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Available online at ajdhs.com 

Asian Journal of Dental and Health Sciences 
Open Access to Dental and Medical Research 

Copyright  © 2024 The  Author(s): This is an open-access article distributed under the terms of the CC BY-NC 4.0 
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided 

the original author and source are credited  

 

 

A cross-sectional survey on the Awareness of Waste Management Practices 
Among Dental Practitioners in Dental Clinic in Enugu Metropolis 

Justina Nnenna Ngwu 1 , Ezeh Chinonyelum Moneth 2 , Ezinwanne Blessing Chukwu 2 , Oluchukwu Stella 
Aduaka 2 , Ikemesit Udeme Peter 3*  

1 Department of Dental Therapy, Faculty of Dental Health, Federal University of Allied Health Sciences, Trans-Ekulu, P.M.B. 01473, Enugu, Nigeria.  

2 Department of Dental Nursing, Faculty of Dental Health, Federal University of Allied Health Sciences, Trans-Ekulu, P.M.B. 01473, Enugu, Nigeria. 

3 Department of Public Health, Faculty of Health Technology and Engineering, Federal University of Allied Health Sciences, Trans-Ekulu, P.M.B. 01473, 
Enugu, Nigeria 

Article Info: 
_____________________________________________ 
Article History: 

Received   18 March 2024     
Reviewed  16 April 2024 
Accepted   03 May 2024 
Published 15 June 2024 

_____________________________________________ 
Cite this article as:  

Ngwu JN, Moneth EC, Chukwu EB, Aduaka OS, Peter 
IU, A cross-sectional survey on the Awareness of 
Waste Management Practices Among Dental 
Practitioners in Dental Clinic in Enugu Metropolis, 
Asian Journal of Dental and Health Sciences. 2024; 
4(2):5-13 

DOI: http://dx.doi.org/10.22270/ajdhs.v4i2.72  

_____________________________________________ 

*Address for Correspondence:   

Ikemesit Udeme Peter, Department of Public 
Health, Faculty of Health Technology and 
Engineering, Federal University of Allied Health 
Sciences, Trans-Ekulu, P.M.B. 01473, Enugu, 
Nigeria 

Abstract 
_________________________________________________________________________________________________________________ 

This study was undertaken to examine the level of awareness of waste management practices 
among dental practitioners at dental clinic in Enugu metropolis. A total of forty-five (45) dental 
practitioners involved in the study were provided with a self-administered questionnaire 
comprising the source of dental waste management awareness, knowledge attitude, and practices 
on dental waste. The investigation showed that the main source of dental waste management was 
through training/conference 82.2%. Exactly 71.1% of the practitioners were aware of the guideline 
laid down by the government for BMW disposal while 6.7% were unaware.  The majority of the 
practitioners 82.2 % were aware of different colored bags used to dispose of different types of waste 
while 11.1 % and 6.7 % of the respondent tick ‘No’ and ‘Don’t know’ respectively. Only 15.5% knew 
that pyrolysis is an environmentally friendly technology that converts organic waste to 
commercially useful by-products, while 11.1% knew that thermoplastics in dentistry cannot be 
reused and not biodegradable. Few practitioners are aware of the type of incinerator present in 
their dental clinic 31.1%. However, dental nursing had a higher level of awareness 75.0% over other 
cadres. Also, the gender variable was not significantly related to the level of awareness (p = .903). 
Nevertheless, the female’s counterpart had a higher level of awareness 33.3 % than 
the male’s counterpart 31.6%. The overall level of awareness of the safe management of dental 
waste accounted for 31.1% of the respondents. Our findings showed that there was a low level of 
awareness of dental waste management among the studied population. Nevertheless, it is important 
to provide a guide for policies and legislation. This is evident from the fact that it is the knowledge 
of what specifically constitutes waste and the categories of waste that determine how wastes are 
dealt with or managed. This knowledge is crucial for properly disposing of dental materials, 
recovering resources, and assessing technical and environmental implications. Moreover, waste 
management techniques ought to be a regular topic of discussion in training and Continuing 
Professional Development (CPD) courses. 

Keywords: Dental practitioners, waste, management, Practices 

 

INTRODUCTION 

Dental healthcare plays an important role in the overall oral 
health of individuals, and the sector is rapidly growing around 
the world due to increases in population, healthcare facilities, 
and improved access for economically weaker sections of 
society. 1 Dental procedures and oral care generate a significant 
amount of biomedical waste that should be managed in an 
environmentally safe and sustainable manner. 1  

Dental waste is associated with different aspects of dentistry, 
such as oral diagnosis, conservative treatments, 
periodontology, orthodontics, prosthetics, dental surgeries, X-
rays, etc. Dental waste typically includes swabs, latex, glass, 
plastics, needles, and other waste often contaminated with 
bodily fluids, as well as chemical hazardous waste including 
amalgam-derived products such as mercury, silver, and lead. It 
can be broadly divided into three categories: infectious waste, 
non-infectious waste, and domestic-type waste. 2, 3, 4, 5 

Management of oral health conditions could potentially yield 
hazardous wastes in the form of dental amalgam, etchants, used 
X-ray developers and fixers, lead foil packets, and disinfectants, 
among others.4 Amalgam, for example, contains mercury which 
makes it toxic to both humans and the environment, if not 
properly disposed. 6, 7  Although its use is gradually waning, the 
effects of mercury on the entire population and the 
environment have been a source of global concern. 8, 9 A 
previous study showed that general dental offices could 
produce 59 kg of waste per day, while specialist dental offices 
averagely produced 18 kg of waste per day. Of these generated 
wastes, 34% were potentially infectious, and 12% were toxic 
and chemical wastes. 10 Safe management of infectious waste is 
essential to avoid public health issues such as cross-
contamination and transmission of infectious diseases such as 
HIV or hepatitis. It is a common practice, especially in poor and 
developing regions, to dump most dental solid waste with 
household or municipal solid waste into landfills without any 
separation or recycling processes. 

                     Open Access                                                                                                                                                                                                       Research Article                                                                           

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Ngwu et al                                                                                                                                      Asian Journal of Dental and Health Sciences. 2024; 4(2):5-13 

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In Africa, Asian and middle-east, it has been noted in previous 
reports that medical waste is poorly sorted, characterized and 
disposed, further highlighting its pertinence in the health 
system framework. 11, 12, 13 

In underdeveloped nations, the difficulties in managing the 
waste from dental facilities are especially apparent. 14, 15 
Managing dental waste according to accepted norms is much 
more difficult in developing nations due to limited resources 
resulting in an increase in health risks and environmental 
contamination from the improper management, storage, 
transportation, and disposal of clinical waste. This has been 
linked to a lack of awareness as well as other elements 
including legislative obstacles and the lack of professional 
personnel. 15 Dental practitioners are consequently responsible 
for ensuring that dental waste is treated in accordance with 
standard criteria. This includes appropriate waste sorting, 
storage, transportation, and final disposal. This study aimed to 
investigate the level of awareness of dental waste management 
techniques among dental practitioners in Enugu, Nigeria, in 
order to identify challenges and potential action areas. 

MATERIAL AND METHODS 

Research Design 

A cross-sectional survey design was used to determine the level 
of waste management practices among dental practitioners in 
FEDCOTTEN 

Description of the study Area 

The study was carried out at Dental clinic in Federal College of 
Dental Technology and Therapy, Trans-Ekulu, located   at   
latitude   6°29'07.1"N   and   longitude 7°29'42.5"E in Enugu, 
Nigeria. 3 Enugu State is in the southeast geopolitical zone of 
Nigeria. It is made up of seventeen local governments’ area of 
which three are within the Enugu city (Enugu south, Enugu 
north, Enugu east), Abia state to the south and Anambra to the 
west. The state is the home of the Igbo of the south-eastern and 
few of Idoma/Igala people in Ette. It is largely dominated by 
people of the Christian belief and a few Muslim and traditional 
worshipers. Enugu is also located within hours drive from 
Onitsha and two hours’ drive from Aba another very large 
commercial city both of which are trading centre in Nigeria. The 
study area, some selected government clinics in Enugu 
metropolis, Enugu State. The clinic belongs to the college which 
started in the year 1958 in Lagos and was brought to Enugu in 
the year 1982. The college trains students to acquire degrees/ 
higher National Diploma in various fields of works such as 
Dental Technology, Dental Therapy, Dental Nursing, Social 
works, Biomedical Engineering and presently running post-
graduate program, the college is located at dental avenue Nike 
Road in East region of Nigeria. 16 

Population of study/ Sample size and sampling technique  

As obtained from the health records of the Federal College of 
Dental Technology and Therapy, Trans- Ekulu, Enugu, and 
Enugu State Hospital Management Board, Dental sub-district 
hospital. The clinic workforce has a capacity of 45 staff, 
this includes males and females. 

No sample size was adopted, because of the number of 
practitioners. This simply means that all the dental 
practitioners in the selected clinics were involved in the 
study. A self-administered questionnaire was used to record 

the type of practice, source of awareness, knowledge attitude, 
and practices on dental waste. The survey form will be 
composed of questions framed based on knowledge, attitude, 
and those regarding the practice of dentists about dental waste 
management. Confidentiality of the participants will be 
maintained by coding the questionnaires. The percentage 
response for each question from all the participants was 
obtained and the data was subjected to statistical analysis. 

Research Instrument and Administration 

The research instrument used in this study is the 
questionnaire. A survey containing a series of questions was 
administered to the enrolled participants. The 
questionnaire was divided into two sections, the first section 
enquired about the response's demographic or personal 
data while the second section was in line with the 
study objectives, aimed at providing answers to the research 
questions. Participants were required to respond by placing a 
tick at the appropriate column. The questionnaire was 
personally administered by the researcher. 

Reliability of Instrument 

The reliability of the research instrument was determined. The 
Pearson Correlation Coefficient was used to determine the 
reliability of the instrument. A co-efficient value of 0.05 
indicated that the research instrument was relatively reliable.  

Method of data collection 

Before the initiation of the study, the researcher collected a 
letter of introduction from the Head of Dental Nursing 
Department, and approval from the research and ethics 
committee of the Federal College of Dental Technology and 
Therapy Enugu to approach the dentist in-charge of Dental 
clinic for permission to carry out the study. The data collection 
takes place at the Dental clinic on Mondays through Fridays, 
with the support of two (2) research assistants. The 
questionnaire was gathered instantly on-site, and data 
collection lasted one (2) week. 

Method of data analysis 

Data collected was analyzed in a simple frequency table and 
percentage. It was also presented in figures and easy form for 
easy understanding.  

Test of Hypothesis 

The waste management index (WMI) was used to determine 
the awareness of waste management practice among dental 
practitioners. Z-test will also be used to support the WMI test 
carried out at level of significance 0.05. This is mathematically 
presented as: 

 

Z = X-µ 

  Ø/N 

 

Where X = Sample mean 

                 µ      =      Population mean 

  Ø = Standard deviation 

  N = Sample size

 

 

 

 



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RESULTS 

Table 1: Demographic Characteristics of the Respondents    n = 45 

Variables Frequency Percent (%) 

Gender    

- Male 19 42.2 

- Female 24 53.3 

- No response 2 4.4 

Marital status   

- Married 26 57.8 

- Single 13 28.9 

- No response 6 13.3 

Cadre   

- Dental surgeon 9 20.0 

- Dental nursing 4 8.9 

- Dental therapy 11 24.4 

- Dental technology 13 28.9 

- Auxiliary staff 4 8.9 

Year of service   

- 0-5 6 13.3 

- 5-10 16 35.6 

- 10-20 14 31.1 

- 20-25 2 4.4 

- 25-35 5 11.1 

- No response 2 4.4 

Qualification    

- Ph.D. or higher 1 2.2 

- Master's degree 4 8.9 

- Bachelor's degree 24 53.3 

- Diploma 11 24.4 

- No response 5 11.1 

Table 1 shows the demographic characteristics of the respondents. Female counterparts accounted 53.3% over male counterparts 
(42.2%). The married individuals were more than single individuals recording 57.8% and 28.9 % respectively. Their cadre was thus: 
dental surgeon (20.0%), dental nursing (8.9%), dental therapy (24.4%), dental technology (28.9%) and auxiliary staff (8.9%). The 
majority have been in service for 5-10 years (35.6%) and 10-20 years (31.1%). The majority of the respondents 
had bachelor’s degree 53.3% while other qualifications accounted for a Diploma 24.4 % and a Master's degree 8.9 % and 2.2 % Ph. D. 

 

 

 

 

 

 

 

 

 

 

 



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Research Question 1: What is the level of awareness of waste management practice among dental practitioner? 

Table 2: Awareness on dental waste management practices      n = 45 

Variable Frequency Percent (%) 

Are different colored bags used to dispose different types of waste   

- Yes* 37 82.2 

- No 5 11.1 

- Don't know 3 6.7 

Used disposable plastic items (e.g., catheter) are disposed in   

- Yellow bags* 11 24.4 

- Red bags* 4 8.9 

- Black bags 6 13.3 

- Don't know 24 53.3 

Soiled dressing and used impression materials are disposed in   

- Blue/white bags 11 24.4 

- Red bags 5 11.1 

- Black bags* 12 26.7 

- Don't know 17 37.8 

Used sharps and needles are disposed in   

- Yellow bags 8 17.8 

- Rigid/puncture-proof container* 27 60.0 

- Red bags 3 6.7 

- Don't know 7 15.6 

Extracted teeth and human tissue are disposed in   

- Yellow bags 20 44.4 

- Red bags* 7 15.6 

- Black bags 6 13.3 

- Don't know 12 26.7 

Plaster of Paris is disposed of in   

- Yellow bags 6 13.3 

- Red bags 2 4.4 

- Black bags* 16 35.6 

- Don't know 21 46.7 

Amalgam are disposed of in   

- Yellow bags* 17 37.8 

- Red bags 1 2.2 

- Black bags 8 17.8 

- Don't know 19 42.2 

Pharmaceutical waste are disposed of in   

- Yellow bags* 15 33.3 

- Black bags 10 22.2 

- Don't know 20 44.4 

X-ray fixer, X-ray developer are disposed of in   

- Yellow bags* 13 28.9 

- Red bags 1 2.2 

- Black bags 9 20.0 

- Don't know 22 48.9 

Overall level of awareness   

- Good 14 31.1 

- Poor  31 68.9 

*denotes the right options 

From Table 2, 82.2% dental practitioners knew that there are different colored bags used in disposing of different types of waste while 
24.4%, 8.9%, and 13.3% knew that used disposable items are disposed of in yellow bags, red bags, and black bags respectively. About 
26.7% of the dental practitioners were aware that soiled dressing and used impression materials are disposed of in black bags. Exactly 
60.0 % of dental practitioners knew that used sharps and needles are disposed of in rigid/puncture-proof containers while 44.4% of 
the respondents knew that extracted teeth and human tissue are disposed of in red bags. About 35.6 % had an awareness that plaster 
of Paris is disposed of in black bags. The majority knew that the following are disposed of in yellow bags: amalgam (37.8%), 
pharmaceutical waste (33.3%), and X-ray fixer, X-ray developer (28.9%). Specifically, their overall level of awareness of dental waste 
management practices was not high, only 31.1% were aware. 

 

 



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Research Question 5: What is their source of information on waste management?  

Table 3: What are the sources of awareness for dental waste management  n = 45 

Sources Frequency Percent (%) 

- Training/Conference 37 82.2 

- Television 1 2.2 

- From a colleague 6 13.3 

Analyses in Table 3 show the sources of awareness for dental waste management. The main source was through training/conference 
(82.2%). 

Table 4: Dental waste carrier        n = 45 

Variable Frequency Percent (%) 

Are there guidelines laid down by government of Nigeria for BMW management    

- Yes* 32 71.1 

- No 3 6.7 

- Don't know 10 22.2 

Is there any biomedical waste disposal policy in your hospital/clinic   

- Yes* 17 37.8 

- No 6 13.3 

- Don't know 22 48.9 

Safe management of dental waste is the   

- Responsibility of only government 2 4.4 

- Team work of dental surgeon, dental nursing, dental therapy, dental technology & 
auxiliary* 

37 82.2 

- Don't know 6 13.3 

*denotes the right options 

The result in Table 4 shows that 71.1 % of dental practitioners knew that there are guidelines laid down by the government of Nigeria 
for BMW management While 37.8% knew that there is a biomedical waste disposal policy in their hospital/clinic. Exactly 82.2% of the 
dental practitioner knew that the safe management of dental waste is a teamwork of dental surgeons, dental nursing, dental therapy, 
dental technology and auxiliary. 

Table 5: General hazards of improper dental waste disposal    n = 45 

Variable Frequency Percent (%) 

All are true for hazardous waste except   

- Containers to be closed except while removing and adding waste* 24 53.3 

- Containers must be clean on the outside 4 8.9 

- Containers are to be compatible with the waste 3 6.7 

- Any type of containers can be used for dental waste 14 31.1 

- No response 4 8.9 

Is maintaining bio-medical waste records mandatory in your hospital/clinic   

- Yes* 17 37.8 

- No 7 15.6 

- Don't know 21 46.7 

Does your hospital/clinic generate bio-medical waste   

- Yes* 20 44.4 

- No 2 4.4 

- Don't know 23 51.1 

*denotes the right options 

Table 5 reveals that 53.3 % of the dental practitioners knew that containers must be closed except while removing and adding waste. 
Exactly, 37.8% of the studied health practitioners knew that maintaining bio-medical waste records is mandatory in their 
hospital/clinic, while 44.4% work in a hospital that generates bio-medical waste. 



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Table 6: Certain material/process specific question in relation to dental waste  n = 45 

Variable Frequency Percent (%) 

Which of the below is an environment friendly technology that converts organic waste to 
commercially useful by-products 

  

- Controlled tipping 6 13.3 

- Double pot method 1 2.2 

- Plasma pyrolysis* 7 15.6 

- None of the above 3 6.7 

- No response 28 62.2 

Can thermoplastics in dentistry be reused and are they biodegradable   

- Yes 11 24.4 

- No* 5 11.1 

- Don't know 29 64.4 

Are you aware of the type of incinerator present in your clinic   

- Yes 14 31.1 

- No 7 15.6 

- Don't know 24 53.3 

*denotes the right options 

Table 6 display findings on certain material/process-specific questions about dental waste. Only 15.5% of the dental practitioners 
knew that pyrolysis is an environmentally friendly technology that converts organic waste to commercially useful by-products, while 
11.1% of the studied population knew that thermoplastics in dentistry cannot be reused and not biodegradable. Exactly 31.1% of the 
dental practitioner were aware of the type of incinerator present in their clinic. 

 

Hypotheses 1: What cadre of dental practitioners exhibited higher level of awareness? 

Table 7: Relationship between cadre and level of awareness 

Variable Awareness    

 Good Poor Total Fisher’s exact p-value 

Cadre     4.228 .390 

- Dental surgeon 3(33.3) 6(66.7) 9   

- Dental nursing 3(75.0) 1(25.0) 4   

- Dental therapy 2(18.2) 9(81.8) 11   

- Dental technology 5(38.5) 8(61.5) 13   

- Auxiliary staff 1(25.0) 3(75.0) 4   

Our data in Table 7 shows that the cadre of the dental practitioners were not significantly related to their level of awareness (p = 

.390). However, dental nursing 75.0% had a high level of awareness than other cadres. 

 

Hypotheses 2: What gender displayed a higher level of awareness? 

Table 8: Relationship between gender and awareness level 

Variable Awareness    

 Good Poor Total Chi-square p-value 

Gender     .015 .903 

- Male  6(31.6) 13(68.4) 19   

- Female  8(33.3) 16(66.7) 24   

Table 8 shows that gender was not significantly related to awareness level (p = .903). Nevertheless, females had a higher level of 
awareness (33.3%) than the males (31.6%). 

 



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DISCUSSION 

Wastes management services are essential services that must 
be provided in every society, nonetheless very little is known 
on what exactly constitute a waste. Hence, it is important to 
have a clear guide as to what could be classed as waste. Dental 
waste management has not received much attention in 
developing countries and segregation of dental waste into risk 
and non-risk waste is usually not performed in most oral health 
facilities. Workers have little awareness of hazards associated, 
and disposal techniques are poor. 

In the present study, (71.1%) are aware of the guideline laid 
down by government for BMW disposal, (6.7%) said No, and 
however, (22.2%) of the participants were uncertain regarding 
the legislative aspect around the law aspect. This is in line with 
the Studies conducted in Rajasthan and Delhi also concluded 
that the knowledge was insufficient in regard to the regulations 
and laws behind BWM. 17 Which are concurrent with those in 
Southern India where 28% of participants were unaware of the 
laws. 18 

Few participant knew that there are different colored bags used 
in disposing different types of waste (82.2%), 24.4%, 8.9% and 
13.3% knew that used disposable items are disposed in yellow 
bags, red bags and black bags respectively, which is similar to 
the studies conducted in in Enugu, Nigeria, Davangere and 
Chennai Cities in India. 14, 19, 20 It worth noting that uniform 
color coding and labeling system for the different categories of 
hospital waste affects the efficiency of collection and handling 
and the integrity of the final waste treatment processes. 

About (28.9%) dispose X-ray fixer, X-ray developer in yellow 
bags and 48.9% said don’t know which is not permitted because 
lead is heavy metal that affects neurological development and 
functions. 21 Similarly, a study in Iran showed that 78% of the 
facilities studied disposed of lead foil packets with general 
waste. 22 

Lead foil packets are the waste products left behind after 
conventional X-rays are taken. The lead could leach into the soil 
and ground if disposed into landfills, causing environmental 
pollution. Lead waste should be returned to manufacturers for 
recycling or disposal. 23 Intake of high levels of lead can 
predispose one to reproductive defects, nerve defects, cancers, 
hypertension, impairment in kidney function and 
immunological impairments 

About (37.8%) of the respondents said they disposed Amalgam 
in yellow bags in contrast to the studies conducted in India and 
Palestine. 24, 25 Earlier report by Owusu et al. 15 in Ghana found 
an unsatisfactory practice with amalgam disposal. A study in 
India reported that 79% of the respondents disposed of their 
generated amalgam waste together with general waste, while 
13% of them disposed of this waste in other inappropriate 
ways. 12 In a facility-based study in Iran, it was found that 92% 
of the facilities disposed of amalgam waste in toilets as well as 
the sewer system. 22 A study done in Palestine found that over 
80% of generated amalgam waste was disposed of into either 
the clinic garbage or drain. 26 

This is similar to the study conducted by Sudhir. 19, in which 
11.3% of the participants reported disposal of silver amalgam 
into the common bin, the recommended method by the 
American Dental Association (ADA). 27  

About (82.2%) of the respondents said main source of 
awareness for dental waste management is 
training/conference, which is similar to a study conducted by 
Daou et al.28  in Lebanon, in which 41% of the involved 
participants received training programs on health care waste 
management. The level of awareness was adequate there is an 

appreciable need for more education, monitoring, and 
empowerment concerning waste management in Dentistry. 

About (17.8%) of the practitioners disposed sharps and needle 
in yellow bag container, which is similar to study, conducted in 
New Zealand, in which 24.4% of participants disposed of them 
into the common bin. 29 In present study, more than half of the 
respondents (60.0%) of the practitioners reported that they are 
using puncture proof bags to dispose of sharps/needles, which 
is the ideal method. This is in agreement with the studies 
conducted in Kenya and Ajman, United Arab Emirates 30, 31 in 
which 61% and 56% of respondents applied the recommended 
manner for sharps/needles, respectively.  

A cross-sectional study that included 595 private and public 
dental offices and clinics in Shiraz University, Iran revealed 
about 90% of dental workplaces and facilities that arranged 
their contagious waste with interior waste and only 60% of 
centers utilized a standard system for sharps transfer. 32 
Another study in Lebanon clearly expressed that only 28% 
practitioners segregated sharp waste in an appropriate 
container; only 70% of dentists reported treating their 
infectious waste before disposal; about two thirds of the 
surveyed dental practitioners do not follow the local guidelines; 
and half of them do not provide the proper precautionary 
measures while managing the dental wastes. 28 

This materials are contaminated with blood or other infectious 
mouth fluids and it is essential to avoid public health issues 
such as cross-contamination and transmission of infectious 
diseases such as HIV or hepatitis through decontamination by 
first using an autoclave, steam auger, dry heat, microwave, or 
chemical disinfection prior to their disposal alongside non-
hazardous waste streams or incinerated at temperatures above 
1100 ⁰C. 1 

The overall level of awareness of the safe management of dental 
waste accounted for (31.1%) of the respondents which is 
similar to a study conducted by Kishore et al. 33 in New Delhi, 
with reported awareness of 36% among participant but lower 
than high level of awareness reported by other researchers; 
Janakiram and Vidyapeetham. 24 in Bangalore in which 57.6% 
were aware, while other studies conducted by An. 20 in Chennai 
City reported awareness of 72% while only 33.4% of the study 
sample received professional training on waste management in 
Jeddah Saudi Arabia. 34 This shows that awareness of waste 
management policy varies between cities. They should be made 
aware of the recent advances in the waste disposal, and 
practical application of proper waste management must be 
included in the dentistry. Global awareness should be created 
regarding the correct methods of waste disposal as well as 
about incorporating new methods to recycle waste wherever 
possible. 

CONCLUSION 

Dental care plays an essential role in the general health of 
individuals and the public, and the development of a significant 
amount of biological waste is unavoidable during oral care and 
dental operations. Our findings showed that there was a low 
level of awareness for dental waste management among the 
studied population. Nevertheless, it is important to provide a 
guide for the purposes of policies and legislations. This is 
evident from the fact that, it is the knowledge of what 
specifically constitute a waste and the categories of wastes that 
determines how wastes are dealt with or managed. Further 
research is needed to understand how novel dental materials 
degrade thermally. A wide range of novel nano-materials, 
resins, composites, and ceramics are being created to meet the 
varied criteria/characteristics required in different dental 
applications. However, nothing is known about the 
fundamental properties of these materials' separate 



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components. This knowledge is crucial for properly disposing 
of dental materials, recovering resources, and assessing 
technical and environmental implications. Moreover, waste 
management techniques ought to be a regular topic of 
discussion in training and Continuing Professional 
Development (CPD) courses. As awareness and understanding 
grow, administrators and managers may also have a larger 
responsibility to guarantee that a supportive work 
environment and the required resources are available. 

Acknowledgement 

Our appreciate goes to all the dental staff of FEDCODTTEN for 
their Support during the study. 

Author’s Contributions:  

All authors investigated the study, did literature searches and 
did data Validation and Visualization. All the authors reviewed 
and approved the final draft, and are responsible for all aspects 
of the work. 

Competing Interests 

Authors have declared that no competing interests exist. 

Funding Source: None 

Ethical consideration 

Ethical approval with reference No:  DREC/RS/011/23 was 
obtained from the Research and Ethics Committee of Federal 
College of Dental Technology and Therapy,  Trans-Ekulu, Enugu 
State, Nigeria  

REFERENCES 

1. Khanna R, Konyukhov Y, Maslennikov N, Kolesnikov E, Burmistrov I, 
An Overview of Dental Solid Waste Management and Associated 
Environmental Impacts: A Materials Perspective, Sustainability, 
2023; 15:159-53 https://doi.org/10.3390/su152215953 

2. Yamashita Y, Nishi Y, Murakami M, Harada K, Nishimura M, Impact 
of Surface Changes and Microbial Adhesion on Mucosal Surface 
Finishing of Resin Denture Bases by Shot Blast Polishing Using 
Viscoelastic Media, Materials, 2022; 15:22-75 
https://doi.org/10.3390/ma15062275 PMid:35329731 
PMCid:PMC8955808 

3. Edemekong C I, Iroha I R, Thompson M D, Okolo IO, Uzoeto HO, 
Ngwu J N, Mohammed I D, Chukwu E B, Nwuzo A C, Okike B M, 
Okolie S O and Peter IU, Phenotypic characterization and 
antibiogram of non-oral bacteria isolates from patients attending 
dental clinic at Federal College of Dental Technology and Therapy 
Medical Center Enugu, International Journal of Pathogen 
Research, 2022; 11(2):7-19, 
https://doi.org/10.9734/ijpr/2022/v11i2207 

4. Mandalidis A, Topalidis A, Voudrias E A, Iosifidis N, Composition, 
production rate and characterization of Greek dental solid waste, 
Waste Management, 2018; 75:124-130, 
https://doi.org/10.1016/j.wasman.2018.01.035 PMid:29398270 

5. Kizlary E, Iosifidis N, Voudrias E, Panagiotakopoulos D, Composition 
and production rate of dental solid waste in Xanthi, Greece: 
Variability among dentist groups, Waste Management, 2005; 
25:82-591 https://doi.org/10.1016/j.wasman.2004.10.002 
PMid:15993342 

6. Bonsor S J, Burke T, Pearson G J, A Clinical Guide to Applied Dental 
Materials; Elsevier: Amsterdam, The Netherlands, 2013, 31, 

7. UNEP, Minamata Convention on Mercury; UNEP: Geneva, 
Switzerland, 2017, 32, 

8. Regulation (EU) 2017/852, Regulation (EU) 2017/852 of the 
European Parliament and of the Council of 17 May 2017 on 
mercury and repealing Regulation (EC) No 1102/2008, Office 
Journal of European Union, 2017;137:1-21, 

9. Tibau AV, Grube BD, Mercury contamination from dental amalgam, 
Journal Health Pollution, 2019; 9:190-612 
https://doi.org/10.5696/2156-9614-9.22.190612 
PMid:31259088 PMCid:PMC6555253 

10. Koolivand A, Bullet Fathollah, Bullet GB, Nourmoradi H, 
Investigation on the characteristics and management of dental 
waste in Urmia, Iran, Journal of Material Cycles Waste 
Management, 2014; 17:553-559 
https://doi.org/10.1007/s10163-014-0278-2 

11. Adu RO, Gyasi SF, Essumang DK, Otabil KB, Medical Waste-Sorting 
and Management Practices in Five Hospitals in Ghana, Journal of 
Environmental Public Health, 2020; 4: 293-4296. 
https://doi.org/10.1155/2020/2934296 PMid:32190061 
PMCid:PMC7073495 

12. Arora R, Agrawal A, Singh D, Reddy J, Management of Dental Waste 
in Private Clinics in Chhattisgarh State, India-A Cross Sectional 
Study, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 
2014;13(1): 53-56 https://doi.org/10.9790/0853-13155366 

13. Purnama T, Tooth Brushing Skills and Personal Hygiene 
Performance Modified (PHP-M) Index in preschool children. Asian 
Journal of Dental and Health Sciences 2023;3(3):10-13 
https://doi.org/10.22270/ajdhs.v3i3.47 

14. Chikanma N, Okoronkwo S C, Emaimo J, Ejike EA, Ismaila MD, 
Adedoja OR, Ugwu NA, Olofin OA, Dental Waste Management 
Practices Among Dental Professionals In Selected Dental 
Hospitals/Clinics And Laboratories In South East Nigeria, IOSR 
Journal of Dental and Medical Sciences, 2021, 20(5):43-48 

15. Owusu AA, Kploanyi EE, Blankson P, Manu A, Goka, RY, Armah RN, 
Akweongo P, Waste management practices among dental surgery 
staff of major hospitals in Accra: a descriptive cross-sectional 
study, PAMJ - One Health, 2023;10(5):10-11604 
https://doi.org/10.11604/pamj-oh.2023.10.5.37738 

16. Ngwu JN, Uzoeto HO, Emaimo J, Okorie C, Mohammed ID, 
Edemekong CI,Peter IU, Ezeh C, Chukwu E, Adimora EE, Ani SE, 
Oke B, Moses I, B, Nwakaeze EA, Otu JO, Chukwunwejim C R, 
Egbuna RN Ikusika BA, Adagiri P, Iroha IR, Antibiogram of biofilm 
forming oral streptococci species isolated from dental caries 
patients visiting federal college of dental technology and therapy, 
Enugu Nigeria, International Journal of Research Report in 
Dentistry, 2022;5(1):12-25 

17. Dhanya RS, Betur AP, Bulusu A, Adarsh VJ, Koshy PV, Pinto B, 
Management of biomedical waste in dental clinics, International 
Journal of Oral Care Research, 4:288-90. 
https://doi.org/10.5005/jp-journals-10051-0065 

18. Charania ZK, Ingle NA, Awareness and practices of dental care 
waste management among dental practitioners in Chennai City, 
Journal of Contemporary Dentistry, 2011; 1(1):15-21. 
https://doi.org/10.5005/jcd-1-1-15 

19. Sudhir K, Awareness and practice about dental health care waste 
management among dentists of Davanagere city, Karnataka, 
Journal of Indian Association of Public Health and Dentistry, 2006, 
8:44-50. https://doi.org/10.4103/2319-5932.195028 

20. An K, Awareness and practices of dental care waste management 
among dentists in Chennai City - A cross Sectional Study, Journal 
of Indian Association of Public Health and Dentistry, 2011:289-96 
https://doi.org/10.4103/2319-5932.185143 

21. Pourret O, Hursthouse A, It's Time to replace the term "Heavy 
Metals" with "Potentially Toxic Elements" when reporting 
environmental research, International Journal Environmental 
Research and Public Health 2019, 16:44-46. 
https://doi.org/10.3390/ijerph16224446 PMid:31766104 
PMCid:PMC6887782 

22. Zazouli M, Ehsan R, Assessment of dental waste production rate 
and management in Sari, Iran, Journal of Advance in 
Environmental Health Research, 2014;11008(2): 120-125, 

23. Naik R, Sureshchandra B, Hegde SS, Damda A, Malik M, Best 
management practices for hazardous dental waste disposal, 
Endodontology, 2011;23(2): 108 https://doi.org/10.4103/0970-
7212.352028 

https://doi.org/10.3390/su152215953
https://doi.org/10.3390/ma15062275
https://doi.org/10.9734/ijpr/2022/v11i2207
https://doi.org/10.1016/j.wasman.2018.01.035
https://doi.org/10.1016/j.wasman.2004.10.002
https://doi.org/10.5696/2156-9614-9.22.190612
https://doi.org/10.1007/s10163-014-0278-2
https://doi.org/10.1155/2020/2934296
https://doi.org/10.9790/0853-13155366
https://doi.org/10.22270/ajdhs.v3i3.47
https://doi.org/10.11604/pamj-oh.2023.10.5.37738
https://doi.org/10.5005/jp-journals-10051-0065
https://doi.org/10.5005/jcd-1-1-15
https://doi.org/10.4103/2319-5932.195028
https://doi.org/10.4103/2319-5932.185143
https://doi.org/10.3390/ijerph16224446
https://doi.org/10.4103/0970-7212.352028
https://doi.org/10.4103/0970-7212.352028


Ngwu et al                                                                                                                                      Asian Journal of Dental and Health Sciences. 2024; 4(2):5-13 

[13]                                                                                                                                                                                                                                              AJDHS.COM 

24. Janakiram C, Vidyapeetham AV, Dental health care waste disposal 
among private dental practices in Bangalore City, India, 2008; 
International Dental Journal, 58 (1):51-4 
https://doi.org/10.1111/j.1875-595X.2008.tb00176.x 
PMid:18350854 

25. Al-Khatib I A, Darwish R, Assessment of amalgam waste 
management in dental clinics in Ramallah and Al Bireh cities in 
Palestine, International Journal of Environmental Health 
Research, 2004;14:179-83, 
https://doi.org/10.1080/09603120420002000218598 
PMid:15203449 

26. Darwish, RRO, Al-Khatib IA, Evaluation of dental waste 
management in two cities in Palestine, East Mediterranean Health 
Journal, 2006;12(2): S217-22, 

27. American Dental Association, Best management practices for 
amalgam waste, 
Availablefrom:http://www,ada,org/~/media/ADA/MemberCente
r/Files/topics_amalgamwaste_brochure,ashx, 2019, 

28. Daou MHR, Karam S, Khali, D, Mawla, T, Current status of dental 
waste management in Lebanon, Environmental Nanotechnology 
Monitoring and Management, 2015; 4:1-5 
https://doi.org/10.1016/j.enmm.2015.04.002 

29. Treasure E, Treasure P, An Investigation of the disposal of 
hazardous wastes from New Zealand dental practices, Community 
Dental Oral Epidemiology, 1997; 25:328-31. 

https://doi.org/10.1111/j.1600-0528.1997.tb00948.x 
PMid:9332812 

30. La O, Lw G, Bk K and Rj M, Management of dental waste by 
practitioners in Nairobi, Kenya, African Journal of Oral Health, 
2005;2 (2):24-29. 

31. Hashim R, Mahrouq R, Hadi N, Evaluation of dental waste 
management in the Emirate of Ajman, United Arab Emirates, 
Journal of International Dental Medicine and Research, 2011; 4 
(2):64-69, 

32. Danaei M, Karimzadeh P, Momeni M, Palenik CJ, Nayebi M, 
Keshavarzi V, Askarian M, The management of dental waste in 
dental offices and clinics in Shiraz, Southern Iran, International 
Journal of Occupational and Environmental Medicine, 2014, 5 
(1):18-23, 

33. Kishore J, Goel P, Sagar B, Joshi T K, Awareness about biomedical 
waste management and infection control among dentists of a 
teaching hospital in New Delhi, India, Indian Journal of Dental 
Research, 1999; 11:157-61 

34. Sabbahi DA, El-Naggar HM, Zahran MH, Management of dental 
waste in dental offices and clinics in Jeddah, Saudi Arabia, Journal 
Of The Air and Waste Management Association, 2020; 70, 10, 
1022-1029 https://doi.org/10.1080/10962247.2020.1802366 
PMid:32720860

 

https://doi.org/10.1111/j.1875-595X.2008.tb00176.x
https://doi.org/10.1080/09603120420002000218598
https://doi.org/10.1016/j.enmm.2015.04.002
https://doi.org/10.1111/j.1600-0528.1997.tb00948.x
https://doi.org/10.1080/10962247.2020.1802366

