When people think of going to the dentist, the vast majority of them undoubtedly think of dental treatment, but it turns out that the actual journey to the clinic in fossil fuel-powered vehicles has an impact far beyond the dental care itself.
A report on the UK dental industry by Public Health England found that travel by clinic staff and patients accounted for more carbon emissions than any other activity associated with dental clinics, at 33.4% and 31.1% respectively.
This is also confirmed by an ongoing project by researchers at McGill University in Montreal, Canada. Professor Christopher Beddoes of the School of Dentistry and Oral Health Sciences said: “Everything we do generates emissions.
In dentistry, one of the biggest culprits is transportation. Transporting patients to and from the clinic accounts for almost a third of total emissions.”
There are a number of strategies that can be used to mitigate this problem. The most obvious is to use teledentistry to reduce travel for staff and patients. Professor Beddoes believes that digital technology is essential to this transformation: “Imagine that you have a tooth extracted.
Instead of returning to the clinic for an examination, we can complete the examination through video conferencing software (such as Zoom) or by phone.”
Other emerging initiatives include developing active travel options for staff and patients, such as cycling or walking, and promoting the use of public transportation and electric vehicles whenever possible.
Waste management in dental clinics, including wastewater management, is also a key aspect of sustainable dentistry. As society’s awareness of sustainable development gradually becomes popular, the harm caused to the environment by the disposal of dental materials such as amalgam has attracted the attention of not only the clinical community but also the government.
According to the International Dental Tribune, the European Parliament decided last year to completely ban the use of amalgam, which will come into effect on January 1, 2025. In addition to complying with these regulations, dental clinics can also minimize waste generation through a series of simple but effective measures.
For example, digital technology reduces the need for impression trays and physical models, and virtually eliminates the need for paper copies of patient medical records. In addition, clinics can introduce recycling measures, correctly separate clinical and non-clinical waste, and deal with food waste through composting.
Dental practices have identified energy efficiency as a core area where they can meaningfully and directly reduce their ecological impact. The primary measure in this regard is to retrofit the practice with more efficient technologies. The first key step for a practice is to conduct an energy audit, a process by which the practice’s total energy use is systematically combed through.
From here, a number of areas for improvement can be identified. Initially, this may require the introduction of new heating, ventilation, and air conditioning systems. In addition, the practice could consider replacing existing dental equipment with more energy-efficient equipment. In-house power generation, particularly through solar power, could also be considered.
The final area to consider is preventive oral care. These measures are already quite familiar to the dental profession, including working with regulators to promote initiatives such as community water fluoridation programs and supervised toothbrushing programs for young children in areas where risk factors for oral disease and poor oral health are highest.
Each strategy designed to achieve sustainability has its inherent time and financial commitments, some of which may be considered prohibitive or cost-prohibitive. While conducting dental practice in an environmentally friendly manner may be desirable, for some it may be seen as an economic trade-off that they are unwilling or unable to implement.
Speaking to World Dental Forum, Dr Nicholas Martin, Professor of Restorative Dentistry at the University of Sheffield, UK, and a leading researcher in sustainable dentistry, articulated this paradox: “The challenge is that as individuals we tend to separate our social responsibilities as environmental citizens from our professional, work-related duties.
The latter are primarily concerned with achieving treatment outcomes in a cost-effective manner, while environmental citizenship becomes secondary or redundant.
We need to extend our responsibilities as environmental citizens beyond our personal or social roles, such as in our homes or communities, to our work environments, which are dental practices.”
Whether this means rebalancing the focus on profitability is more of an attitudinal question than a financial imperative, in Professor Martin’s view: “Preventing oral disease is the most important and effective way to help the people we serve, while, as an unintended consequence, achieving the greatest environmental benefits.
However, the different legislative and financial frameworks within which the dental profession operates around the world ignore this approach, instead focusing on remuneration for interventional, surgical treatments.
The solution seems obvious, but elusive!” From this perspective, a clinical focus on oral health and tangible patient care, rather than solely pursuing profits, is the most effective way to build a sustainable, ethical and economically sound dental practice.
A final important point is that regulatory frameworks related to sustainable dentistry vary widely from country to country. A report from the European Federation of Periodontology last year noted: “Countries such as Sweden and Germany have strong regulatory frameworks to promote sustainability, making it easier for dental practices to invest in green technologies.
In contrast, southern and eastern European countries may still struggle with economic constraints and less stringent environmental regulations. In these regions, local efforts and initiatives are essential to promote sustainable development in dental care.”
This passage highlights an essential element of any sustainability initiative, namely how regulatoryly difficult it is to achieve.
In countries with a strong policy framework, the shift to an environmentally friendly practice is not only encouraged, but may also be accelerated through incentives and subsidies; whereas in countries lacking such guidelines, improving sustainability may not only be entirely the responsibility of the practice, but may also be increasingly restrictive from a financial perspective.
Therefore, the transition to a higher level of sustainability in the dental industry is essential, but it also comes with a range of challenges and barriers.
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