Administration’s regulatory roadblocks stymie dental guidelines

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Photo: David Joyce via Flickr

At more than 100,000 offices and clinics across America, dentists stay busy placing and removing amalgam fillings as they care for their patients.

Dental amalgam – a mixture of metals such as silver, tin, copper and zinc bound together by mercury – is valued by clinicians for its workability, low cost and strength. Regulated as a medical device, dental amalgam is considered safe for most patients over the age of 6.

However, dental amalgam has an environmental downside. In the process of restoring teeth, the nation’s dental offices flush mercury and other metals into public water treatment systems each year. That disposal practice allows mercury to enter the food chain as methylmercury, a neurotoxin.

A federal rule announced in the final days of the Obama administration would have required dentists to install equipment designed to capture mercury and other metal waste for safe disposal and recycling.

The U.S. Environment Protection Agency stated that “compliance with this final rule will annually reduce the discharge of mercury by 5.1 tons as well as 5.3 tons of other metals found in waste dental amalgam” to public water treatment plants.

Leaders of organized dentistry had embraced the measure. “With the cost of implementation estimated at between $59 million and $61 million, the American Dental Association even called the final rule … a “fair and reasonable approach to the management of dental amalgam waste,”  wrote Josh Russell in a piece for Courthouse News.

Many dentists had already purchased the necessary equipment to comply, Tony Edwards reported in DrBicuspid.com.

The mercury rule was scheduled to become official on Jan. 24 with its publication in the Federal Register.

But in an Inauguration Day memorandum, President Donald Trump, who rode to victory amid promises to drastically slash regulations, instructed federal agencies to pull back scores of Obama administration rules that had not yet published.

“We’re going to be cutting regulation massively,” but the rules will be “just as protective of the people,” the president told reporters Jan. 23.

In compliance with the president’s order, the EPA withdrew the dental mercury rule.

One environmental group sued last month to save it.

“EPA’s withdrawal of the mercury rule is not just illegal, but senseless” contended Aaron Colangelo, litigation director at the National Resources Defense Council, in a statement announcing the lawsuit. “The rule imposes minimal burden, drew widespread praise from dental providers and benefits public health and the environment,”

The case, Natural Resources Defense Council v EPA et al., was filed in federal court in New York. Check out this new AHCJ fact sheet that will help you in localizing the story for your community.

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