Clinical Guide Adaptation for Amalgam Waste Management in Dental Settings in Iran.

Dental clinics are one of the major producers of mercury-containing waste due to the use of dental amalgam.  The atmospheric transport and persistence of mercury and its compounds in the environment, coupled with their high potential for bioaccumulation and detrimental effects on human health and ecosystems, underscore the necessity for effective management of mercury waste. Due to the lack of comprehensive and integrated guidelines for the effective management of dental amalgam waste in Iran, the objective of this study was to adapt a guideline for the management of amalgam waste in dental settings within the country. The method used was based on the adaptation principles presented by the Ministry of Health and Medical Education, and included searching and reviewing guidelines related to the management of amalgam waste in developed countries, extracting recommendations, revising the recommendations considering the local infra-structures and conditions, and receiving expert opinions and reaching consensus according to the RAND/UCLA Appropriateness Method. The final guideline includes 34 recommendations in 5 areas: manage-ment of the amalgam scraps, considerations for dental equipment, management of the extracted teeth containing amalgam restorations, management of the amalgam capsules, and considerations for placement and replacement of the amalgam restorations. The use of this guideline in medical universities, public and private dental clinics, along with the supervisory role of the Ministry of Health and Medical Education, can be a way to minimize the environmental hazards of mercury.