Is Your Dental Office Waste Handler Part of the Mob?

Michael W. Davis, DDS
The Godfather, Paramount Pictures, 1972


The Godfather, Paramount Pictures, 1972

Organized crime has infiltrated the legitimate business of waste handling.1 Most of the original five crime families of New York City had some involvement in the waste disposal industry. Further, certain companies handling hazardous dental waste also have allegedly been highly problematic.2-4 We’ve seen everything from inappropriate and unlawful disposal of amalgam waste in public landfills to allegedly highly abusive contracts.

If the waste handler declares bankruptcy or simply disappears, the liability for potential cleanup rests upon the originator of the waste. That means the dental clinic owner could ultimately be financially and legally responsible for the acts or inactions of others. This certainly includes the beneficial dentist owner of a dental practice or even the nominal (figurehead) dentist owner of a corporate practice.

Due diligence must be exercised in review of hazardous waste management contracts. One can’t simply rely upon verbal representations. Too often the contracts are for an extended established time period, which the dentist can’t easily rescind.

Some are self-renewing, unless the handler is advised in writing by a given date. Some agreements have had a very reasonable initial fee for hazardous waste removal, followed by grossly exorbitant fee increases thereafter. It’s not unusual for handlers in areas with little competition to charge fees three to four times in excess of the going rates of more competitive regions.

The hazardous waste handler should supply the dental clinic owner with a manifest that confirms the date of waste pickup, where it was transported to, and finally the date of destruction or recycling. The handler also generally supplies proper containers for sharps disposal as well as properly color-coded storage containers for materials exposed to liquid bodily waste.

You should: 

  • Verify the waste handler’s Environmental Protection Agency (EPA) license and number.
  • Thoroughly read and review the hazardous waste handler’s contract. If the contract is written in excessive legalese, have your attorney review the contract or select another handler.
  • Do a background check on the waste handler. Is the handler supported by your state or district dental society? Can you access other clients (doctors) to verify the handler’s support for that company? Does the handler have a history of possible malfeasance or misrepresentations, based on an internet search?


  1. Phipps M. 10 Businesses Supposedly Controlled by the Mafia. How Stuff Works;
  2. Davis MW. A Review of the ADA Mercury Hygiene Recommendations. Dentistry Today Jan 1, 2003;–sp-1049442323
  3. Soderlund K. Stericycle Contracts: Read the Fine Print. ADA News Jun 20, 2016;
  4. Karmasek J. Illinois Federal Judge Preliminarily OKs $295 Million Settlement in Stericycle Class Action. Legal News Line Nov 2, 2017;

Dr. Davis practices general dentistry in Santa Fe, NM. He assists as an expert witness in dental fraud and malpractice legal cases. He currently chairs the Sante Fe District Dental Society Peer-Review Committee and serves as a state dental association member to its house of delegates. He extensively writes and lectures on related matters. He may be reached at or

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