Part Two: Dental Carpules and Strawberries

April 1, 2008
My adventures to the store do not always lead me to my intended destination. There was my trek about a week ago when I left to get milk, and I got sidetracked by a garage sale.

by Noel Kelsch, RDHAP

My adventures to the store do not always lead me to my intended destination. There was my trek about a week ago when I left to get milk, and I got sidetracked by a garage sale. To my husband's utter frustration, I forgot the milk, but we acquired a large assortment of Christmas decorations for our front yard. Then just yesterday, I was waylaid once again by an urgent detour to the post office with a package I'd forgotten to send my daughter.

But today on a crisp, spring morning, I was determined to fill our fridge with milk! Just blocks from home I was distracted by a hand-painted sign in front of my favorite mom-and-pop market letting our small town know that the most luscious, red treats the size of golf balls were in the store ready to be taken home and savored. Customers were already lined up around the corner, just as they had been the year before.

I asked the woman in front of me what were they all waiting for and she said, "I came for the strawberries." "Me too!" I quickly replied, settling into my place in line. She had never intended to stop after dropping her children off at school. She was still wearing her magenta housecoat and slippers, but was so drawn in by the remembrance of last year's sweet strawberries that she could not resist. Several people joined in and echoed her sentiment. The talk of recipes and traditions made you feel comfortable, and time flew by as the line trickled into the store.

I looked at my watch and realized that I would soon be late for work, so I stepped into the store for the item I had originally come for — milk. I would have to skip the berries for now. To my surprise, the line I'd been in was curling around a desk where employment applications were being taken for a new store that would be opening soon.

I told the manager about the line confusion and he said, "Well, there is a sign outside! You just have to read it." When I left the store, I saw the sign but it was covered by a large group of people leaning against the wall. I took the sign and asked a tall gentleman to place it above the door where it could be read. I had just wasted a half hour following people who thought they knew what they were doing because they had done this before.

On the way to work, I thought about how my strawberry experience was a lot like infection control in dentistry. Setting up an infection-control protocol requires one to stop and think about the task at hand from start to finish — not just "follow the line" because everyone else is doing it. Even though you may have done it one way one year, you must read and check up on the most current information on each and every protocol.

Each item that we use has specific, important guidelines that accompany it so that we can keep our patients and ourselves out of harm's way. We must understand a complex set of regulations and scientific facts, as well as each new insert accompanying the product. Sometimes it is necessary to do more than just read the label. You must ask questions when instructions do not make sense and see why you must do what you are instructed to do. Understanding application is the core of the science of infection control.

Throwing something away seems an easy undertaking. But disposal of dental carpules involves understanding local, state, and federal regulations and agencies. These agencies and regulations are designed to keep you and your patients safe.

The first source of the information about disposal of dental carpules accompanies the product and is called the Material Safety Data Sheet (MSDS). Reading this insert can give you some information about the use and disposal of dental carpules. The MSDS for Xylocaine from DENTSPLY Pharmaceutical states that there is a very low health risk with normal handling of this product. It is not classified for dangerous transport and should be disposed of in accordance with state, local, and national legislation.

The next resource is the Occupational Safety and Hazard Association. OSHA regulates anything that could harm people on the job. Their answer was clear (See Table 1 at the "Download Center" in the "Resource Center" at After discussing the use and disposal with OSHA, I was directed to the federal Environmental Protection Agency to find out what the law was regarding disposal. The federal EPA informed me that each state has laws that may or may not reflect the federal standard. I was instructed to contact each state EPA agency. Nine months and 741 phone calls and e-mails later, I have some important answers for you (See Table 2 at the "Download Center" in the "Resource Center" at

Determining the proper disposal of dental products and materials is the responsibility of every dental professional. It is imperative that we understand all of the laws and regulations governing each task we perform.

About the Author

Noel Brandon Kelsch, RDHAP, is a freelance cartoonist, writer, and speaker. Noel's cartoons can be seen in RDH magazine and her articles have been published in both dental and nursing trade magazines, as well as books. She has received many national awards including Colgate Bright Smiles Bright Futures, RDH/Sunstar Butler Award of Distinction, USA magazine Make a Difference Day award, President's Service award, Foster Parent of the Year, and is a five-time winner of the Castroville (Calif.) artichoke cook-off! Her family lives in Moorpark, Calif. She can be contacted at [email protected].

Got An Infection Control Question?

The Organization for Safety and Asepsis Procedures (OSAP) is the world"s leading source of education and information promoting evidence-based infection control and safety policies and practices in dentistry. OSAP is the only evidence-based, nongovernmental organization in the world that concentrates solely on the provision of information, education, and publications on the subject of dental infection control and occupational safety and health. OSAP also has a unique constituency comprised of three major categories: clinicians, educators and trainers, and the dental industry. All three groups are represented on the Board of Directors and play a role in developing well-reasoned, science-based, practical solutions to the world"s complex infection control and safety issues.


Can dental carpules be disposed of in general trash?
Yes, in many states, if the carpule has been used and has not been broken, you may dispose of it in your general trash.

How should we dispose of syringes that do not have needles attached?
In most states, if a syringe does not contain a sharp or fluid blood (such as those used for irrigation), there is no need to discard it in a medical or biohazard container; it is simply discarded with the regular office waste. To ensure compliance, however, always consult your state and local regulations.

Tables 1-2 referred to in the article above can be found in the Download Center in the Resource Center at

Table 1 is a question-and-answer table with OSHA's determinations about dental carpules. Table 2 is a 50-state listing of EPA regulations regarding the disposal of dental carpules.