When I was in dental school, it was “against the rules” to give patients back their extracted teeth. I never really questioned this rule because I figured that not many people would really want their teeth back. When a patient would ask for their freshly extracted tooth, I would make up some excuse about how it was against regulations for me to give them their extracted tooth.
I remember a female oral surgeon let me bend the rules once with a teenager who begged for his extracted teeth, but she told me to keep it on the down-low.
So that’s what I learned in dental school and thought was gospel: Patients are not allowed to get their extracted teeth back.
There are many dentists that refuse to give patients their teeth after removal. I know of one that even gives kids a “Tooth Fairy I.O.U.” coupon in lieu of their extracted tooth and tells them to simply put that under their pillow and that the Tooth Fairy will understand.
But is it really necessary to go that far and be a Tooth Fairy Scrooge when it comes to giving patients their extracted teeth?
Let’s find out.
Can You Keep Your Extracted Teeth?
Yes, you can keep your extracted tooth. There are no federal laws or regulations that prohibit, let alone discourage, dentists from giving patients their extracted teeth.
Let’s take a look at some of the excuses dentists use to justify keeping extracted teeth that a patient requests to keep:
- “It’s infectious waste and could infect other people if I let you take it. I can’t be held liable for that.”
- “OSHA prohibits me from giving you back your extracted tooth.”
- “It’s against the CDC regulations for me to give it back.”
Below, I’ll discuss what the Occupational Safety and Health Administration (OSHA), and the Centers for Disease Control and Prevention (CDC) say about giving extracted teeth to patients.
What the Experts Say About Giving Extracted Teeth to Patients
According to OSHA’s Bloodborne Pathogen Standard, extracted teeth are considered potentially infectious materials and must be handled accordingly. When a dental office disposes of extracted teeth, they must be placed in medical waste containers. However, since OSHA only regulates employee interactions, not patient interactions, OSHA has no say in whether a patient can keep their extracted tooth as stated by the textbook, Cottone’s Practical Infection Control in Dentistry:
Extracted teeth can be returned to patients on request, at which time provisions of the federal OSHA standard no longer apply. Again, some state and local regulations may be more stringent, so it is best to be knowledgeable about applicable regulations in your local area.
In her book, Recommended Infection-Control Practices for Dentistry, (yep – it’s one of those books that you just can’t put down!) Barbara Gooch states the following:
The handling of extracted teeth used in dental educational settings differs from giving patients their own extracted teeth. Several states allow patients to keep such teeth, because these teeth are not considered to be regulated (pathologic waste) or because the removed body part (tooth) becomes the property of the patient and does not enter the waste system.
The CDC has stated that “Extracted teeth may be returned to the patients upon request and are not subject to the provisions of the OSHA Bloodborne Pathogens Standard.”
So now that we’ve addressed what the CDC and OSHA have to say about extracted teeth, let’s address the other excuse that dentists sometimes use: that the tooth is infectious waste and could pose an infection risk if they carry it out of the office.
Now obviously a tooth that has just been extracted does have some blood and saliva on it. However, it doesn’t require much time to quickly disinfect a tooth and rinse it off. Dentists already have protocols in place for disinfecting extracted teeth that need to be sent to dental labs. The CDC, when discussing sending extracted teeth to dental labs, states that:
[Extracted teeth] should be thoroughly cleaned (i.e., blood and bioburden removed), disinfected with an EPA-registered hospital disinfectant with a tuberculocidal claim, and thoroughly rinsed before being handled in the in-office laboratory or sent to an off-site laboratory.
Clearly this is a different scenario since we are talking about teeth being sent home with patients rather than being sent to dental labs. But I believe that if an office is disinfecting teeth before giving them back to patients, then it is highly unlikely that the teeth pose a greater infection risk than the person that the tooth came from, should they have a disease.
Now that we’ve established that there are no nationwide bans on dentists giving patients their extracted teeth, and that disinfected teeth are highly unlikely to cause infection, let’s explore state regulations.
Do State Dental Boards Allow Dentists to Give Patients Their Extracted Teeth?
I called the dental boards of the four most populous states in the United States as well as the dental board of Virginia, since that’s where I practice. These five states comprise over 35% of the population of the United States so it’s somewhat representative.
Here’s what the state dental boards had to say:
Unfortunately, California did not return my phone call. I left them a voicemail asking if they had any state regulations that would prevent a dentist from giving their patient a recently-extracted tooth.
Fortunately, I was able to spend some time digging through the laws, rules, and regulations governing the practice of dentistry in California and I am confident that they do not have any laws that would forbid a patient from taking their extracted tooth home.
The dental board in Texas had to research my question and then get back to me. When they did, they told me that as long as the tooth was sterile, it could be given back to the patient. I then clarified whether the tooth had to be sterile or just cleaned off, since sterilization would be time-consuming. They then told me that as long as I cleaned it off well, it would be fine to give it back to the patient.
When I called the state dental board of New York, the man I spoke with told me that I could only give baby teeth back to patients but that it’s not allowed to give adult teeth back to patients. I then threw him a curveball and asked about an adult tooth that had a gold crown on it that the patient really wanted back. He relented and said it would be fine as long as it was clean. When I asked him if New York had any written rules regarding this sort of situation, he said there were none.
Florida wins the gold medal for clarity, as they were the only state that actually covers this scenario in their state’s rules and regulations. The following is from their regulations, 64B5-25.007 Disposition of Biohazardous Waste.
(2) Extracted teeth may be rendered non-biohazardous by disinfection so that they may be returned to the patient or the patient’s legal guardian.
The kind lady that answered the phone at the Virginia Dental Board told me that my home state of Virginia does not have any rule or regulation that would keep a dentist from giving their patient an extracted tooth.
There Likely Are No Laws Preventing Patients from Keeping Their Extracted Teeth
It would be nearly impossible for me to search out every state and local regulation regarding extracted teeth, but I find it highly unlikely that a state or municipality would actually have a rule preventing dentists from giving people their extracted teeth.
I’ve pulled out lots of wiggly teeth for kids at no charge and I can’t imagine telling them that if I pull it out, their tooth is infectious waste, but if they pull it out at home, they can put it under their pillow.
Next let’s take a look at what on earth would compel someone to keep their extracted tooth…this is where things get interesting!
Why Would Someone Want to Keep Their Extracted Tooth?
I’ve extracted hundreds of teeth, but here’s one that stands out: We had just finished taking out a woman’s remaining teeth; about a dozen or so. She glared with hateful eyes at the dental tray and growled, “Where’s that brown one?! I’m taking that little $#@%&! with me. It’s given me a lot of trouble in my life.”
I smiled underneath my mask and told her she could have it. I pictured her taking the tooth to her backyard, hanging it from a tree and firing a round at it, blowing it to pieces.
Throughout my dental career, I’ve also heard several other reasons from people who want to keep their teeth:
- One patient was making a necklace of all her extracted teeth.
- An elderly lady wanted to show her grandchildren her tooth so that they wouldn’t repeat her oral hygiene mistakes. I admire her motivation, but hate to imagine the horrific look on that little grandchild’s face when he sees Granny’s rotten tooth!
- There are quite a few 20-something guys that simply want to show their teeth off to their friends.
- A gentleman from a foreign country wanted to take his tooth back to his native land and have it buried there.
- Many people believe that all parts of their body should be buried for religious purposes. There is quite a debate on Mi Yodela, a question and answer site about Judaism regarding the burial of body parts before and after death. I also came across a site on Islam burial practices which recommends that “teeth cut off or extracted during lifetime are also buried.” As I’m not a member of either of those faiths, I cannot vouch for these sites, but it does add an interesting dynamic to this debate.
- Many people keep a collection of their teeth. While this may be cute for baby teeth (I think my mom still has a 35mm film canister of my baby teeth somewhere), it’s not so cute for ugly, decayed adult teeth that needed to be pulled!
For whatever reason, many people hang on to their extracted teeth. According to users on this Ask forum, some people have kept their extracted teeth until they die, when the teeth have been sold at estate sales. One woman recounted the story of her dad keeping his extracted molars: “My dad has all of his extracted molars in with the tooth washers in his nuts and bolts organizer.”
What to Do When Your Dentist Won’t Give You Your Extracted Tooth
Some dentists may know that they are permitted to give patients their extracted tooth but still have the attitude of, “If you really wanted to keep this tooth, you should’ve taken better care of it, then you could’ve kept it — in your mouth.”
There are many cases reported by the media where patients have been upset that their dentist wouldn’t give them back their teeth. Here are a couple of those cases for your reading pleasure.
My favorite story has to be of a man who was so upset that his dentist wouldn’t give him back his extracted tooth, that he wrote to his elected representative, North Dakota Senator Kent Conrad. Senator Conrad wrote to OSHA on behalf of his constituent and OSHA replied that there is nothing in the bloodborne pathogen standard that would prevent a dentist from giving a patient back their teeth.
An Arizona woman, Becky Coty, had a tooth extracted with a gold crown and the dentist would not return it to her. After she contacted the local news channel, which published her story, the dentist reached out and compensated her for the tooth.
Unfortunately, there’s probably not much you can do (aside from trying to get some publicity) if your dentist doesn’t want to give you back your extracted tooth after it’s been taken out.
How to Keep Your Extracted Teeth
If you know that you want to keep your extracted teeth, it’s best to discuss this with your dentist in advance. Although there aren’t any laws prohibiting dentists from giving back teeth, I’m not aware of any laws that require dentists to give patients their extracted teeth upon request. It’s more of a gray area.
I recommend letting your dentist know ahead of time that you want to keep your tooth. That way the issue can be resolved beforehand. If your dentist resists the idea, you can always check around and you’ll likely be able find a dentist who will let you keep your extracted tooth.
My guess is that most dentists simply default to what they learned in dental school, which seems to vary. Unlike my school, New York’s Stony Brook School of Dental Medicine states in their Policies & Procedures Manual, “Return of extracted teeth to the patient is allowed, if the patient requests.”
Do you have any questions about extracted teeth and who they belong to? Any crazy stories about what people have done with their extracted teeth? I’d love to hear about them in the comments section below. Thanks for reading!