Dental amalgam waste management — ORE Part 1 MCQ

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HardDental Public Health, Ethics, Law and Infection ControlDental amalgam waste managementORE Part 1

A practice replaces several old amalgam restorations each week. The suction line has no amalgam separator, and waste amalgam particles are being disposed of with general clinical waste. The practice manager asks why this creates an environmental compliance problem. What is the most likely cause?

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Correct answer: D — Mercury-containing waste can contaminate wastewater and the wider environment

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as D · D = shown as E

The correct answer is A. Dental amalgam contains approximately 50% mercury by weight. Without an amalgam separator installed on the suction line, mercury-containing particles pass directly into wastewater and, if disposed of as general clinical waste, into the wider environment. This constitutes a breach of Regulation (EU) 2017/852 on mercury (retained in UK law), which prohibits the release of amalgam waste into the environment under any circumstances. SDCEP guidance and Health and Safety Executive standards mandate the use of amalgam separators to achieve at least 95% removal efficiency. Option B (composite resin oxygen release) is unrelated to the stem and has no environmental compliance relevance. Options C, D, and E describe unrelated materials and chemically implausible phenomena, serving as distractors. A candidate must integrate knowledge of amalgam composition, environmental pathways, and UK/EU regulatory requirements to recognise that mercury contamination of wastewater is the specific compliance problem.

Reference: SDCEP Practice Support Manual, Mercury Handling section (current); Regulation (EU) 2017/852, Article 10 (retained UK law); The environmental effects of dental amalgam, PubMed 11225525 (2001). https://www.psm.sdcep.org.uk/topics/health-and-safety-general/mercury-handling/