HARRISBURG – The office of Donald Robbins looks more like a science laboratory than a dental-exam room.
The Exton dentist uses an atomic spectrometer, intra-oral camera, and high-efficiency mercury air cleaner to keep his patients and staff free from mercury, an ingredient in fillings that some say can cause serious health problems.
Robbins is proud that his equipment is unusual for a dental office, although he thinks it shouldn’t be because it safely disposes of mercury, a common element of dental fillings.
Now Pennsylvania’s Department of Environmental Protection has entered the debate over the safe disposal of mercury. In partnership with the Pennsylvania Dental Association, the DEP has issued voluntary guidelines for how to dispose of mercury, which is highly toxic, especially in its basic form.
So-called amalgam fillings are the most commonly used and are composed of an alloy of mercury, silver and tin. When fillings are replaced or removed, waste containing mercury is produced.
Most dentists place the waste in special containers that are picked up and processed as hazardous material. There are instances, though, when a dentist might flush a portion of that waste down the drain while installing or removing fillings.
Under the voluntary program, DEP teams will visit dentists in 16 eastern counties – including those in the Philadelphia area – to check how they are disposing of the amalgam waste. Inspectors will also remove for recycling any basic mercury, now obsolete, that dentists might have in storage from years ago.
The dental program began in early July and will run for three months. It is part of a broader effort the DEP launched in January 2004 to reduce mercury in the environment.
“We’re gathering data to see if we should be doing regulatory activity or if the voluntary best-management program activities are sufficient in themselves,” DEP spokesman Charlie Young said.
While there is no consensus on how much dental mercury ends up in the water supply, some dentists, such as Robbins, see mercury not only as a threat to the environment but also as a danger to the patient, even as part of the amalgam alloy.
“This should be a Superfund toxic cleanup,” Robbins said. “If this much mercury was in the wastewater in the ground, it would be a major event to get it out.”
But most dentists, such as Najeed Saleh, a professor at the University of Pennsylvania School of Dental Medicine, agree that amalgam fillings pose no harm to the patient, unless the patient has allergies.
He said that some dentists use the slogan “mercury-free” to market their practices and that most of the concern over amalgam fillings is because of external environmental reasons.
If the DEP’s trial shows that dentists are not adhering to the mercury-disposal guidelines, then state regulators might mandate certain equipment for dental offices, said Stephanie Glecos, a spokeswoman for the Pennsylvania Dental Association.
One such device that might be required is an amalgam separator, which costs about $2,000. It removes more than 95 percent of the mercury from the waste and places the solids in a collection tank.
San Francisco and Washington state have gone a step further, requiring dentists to use amalgam separators.
In Philadelphia, Councilwoman Blondell Reynolds Brown has introduced a bill that would require amalgam separators in dental offices.
Still, some consumer activists said the state should ban amalgam fillings or at least require amalgam separators.
“It’s actually a farce. It’s ridiculous because they’re not mandating an amalgam separator to stop the mercury from going into the wastewater,” said Freya Koss, spokeswoman for Consumers for Dental Choice. “Volunteerism doesn’t work.”