This classification subjects the tooth to strict public health and occupational safety guidelines designed to prevent the transmission of bloodborne pathogens.
The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard mandates that dental offices treat these items as regulated medical waste (RMW) if they are to be discarded. Improper disposal is illegal and poses a risk to both the dental staff and the wider public health system. Consequently, the dental practice is responsible for placing the extracted tooth into designated regulated containers, often sharps containers or red bags, for specialized transport and disposal by a licensed waste management company.
Handling Amalgam Fillings
Special handling is required if the extracted tooth contains amalgam, which is a dental filling material containing mercury. Because the incineration used for typical regulated medical waste could release toxic mercury vapor, teeth with amalgam must be segregated from other waste. They are treated as hazardous waste and are typically sent to a specialized recycler or managed according to specific state and federal environmental protection regulations. The dental office must temporarily take possession of the tooth to ensure compliance with the law.
Patient Rights and Retrieval Procedures
The extracted tooth remains the patient’s property, despite the medical and regulatory necessity for the dental office to retain it initially. Patients have the right to request the return of their tooth, and the dentist is not prohibited from releasing it once certain safety protocols are followed. The primary requirement before releasing the tooth is that it must be rendered safe for the patient to handle and transport, which means removing all biohazardous material.
To achieve this, the tooth must be thoroughly cleaned and disinfected, often through chemical sterilization procedures. For instance, teeth containing amalgam cannot be heat-sterilized due to the risk of mercury vaporization, so chemical immersion in a solution like formalin is often the required method for disinfection. Once the tooth has been cleaned and the biohazard risk to the dental team is eliminated, the tooth is no longer subject to OSHA’s Bloodborne Pathogens Standard.
The patient may then be required to sign a release form acknowledging that they are taking possession of the material and accepting responsibility for its subsequent handling and disposal. If the tooth was originally retained for pathology, the patient must wait until the diagnostic examination is complete before the tooth can be released. This process ensures the patient’s legal right to their property is upheld while maintaining the necessary standards for infection control and public safety.