amalgam separator, dental safety, infection control

NOW is the Time for SAFER Amalgam Capturing Systems

With heightened safety concerns, we wanted to look at an area of dentistry that will require every dental office, with few exceptions, to install an amalgam separator or equivalent device by July 2020.  A few municipalities are extending this deadline to work around the current Covid19 dental office closings.

When the EPA reinstated the Amalgam Separator Ruling in 2017, the goal was to ensure dental amalgam waste is captured and recycled properly.  It is an “environmental ruling” to ensure mercury contained in dental amalgam does not enter the air, water, and land.

The EPA also set up Best Management Practices (BMP) a set of guidelines as to how you should collect the amalgam waste, dispose of, recycle, and what cleaners with high PH couldn’t be used.  Again, all designed for the environmental protection.

However, the ruling overlooks a focus on Safety, specific to Dental Patients and Dental Professionals.  Current amalgam collection risks include exposure of toxic materials, leaking, backflow and clogging.  Initially, the EPA approved only traditional ISO amalgam separators.  They are designed to collect amalgam waste for extensive periods of time in a bucket style collection system.  Most often they are found in utility rooms near the vacuum.  They require cleaning or changing every few months or years.

For safety purposes, keeping the removed amalgam around the office for extensive time periods seems counter-intuitive.  Shouldn’t the goal be to remove amalgam when its removed?  Not in 30 days, 6 months or 2 years.  Contrary to belief, dental amalgam, when removed does not flow to the amalgam separator.  Instead, particles collect in your valves, trap, vacuum lines and eventually the separator.  Research shows an average of 68% of the amalgam sits in the chairside trap.  The amalgam separator receives the remaining amalgam waste.  Best Management Practices requires collection and recycling of the chairside trap amalgam waste along with the separator.

We believe when amalgam is removed from a patient it should be immediately captured and placed out of harm’s way.  It should also not enter the chair lines, trap or vacuum.  When the EPA revisited the original ruling and added the equivalent device section to the final ruling it allows for this.  The EPA made room for new technologies, they will be advanced, safer, more efficient, and will collect sooner rather than later.  Most states recognize the EPA Equivalent Device Ruling found in 441.30(a)(2) of the final ruling.

At some point, the dental market will reopen.  When this occurs, safety should be the #1 priority.  We owe it to our community to insure safer protocols, especially those with loopholes.

To learn about your office risk, ask how often are the lines flushed?  How often are the evacuation valves properly cleaned?  How often is the chairside trap emptied?  Are patients instructed to close around saliva ejectors?  The CDC and countless research state when patients close around a suction device, 1 in 4 likely receive backflow.  All of these pertain to safety and should be prioritized for every patient, not once a day.

If you have a traditional amalgam separator, make sure protective equipment is provided for the employee designated to clean the separator.  OSHA recommends a respirator, utility gloves and face shield and because of splatter PPE is suggested.

Or, maybe it’s time to consider a safer system in the Equivalent Device category.  These devices are safer, more efficient, single-use, recyclable and are used when your removing amalgam.  And no longer will amalgam enter the valves, lines and trap.

Finally, urge your local and state legislators to not only focus on the environment, but also move in the direction of safer solutions.

amalgam separator, cross contamination, dental assisting, dental hygiene, dental safety, EPA, infection control, Uncategorized

EPA Compliance 101 Amalgam Separators

This July if your a dental office – you most likely have either purchase a amalgam separator or shopping for a new system.  Capt-all HVE Amalgam Capture Tips are EPA Compliant as equivalent devices that meet the 95% collection requirement and can be easily added on the EPA One Time Compliance Forms…See below for the Equivalent Device Sections circled in red!standardepaform

amalgam separator, dentistry, rdh, Uncategorized

NEW Handheld or Traditional Amalgam Separator – What’s Right for your Practice?

This year, we have a major deadline!  The EPA has set a deadline on July 14, 2020 requiring the majority of dental offices to install an amalgam separator or similar device that prevents mercury contained in dental amalgam from entering the air, water, and land. (1a)

For the past few years dental offices have been gradually installing traditional style Amalgam Separators to prepare for the EPA ruling.  For reference, traditional style Amalgam separators are devices designed to capture amalgam particles from dental office wastewater through sedimentation, filtration, centrifugation, or a combination of these mechanisms and work with the central evacuation. (1b). They are most likely installed next to the central vacuum to tie all lines together and offer ease of access for routine maintenance required.

Traditional amalgam separators have been an excellent choice to meet the compliance requirements over the years.  However, as many offices will attest, routine maintenance, space requirements, installation challenges, wear and tear, leaking, cleaning and recycle-ability all can make these various systems time consuming, costly and aggravating.

We are not here to disparage or downplay the role these systems have played in protecting the environment!  All have had an excellent impact on assuring mercury stays out of municipal sewer systems.  With the challenges posed above, we would like to introduce you to a new alternative system that may be right for your dental office compliance, Capt-all!

Capt-all is a handheld amalgam separator HVE Tip.  It allows offices to become compliant removing amalgam by meeting the EPA 441.30(a)(2) requirement that includes a provision that allows the performance standard of the rule to be met with the use of an amalgam-removing technology other than an amalgam separator (i.e., equivalent device). (1c)

The benefits of Capt-all make it a viable option for many offices who may fit into these categories:

*Amalgam removal cases are reducing – Capt-all is used ONLY when necessary.  If you’re a office only doing a few removals here and there, the introductory 25 pack allows you to remove when you need to!

*Space is limited for access and installation of a traditional separator – Space is a premium and many offices have limited space in the utility room.  This makes routine maintenance and access difficult to empty and clean.  Capt-all is a chairside device and takes NO space up in the utility room.  Unused Tips are small enough to place in a drawer.

*The office is tired of cleaning prophy and everything else inside the Amalgam Separator – because traditional separators collect heavier waste, they tend to fill up with all sorts of junk.  It’s a yucky job that no one likes to do.  Capt-all alleviates this because its used only when necessary, not when prophy or other materials are used.  Also, Capt-all has NO cleaning and simply removed and contained after use!

*High Cost of the equipment, installation and maintenance – Most traditional systems will start around $1000 to include installation.  Recycling costs can vary as well as routine maintenance.  Capt-all is $7 per HVE Tip!  So if your office removes 5 a week or 5 a day the cost is $35!  The recycling fee is included, NO installation is necessary, and maintenance is a thing of the past!

*Its not just the amalgam separator that requires cleaning, so do traps and filters – when removing amalgam particles are created.  They do not all filter into the separator.  The do line the filters, traps and interior pipes where it flows.  Capt-all alleviates the worry and keeps all particles chairside!

*Our office has no time for installation and or recycling commitments – offices are busy and time is precious.  The standard Capt-all kit includes everything to be compliant, requires NO installation and makes recycling easy!  After usage of a Capt-all Tip, simply place the used tip into the accompanying recycle container that has a prepaid shipping label.  Once fully, simply reorder Capt-all Tips and drop the recycling container in the mail back to us!

Hopefully this answers some questions about the new handheld Capt-all Amalgam Separator HVE Tips when compared to traditional amalgam separators.

Capt-all is scheduled for market introduction at the Chicago Midwinter Dental Meeting this February in 2020 and is stocked by the following distribution partners:

Henry Schein Dental                       Patterson Dental Supply

Benco Dental Supply                      Dental Health Products Inc

For further information, please visit our website at www.dovedentalproducts.com.

(1a) https://www.epa.gov/eg/dental-effluent-guidelines

(1b) https://www.ada.org/en/member-center/oral-health-topics/amalgam-separators

(1c) https://www.epa.gov/sites/production/files/2017-12/documents/dental-office-category_frequent-questions_nov-2017.pdf

dental assisting, dental hygiene, dental safety, dentistry, distribution, infection control, rdh, Uncategorized

2020 Dental Distribution Partners

We are excited for this year, 2020 to announce our partnerships for dental distribution of the DOVE Dental Products full line.  They include:

Henry Schein Dental

Patterson Dental

Benco Dental

DHPI (Dental Health Products)

Each has our new products (Capt-all and SE Plus) stocked as well as our legacy disposable valves.  If you have any questions, please contact your local representatives from each company.

Have a great year!

cross contamination, dental assisting, dental hygiene, dental safety, dentistry, infection control, rdh

DOVE Dental Products Acquires Capt-all, The Only Handheld Amalgam Separator HVE Tip

DOVE Dental Products Acquires Capt-all, The Only Handheld Amalgam Separator HVE Tip

Chesterfield, MO, December 6, 2019 – DOVE Dental Products, the leading manufacturer in disposable evacuation dental devices, announced the acquisition of Capt-all.

Capt-all is the only handheld Amalgam Separator device designed to collect dental amalgam waste into a patented designed tip that fits into any standard HVE Valve device.  Once amalgam is captured into each Capt-all Tip, it can then be safely sent back in a recyclable container to properly dispose of the captured amalgam.

Starting July 14, 2020 the EPA Final Amalgam Separator Rule requires most general dentists to install an amalgam separator to prevent mercury from entering the air, water and land.  (Ref 1)

Using Capt-all allows for offices to quickly comply with the upcoming ruling.  Capt-all keeps amalgam out of the dental equipment, vacuum lines and secondary filters.  Other benefits include no installation requirements, its ease of use, avoidance of messy clean ups and Capt-all is only used when Amalgam Removal is necessary.

Available January 2, 2020, Capt-all will be sold through Dental Distribution including Henry Schein Dental, Patterson Dental Supply, Benco Dental and Dental Health Products Inc.  The starter package for Capt-all will contain 25 Tips and 1 prepaid recyclable shipping container.  Upon recycling of the used tips, customers can obtain a manifest containing the return shipment confirmation.

About DOVE Dental Products

DOVE Dental Products develop cost-effective disposables for increasing patient safety.  DOVE  Dental principals have a proven track record in successful start-ups,  product and market development, marketing, manufacturing and  intellectual property development.  DOVE (Disposable Oral Valve Evacuation)  Dental HVE and Saliva Ejector Backflow Prevention Valve devices are simple to  install and intuitive with performance.  All DOVE products are Made In the USA and are manufactured by a ISO 13485 facility in Phoenix, AZ.

Ref 1:  https://www.agd.org/docs/default-source/advocacy-papers/finalized-epa-amalgam-separator-frequently-asked-questions.pdf?sfvrsn=e6aa76b1_0

cross contamination, dental assisting, dental hygiene, dental safety, dentistry, infection control, rdh

Stop! Don’t Close on the Suction by Jennifer Reese RDH, BHSA

The day and life as a dental hygienist:

“Open bigger. Turn towards me. Stay open. Oh, don’t close on the suction.”

Throughout my hygiene career it is a priority to place patient care first, providing comfortable quality treatment, maintaining proper infection control, and comprehensive assessments; in the midst of watching the clock and time managing the day. While wearing many hats in our small office, I took on the role of infection control. Implementing the latest protocols office wide including cavicide wipe and rewipe, autoclave handpieces after every patient, change our traps, clean and scrub our suction lines, run our evacuation detergent nightly, and barrier protect next to everything touchable.

In school we learn about backflow risk from saliva ejectors. We are taught to instruct the patients not to close on the suction straws. However, the reality is patients’ frequently do close around the suction during treatment. I was tired of cringing under my mask when a patient close tightly without being able to stop them knowing they are at risk to be exposed to back flow.

According to the Centers for Disease and Control (CDC), backflow occurs when previously suctioned fluids and microorganisms remain present in the suction tubing or valve and flow back into the patient’s mouth. Backflow cross-contamination can occur when there is pressure in a patient’s mouth caused from closing their lips and forming a seal around the tip of the ejector, raising the ejector above the patients’ mouth during use, and when the saliva ejector is used at the same time as the high volume suction. The CDC also advises dental professional to inform patients to avoid closing their lips tightly around the tip of the saliva ejector and to contact the manufacturer of the dental unit to review proper maintenance procedures.

As a hygienist we took an oath as a patient advocate, to stand up to what is wrong, and to provide the best care possible. We know that backflow can occur, we should not put our patients at risk, we know better and there are solutions.

Take out your saliva ejector and take a look into your valves, would you want someone using it on you? Every dental unit is different; I learned many do have removable HVE and saliva ejector valves, which need to be autoclaved between each patient. Check your instructions for use (IFU) manuals for your valves. The proper maintenance process for the HVE and saliva ejector valves in our office took excessive time. They required autoclaving after every patient, checking and replacing O-rings, and disassembling them weekly. Unfortunately, this is something many of us do not learn before entering the workplace, instead, we learn it while on the job. It is our responsibility to read the manuals on each device and properly maintain them whether it takes time or costs a little extra.

At our office, we tried other backflow products, sampled using sleeves on our valves and attempted to clean properly between patients as instructed. Each process implemented proved to be too lengthy of a process or uncomfortable, and were really only putting a Band-Aid on the real issue of our evacuation valves which were a petri dish of all the days’ patients.

In the end, our office agreed upon Dove disposable valves which are disposable HVE and Saliva Ejector Valves that stop and eliminate the risk of backflow. For us, we removed backflow risk and alleviated the nuance of timely cleaning of the valve parts. We finally have peace of mind when patient close around the suction straws.

Jennifer Reese RDH, BHSA

https://www.linkedin.com/in/jennifer-reese-b6189963/

 

 

 

 

 

dental hygiene, dental safety, infection control, rdh

Dental Patients Likely Receive Backflow

Today, most would agree patient safety is of utmost importance.
Unfortunately, on a daily basis we continue to see dental offices instructing patients to close around suction straws. Research concluded as far back as 1993 that patient safety is compromised when lips are closed around saliva ejectors during procedures. The CDC also provides us clear warnings about the risk from saliva ejector backflow.
https://www.cdc.gov/oralhealth/infectioncontrol/questions/saliva.html

Studies concluded 23% (Nearly 1 in 4) likely receive prior patient backflow when lips close around straws. Flushing the lines will not address this problem nor will the cleaning of the valve components.  Countless studies, education, and training clearly show the risks of backflow. Using a disposable backflow eliminating product is the only way to guarantee backflow prevention. NEW affordable backflow eliminating products are readily available.

Instructing patients to close around saliva ejector straws goes against everything we know for the past 20 years. Simply wiping valves between patients is not enough. Recent ATP surface testing displayed over 99% of evacuation valves failing when only wiped between patients.
https://www.rdhmag.com/articles/print/volume-37/issue-11/contents/is-wiping-the-valve-between-patients-enough.html

Ask yourself;  Knowing that Dental Backflow is a proven fact, why do most offices continue to place patients at risk?

– If your patients knew the facts about backflow, would they want you to do something about it?