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Practice Tips #24: Amalgam Separators

The Right Amalgam Separator for You

Dental amalgam has frequently been in the news and the FDA is planning on meeting in December of 2010 to further discuss the classification of amalgam.

While amalgam is a cost-effective restorative material, when introduced into the waste stream, amalgam can be broken down into its constituent components (most often through incineration during the waste treatment process). This can release into the environment the mercury that comprises roughly 50% of amalgam. Regardless of ones feelings on this charged issue, further legislation seems likely.

Many areas require installation of amalgam separators on dental office waste lines. The American Dental Association lists an ISO11143 certified amalgam separator as part of their BMP’s (see ADA website here).

What is ISO 11143?
ISO is the International Organization for Standardization, 11143 is the number assigned to the standard developed by representatives of member countries (including the United States) to determine the requirements for dental amalgam separators and the means to verify (test) the efficiency thereof.

A committee comprised of numerous industry experts including manufacturers and dentists spent several years to create the most recent revision of the standard. ISO 11143 requires amalgam separators to remove at least 95% of all amalgam from the waste stream.

Many local regulations exceed this requirement asking for 99% removal. While amalgam separators have been in use for a long time (primarily in Europe), the most recent revision of standard 11143 was approved in 2008, so it accurately reflects current concerns and technologies.

When looking for an amalgam separator, the first thing to verify is ISO 11143 certification and at what efficiency. As it is specified in many regional regulations, most separators on the market are certified at or above 99% efficiency (such as all models carried by American Dental Accessories, Inc.). To be certain, verify your local requirements and get certification from the dealer for whatever separator you purchase. They should verify it meets or exceeds your local requirements.

Certification will often need to be made available for local regulators – be it sent in or simply available for any inspectors that may happen to visit (this will vary according to local regulations). Many areas have lists of approved separators, but these are often infrequently updated. While inclusion of a separator on this list is helpful, exclusion is not necessarily conclusive.

Additionally, check your local regulations for any special stipulations covering installation. Do you have a cuspidor? Most areas where cuspidors are frequently used have them specified in the regulations and require the cuspidor also drain into a separator. This would normally require either purchasing a separator that can operate under a gravity feed (such as the AD-1500) or using a vacuum drain kit to connect your cuspidor to the central vacuum.

How Big of a System Do You Need?
Consider the needed capacity. How many operators will the unit serve? Are you a solo practitioner? Do you have an associate? Group practice? How many operatories? Make certain that the system you get has the capacity you need. Most systems are rated for a certain number of operatories and have a longevity based on the total number of users.

Where is Your Install Location?
Most systems will install in one of two locations, either chairside or at the central vacuum. Chairside systems are generally smaller and will only serve one chair (as the name implies). Often the cost of two or even three chairside systems can be less than one central system. Systems installed at the central vacuum are designed to serve the entire office. Make sure if you get a central system that it is rated for as many operatories as you have. Most separators try to be as compact as possible, but check the dimensions of what you’re getting and compare that to where it will be installed. Make sure you have enough room to install it.

What About Cost?
Once you’ve determined what system(s) meet your local regulations and have the capacity you require, you can start to compare costs. When looking at cost, the initial purchase price is only one part of the equation. You should also compare recurring costs, replacement separator cartridges, disposal, and any other maintenance costs. The ADA recommends amortizing costs on an annual basis to determine ongoing maintenance costs.

For example, if one system sells for $700 and has a replacement cartridge that sells for $500 and is expected to last 6 months, you’ve got a projected cost of $1700 for the first year and $1000/year thereafter. If another system sells for $800 with a cartridge that sells for $600 but the cartridge is rated for 18 months, you’ve got a cost of $1400 for the first year and $400/year every year thereafter.

Additionally, some systems include disposal of filled cartridges in the replacement cartridge cost. Be sure to take this into consideration as well.

If you have a waste hauler that already disposes of amalgam scrap (chairside traps etc.) who can cheaply or easily add any filled separator cartridges to the pick-up it may be better to use a system that doesn’t have extra charges added in for disposal. However, if seperate disposal is something that you can’t easily arrange or which will be more costly, having disposal taken care of with the replacement cartridge may be more cost effective for you.

In addition to the purchase price, you may need to factor in installation costs. For units installed at the central vacuum, you will often need to hire a plumber or dental technician to perform the installation for you. An interruption of the (typically) PVC vacuum lines will need to be made, additional lines may need to be routed, the separator may even need to tie into your existing ventilation. Some central systems also use electricity, so additional accommodation may need to be made to provide power to the system. This may also require the services of an electrician. Naturally, central systems will serve the entire office.

If using chairside systems, you will need to install one in each room, so add the costs of the total number of units to determine if this is truly more economical than a central system. Typically, the break-even point is 3 rooms. Chairside units (such as the Asdex AS-9 or the Simple One) are normally much simpler to install as they will typically install on the flexible vacuum drain hose from the chairside trap. These systems can often be installed in just a few minutes by untrained staff using little more than a scissors and a screwdriver.

AS-9 installation instructions

As more regulations come into existence, it becomes more important to increase your knowledge of the available options.

American Dental Accessories, Inc.

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