“Sustainable,” “eco-friendly” and “green.” These terms describe environmentally-centered business practices and products that have grown exponentially in recent years, in tandem with the rising consciousness of our species’ environmental impact. Although some might be tempted to dismiss this as another buzzword-based marketing trend, in reality, it’s indicative of a greater movement that began decades ago.
In the 1960s – after a century of rapid industrialization, urbanization, and population growth – emerging evidence showed that these developments came at a grave cost to natural conditions around the world. In the United States, those effects included widespread deterioration of water, soil and air quality, as well as the devastation of entire ecosystems. In response to growing concerns, the country formally committed to a more sustainable trajectory, reflected in the signing of the National Environmental Policy Act of 1969 (NEPA) and the subsequent establishment of the Council on Environmental Quality (CEQ) and Environmental Protection Agency (EPA).
The existential threat of climate change looms larger than ever, serving as a constant reminder that we must prioritize environmental sustainability to ensure our current health and that of future generations. Although governments and a select few industries undeniably bear the bulk of responsibility (proportionate to their environmental impact), all individuals and businesses – including dental practices – can contribute to the welfare of our planet by making the shift toward sustainability.
Environmental concerns in dental practice
Primary threats to the environment include pollution, natural resource depletion and carbon dioxide (greenhouse gas) production. The latter, caused by the burning of landfill waste and fossil fuels (such as coal, natural gas, and oil) is arguably the most detrimental because it also is the greatest driver of global warming. Modern dental practice not only involves high use of resources like water and electricity but also excessive waste and pollutant generation. In turn, the average dental practice’s carbon footprint – a measure of greenhouse gas emissions produced either directly or indirectly – is significant.
Much of this harmful footprint comes from waste produced in the name of infection prevention: The Eco-Dentistry Association (EDA) reports that U.S. dental practices collectively discard an estimated 680 million single-use, infection control–related plastic and paper products annually (chair barriers,
light handle covers, patient bibs), as well as 1.7 billion sterilization pouches. Countless gloves, masks, suction tips, saliva ejectors, needles, and other single-use products also are disposed of daily, most of which contain nonbiodegradable materials. In addition, dental practices generate 3.7 tons of mercury waste each year and consume 9 billion gallons of water annually.
The 3 r’s: opportunities for sustainable dentistry
Considering this data, it becomes clear that dental offices have wide-ranging opportunities to practice sustainability and improve their impact on the environment. And the good news is that they needn’t sacrifice infection prevention or patient care to achieve their green goals. By following the 3 R’s – reduce, reuse, recycle – practices can minimize negative environmental effects while maintaining high treatment and safety standards.
Reducing waste and resource consumption
According to the EDA, recycling frequently is considered the first-line solution to handling waste but reducing and reusing are far more effective. In dentistry, the reduction component offers the most opportunities for sustainability and centers on minimizing landfill waste as well as conserving water and electricity. A first step practices can take is reducing the number of single-use plastics they use (while maintaining asepsis) – examples include cutting back on frequently used items such as surface barriers, homecare product bags, plastic cups, high-volume evacuation (HVE) tips, scrubs, and gloves, and considering eco-conscious, biodegradable (or reusable) alternatives. Similarly, practices should aim to purchase supplies in bulk to reduce shipping waste (which accounts for 33% of all garbage). Going digital likewise reduces paper use.
Minimizing hazardous and chemical waste is another way dental offices can practice environmental responsibility. A study funded by the American Dental Association (ADA) found that dentistry contributed more than 50% of mercury entering wastewater, so it’s important for practices to ethically handle and dispose of all amalgam waste and consider focusing on alternatives to amalgam restorations. As of July 2020, the EPA requires that most dental offices install amalgam separators but choosing equipment that meets their standards is key.
Other steps to manage hazardous and chemical dental waste include transitioning from traditional radiographic film to digital imaging solutions and using cleaning solutions and disinfectants that are enzyme-free, biodegradable and free of volatile organic compounds.
Lastly, dental practices should work to conserve water and electricity by monitoring use and upgrading systems. Powering off all electronic equipment after use and purchasing Energy Star-rated devices serves to save electricity, as does using LED lights, which can reduce energy consumption by 70%. On the other hand, vacuum systems are undoubtedly the greatest culprits of water consumption in dentistry, using upward of 360 gallons per day. Switching off systems when not in use, retrofitting existing equipment for efficiency, and installing waterless (dry) vacuum alternatives are all ways to minimize water use and practice green dentistry.
Reusing and substituting infection control items
As mentioned, single-use infection control items are the primary source of waste produced by dental offices. Therefore, choosing reusable substitutes whenever possible goes a long way toward achieving a greener practice. Alternatives include cloth sterilization bags and patient barriers – items that have long proven to provide adequate infection control in hospital operating rooms – as well as washable cloth lab coats in place of disposable paper ones.
According to the EDA, transitioning from two-ply paper, one-ply plastic patient bibs to reusable ones, a single practice can divert as many as 40,800 pieces of paper and 20,400 pieces of plastic from the landfill each year. More items that can be replaced with reusable alternatives are face shields, gloves, and air/water syringes, as well as impression trays and suction tips, both of which can be swapped with sterilizable, stainless steel versions.
Recycling dental instruments and equipment
Though recycling is, as the EDA says, a “last resort” option for environmental conservation, it’s still an essential part of going green. Suggestions for best recycling practices include partnering with an instrument recycling program and sharps disposal service; instead of adding to landfill waste, old, discarded items can be repurposed as industrial metals and other building materials. Similarly, working with a medical shredding company ensures that paper waste is properly recycled while also maintaining HIPAA compliance.
Finally, some dental organizations, like the University of Michigan School of Dentistry, have had success with the implementation of a glove recycling program. According to their projections, even if only 1 in 8 gloves is recycled, such a program can potentially divert an estimated 2,000 lbs. of waste from the landfill annually.
Reimagining dental care
For many dental practices, environmental responsibility may seem like a remote concern. After all, they aren’t the ones cutting down great swaths of forests or spilling oil into the oceans. But, as environmentalist Paul Hawken explains in his 1993 book The Ecology of Commerce, “The ultimate purpose of business is not, or should not be, simply to make money. Nor is it merely a system of making and selling things. The promise of business is to increase the general well-being of humankind through service, a creative invention and ethical philosophy.” Dentistry is inherently a business that centers on care – for the health and well-being of patients and team members alike. By making sustainable choices, practices can take this core ethos to its natural conclusion, fulfilling their ultimate purpose of caring not only for the community but also for the entirety of the planet.
Products for green dentistry
There are many routes practices can take on the road to going green, but choosing products designed with sustainability in mind is a great place to start. Ask your Patterson rep about environmentally friendly dental products and for ways your practice can go green.
Eco-Dentistry Association. Green dentistry.
Kamodia S. Glove recycling case study: University of Michigan School of Dentistry case study. Greening the Dental Clinic.
Vogell S, Azzam M. Basic concepts of green dentistry. Decisions in Dentistry. March 13, 2020.
This article originally appeared in the December edition of OnTarget. Read the latest edition and view current promotions at pattersondental.com/dental/ontarget.
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