Disinfectants' effect on mercury release from amalgam

Background. Mercury environmental discharge is under increased scrutiny by the U.S. Environmental Protection Agency (EPA). Dental amalgam should be processed properly to prevent an additional environmental burden. Some processing agencies require that submitted amalgam be noninfectious. Investigations have demonstrated that oxidizing disinfectants mobilize mercury from amalgam into solution and add mercury to the environmental burden if it is disposed of improperly. The authors conducted a study to evaluate the effect of representative disinfectants on amalgam mercury release. Methods. The authors sized a high-copper spherical amalgam alloy to match that typically found in dental unit suction traps. They exposed 20 grams of the alloy to several disinfectant solutions and evaluated the filtered supernatant solution for mercury content. Results. Chlorine disinfectant materials discharged the most mercury ions, followed by bromide, iodophor, peroxide/peracetic acid and phenolic disinfectants. The quaternary ammonium compound did not discharge mercury ions above the detection limit (0.2 parts per billion) into solution. Conclusions. A quaternary ammonium compound did not mobilize mercury ions into solution when used as a disinfectant agent for amalgam. Chlorine disinfectants mobilized mercury ions the most, followed by bromide, iodophor, peroxide/peracetic acid and phenolic disinfectants. Clinical Implications. Dentists are obligated to be good environmental stewards and should follow practices that reduce environmental mercury release. Dental personnel should be aware that oxidizing disinfectants mobilize mercury ions into solution, which will be added to the environment if they are processed improperly. If required by processing, dental personnel should consider the different oxidizing effects of commonly used disinfectants.