Waste generated during the course of dental care will be disposed in a fashion consistent with University, local, and state regulations pursuant to the protection of individuals with possible exposure risk. This section describes the accepted procedures for waste management.

Definitions	Disposable Items Management
Regulated Waste Categories	Managing Extracted Teeth
Biohazardous Waste management	Patient Requesting Extracted Teeth
General Clinical Material	Educational Use of Extracted Teeth

Definitions

The following definitions will be useful in understanding proper waste management strategies.

Blood/Body Fluids: flowable "liquid" blood or body fluids.

Blood, or Body Fluid Saturated Items: items in which the blood or body fluid in question is not dried, or fully absorbed and has the potential to drip. (cotton rolls, gauze, etc.)

Bloody Wastes: items that have come into contact with blood, or body fluids and on which the fluid has dried. (Gloves, bibs, rubber dams, etc.)

Regulated Waste Categories

Local and state regulations identify "Regulated Waste" as potentially harmful items to others during the disposal process. The following are the various categories of such waste.

Items referred to as "sharps" including such items as used and unused needles, scalpel blades, sutures, anesthetic carpules, instruments, and broken glass

Human tissues and foreign bodies including teeth removed during surgery

Blood-contaminated material or items which would release blood or other potentially infectious materials, including saliva, if compressed. (Blood, or Body Fluid Saturated Items)

Liquid blood in free flowing form (Blood/Body Fluids)

Chemical hazards

Biohazardous Waste management

To meet these regulations, the following waste management procedures shall be followed:

General Clinical Material

Sharps removed from their original packaging will be disposed in the red puncture-resistant, leak-proof containers shown here and found in each operatory. Care must be taken to avoid overfilling the container and defeating its protective purpose. Full containers are to be sealed and placed in a cardboard box, then sealed for pickup by the safety assistant.

All human materials (except extracted teeth) removed during surgery should be managed in accordance with the Tissue Management Policy of the School. The Division of Oral Pathology will arrange for appropriate disposal following examination and reporting.
All blood-contaminated disposable materials will be transferred from the patient's mouth and placed directly into a bedside collection bag taped to the bracket table or mobile cart in the operatory. (This is true for materials which would release blood, Blood, or Body Fluid Saturated Items, or other potentially infectious materials, including saliva if compressed, or which are caked with dried blood or other infectious materials, Bloody Wastes.) Materials placed in this bag will include, but will not be limited to, soaked or blood-contaminated cotton rolls, gauze, cotton pellets, floss, or tissue dressings ("packs").

Following patient treatment, the bedside bag will be closed and placed in the biohazardous waste bag-lined receptacle (red crates) located in each clinic. Staff will collect and close the autoclave bag lining the crate at least daily or, when full, deposit in a special biohazardous waste container on each floor; it is then taken to T-276 for disposal.
All glass regardless of whether it is contaminated with infectious material, harmful chemicals, or not must be sealed in a cardboard container and labeled as shown here prior to disposal to prevent injury waste management personnel.

Disposable Items Management

Items manufactured for "single use" are not to be reused. Such items include needles, plastic suction tips, prophylaxis points, cups and brushes, examination or surgical gloves, masks, operatory surface covers, and disposable clinic attire. Used disposable items must not be removed from the clinic, and should be discarded in available containers immediately after use.

Managing Extracted Teeth

Extracted teeth are prime examples of infectious waste and must be handled as biohazardous material in the dental school. Handle extracted teeth only with forceps or gloved hands.

Patient Requesting Extracted Teeth

Extracted teeth should NOT ordinarily be returned to patients and, unless they are to be used for research or educational purposes, the teeth are infectious waste and must be treated prior to disposal. If the patient insists on obtaining his/her extracted tooth, it may only be returned to that patient following a 10-minute soak in a 1:10 solution of sodium hypochlorite (i.e., chlorine bleach).

Educational Use of Extracted Teeth

Teeth to be used for research or educational purposes must be placed in a leak-proof container of 1:10 sodium hypochlorite. The container should be no more than one-third filled with teeth, and all teeth must be completely submerged for at least two weeks before handling. Care should be taken to avoid contamination of the outside of the container.

Gloves always must be worn when handling the container. Eyeglasses and gloves must be used to prevent exposure to the sodium hypochlorite when adding sodium hypochlorite to, or when retrieving the teeth from, the container. Teeth should be thoroughly rinsed with water to remove as much residue as possible.

Teeth with amalgam restorations must not be heat sterilized to avoid the possibility of mercury vapor release during the sterilization procedure.

Biohazardous Waste Management