Potential public health risks related to mercury/amalgam discharge from dental offices.

Mercury is a toxic and bioaccumulative metal. It exists in elemental, inorganic and organic forms. The use of mercury by the dental profession represents approximately 6 percent of the total annual domestic consumption and is estimated to contribute significantly to the discharge of mercury (14 percent in one study) to waste-water streams. Publicly owned treatment works (POTW) must obtain and comply with a National Pollutant Discharge Elimination System waste-water discharge permit. When minimal mercury discharge limits into surface waters are exceeded, an upstream search for contributors of mercury to the waste stream may result. Given the present sociopolitical environment, mercury discharge from dental offices will increasingly receive scrutiny. Strategies to minimize discharge of mercury/amalgam waste include engineering controls such as changes in the discharge process, changes in the composition of commercial products, and changes in control equipment. Governmental strategies include an outright ban, the setting of discharge standards, and educational efforts. Study of these strategies with evaluation of effectiveness is needed.