Following a six-month delay, the U.S. Environmental Protection Agency (EPA) published its final rule governing the discharge of mercury and other metals entering the waste stream from dental practices. The effective date of the rule, which regulates dental practices that place or remove amalgam, is July 14, 2017. The compliance date for the rule is July 14, 2020. The EPA first finalized the rule requiring most dental offices nationwide to install amalgam separators in December 2016, but withdrew it following the White House's Jan. 20 memorandum ordering federal agencies to freeze all new or pending regulations.

Under the new standards, the amalgam separator must be compliant with either the American National Standards Institute (ANSI) American National Standard/ADA Specification No. 108 for Amalgam Separators (2009) with Technical Addendum (2011) or the International Organization for Standardization (ISO) 11143 Standard (2008), or subsequent versions so long as that version requires amalgam separators to achieve at least a 95 percent removal efficiency.

Dentists who already have separators are grandfathered for 10 years. Dentists who do not place amalgam and only remove amalgam in unplanned or emergency situations are also exempt. The new rules apply to dental offices, dental schools, and clinics that discharge water to a municipal treatment plant. The regulation exempts mobile units or offices where the practice "consists only" of the following specialties: oral pathology; oral and maxillofacial radiology; oral and maxillofacial surgery; orthodontics; periodontics; and prosthodontics. Dental offices must also submit a compliance report and have maintenance and inspection records available.

Impact on General Dentistry: The AGD weighed in with the EPA when the regulation was first proposed in Nov. 2014 and engaged with the EPA throughout the rulemaking process. A fact sheet pertaining to the new standards can be found here.