Article
Green Dentistry in 2018?
I read with interest the article entitled ‘Green Dentistry in 2018?’ by Trevor Burke, published in your September 2018 issue. It was great to see prevention being highlighted as the key to environmentally sustainable dentistry, and the growing concern over single-use plastic items in healthcare.
During our role as scholars in sustainable dentistry, we distributed a questionnaire at the 2017 British Dental Industry Association (BDIA) Dental Showcase, through which 713 delegates were asked about their knowledge and participation in environmentally sustainable dental practice. The majority of the respondents were interested in environmental sustainability (77%) and sustainable waste management was prioritized by a high proportion of respondents. Dental practices generate a significant amount of waste, especially nitrile gloves and paper, and it is important that the dental team is aware of the environmental impact of poor waste management, which can lead to disposal of non-clinical waste in the clinical waste stream for incineration, increasing costs to the practice and potential harm to the environment.
Forty seven percent of respondents prioritized sustainable energy use in their practice, with sustainable travel considered least important (42%) by the dental team, despite recent studies showing that travel contributes the most carbon emissions within dentistry. The low priority given to travel emphasizes the need to provide dental practices with education and guidance on how to facilitate more sustainable travel options for staff and patients. The environmental impact of patient travel also needs to be considered in service planning. Over recent years, the NHS has increasingly centralized its dental service, increasing the distances travelled. However, a recent procurement of orthodontics for the NHS within Southern England has favoured smaller contract sizes, increasing the number and spread of orthodontic services, whilst making care more accessible to patients and reducing travel-associated carbon emissions.
Although a high proportion of respondents were interested in environmental sustainability and wanted to learn more about it, a low proportion (32%) knew their practices’ carbon footprints, possibly due to a lack of awareness and the resources to calculate it. There are carbon calculator tools available, however none is specific to dentistry. If dental practices were able to measure their carbon footprint easily they could directly see the impact of making sustainable changes to their practices.
Forty one percent of respondents thought that practising sustainable dentistry would decrease costs. It is quite reasonable that there would be a lack of knowledge within this area. There is currently limited research regarding cost savings related to sustainable dental practice, though the Plymouth University waste management research showed that implementing a waste reduction strategy can lead to monetary and carbon savings. One of our other projects this year involved creating a guide to sustainable dentistry, available at: https://sustainablehealthcare.org.uk/dental-guide. It's hoped that this resource will be used by practices to implement changes and generate more evidence about the cost-saving potential of environmentally friendly dentistry.
Compulsory education in environmental sustainability is currently absent from the undergraduate curriculum in many institutions. Incorporating environmental sustainability education into training curricula across the dental team could be an effective way to develop knowledge and skills for tackling the issue. Opportunities to carry out sustainable practice audits, projects and teaching may enhance awareness and the ability to practice sustainably, which people can continue to build on throughout their professional careers.
It was encouraging to hear that progress has been made in the 20 years since Trevor's initial article, including the widespread computerization of practices, digitization of radiographs and early movement towards CAD-CAM and intra-oral scanners. I would like to highlight the Centre for Sustainable Healthcare hosts Dental Susnet (https://networks.sustainablehealthcare.org.uk/network/dental-susnet) where new ideas, resources and research in sustainable dentistry can be discussed and disseminated, and I hope that as a profession we can embrace sustainability for the health of both our patients and planet.