Green dentistry: the art and science of sustainable practice.

Dentistry is highly energy and resource intensive with significant environmental impact. Factors inherent in the profession such as enormous electricity demands of electronic dental equipment, voluminous water requirements, environmental effects of biomaterials (before, during and after clinical use), the use of radiation and the generation of hazardous waste involving mercury, lead etc have contributed towards this. With rising temperatures across the world due to global warming, efforts are being made worldwide to mitigate the effects of environmental damage by resorting to sustainability concepts and green solutions in a myriad of ways. In such a scenario, a professional obligation and social responsibility of dentists makes it imperative to transform the practice of dentistry from a hazardous to a sustainable one, by adopting environmental-friendly measures or 'green dentistry'. The NHS in the UK has been proactive in implementing sustainability in healthcare by setting targets, developing guidance papers, initiating steering groups to develop measures and implementing actions through its Sustainable Development Unit (SDU). Such sustainable frameworks, specific to dentistry, are not yet available and even the scientific literature is devoid of studies in this field although anecdotal narratives abound. Hence this paper attempts to present a comprehensive evaluation of the existing healthcare sustainability principles, for their parallel application in the field of dentistry and lays out a blueprint for integrating the two main underlying principles of sustainability - resource use efficiency and eliminating or minimising pollution - in the day-to-day practice. The article also highlights the importance of social values, community care, engaging stakeholders, economic benefits, developing policy and providing leadership in converting the concept of green dentistry into a practised reality.

What's in a bin: A case study of dental clinical waste composition and potential greenhouse gas emission savings.

BACKGROUND: Dental practices have a unique position as dental staff use a high number of dental materials and instruments on a daily basis. It is unclear how dentists' and dental care professionals' choices and behaviours around selecting and using materials impact on the amount of unnecessary waste production. Although there are a number of articles exploring the quality and quantity of waste in dental practices, there are no studies on organisational strategies to decrease unnecessary waste. There is no clear economic analysis of the impact on associated cost to dental practices which consequently can affect the access of dental care for disadvantaged groups. METHODS: This study used an audit approach to explore the potential for sustainability in dental practice by measuring the nature and quantity of dental clinical waste, and assessing the feasibility of measuring the financial costs and potential carbon savings in the management of dental clinical waste. CONCLUSIONS: The data from our study would appear to support the view that it is possible to reduce carbon emissions and increase profitability. Successful implementation of an environmentally sustainable approach to waste management will be dependent on the practicalities involved and the financial incentives for adopting such practices.

Going green with eco-friendly dentistry.

Eco-friendly dentistry is currently transforming the medical and dental field to decrease its affect on our natural environment and reduce the amount of waste being produced. Eco-friendly dentistry uses a sustainable approach to encourage dentists to implement new strategies to try and reduce the energy being consumed and the large amount of waste being produced by the industry. Many reasonable, practical and easy alternatives do exist which would reduce the environmental footprint of a dental office were it to follow the 'green' recommendations. Dentist should take a leading role in the society by implementing 'green' initiatives to lessen their impact on the environment. This article provides a series of 'green' recommendations that dentists around the world can implement to become a leading Stewards of the environment.

Managing the phase-down of amalgam: part II. Implications for practising arrangements and lessons from Norway.

The announcement of the Minamata Convention has triggered the lead into a phase-down in the use of dental amalgam. This paper considers aspects of this development in the context of the experience of banning the use of dental amalgam in Norway. It is suggested that strong top-down leadership and joined-up working by all relevant stakeholders, including patients, may be one of the most important keys to an effective, seamless transition to the provision of preventatively orientated, patient-centred, minimally interventive operative dentistry, based on state-of-the-art selection and application of tooth-coloured restorative materials. The benefits of such a transition are considered to be an important goal for dentistry in the UK.

Evidence summary: can plastics used in dentistry act as an environmental pollutant? Can we avoid the use of plastics in dental practice?

Since August 2009, members of the Primary Care Dentistry Research Forum (www.dentistryresearch.org) have taken part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question that receives the most votes each month forms the subject of a critical appraisal of the relevant literature. Each month a new round of voting takes place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website. The paper below details a summary of the findings of the twelfth critical appraisal. In order to address the question, searches of the literature were conducted to identify any articles discussing or evaluating the use of plastic in dental practice, or interventions that might reduce the use of plastics in dental practice. There were no studies identified that directly answered the question of this review. In a narrative review, environmental audit was suggested as a strategy that could help dental practitioners make more informed decisions in their practice; but there were not any studies that evaluated this. Further studies are need to demonstrate what proportion of dental waste includes plastics and whether specific interventions such as environmental audit can decrease the amount of plastic use and waste along with improving other environmental outcomes.

Gerenciamento dos resíduos radiológicos em consultórios odontológicos da cidade de Pelotas (RS, Brasil) / Radioactive waste management in dental offices from the city of Pelotas (RS, Pelotas)

Objetivo: Avaliar a segregação, tratamento e destino dos resíduos radiológicos dado pelos cirurgiões dentistas de Pelotas que possuem aparelhos de raios-X em uso no consultório odontológico e cadastradosna Vigilância Sanitária; e analisar o conhecimento dos mesmos acerca de sustentabilidade. Materiais e Métodos: Quarenta cirurgiões-dentistas de Pelotas-RS responderam um formulário contendo 16 perguntas que abordaram o conhecimento destes profissionais sobre a sustentabilidade, separação dos componentes sólidos do filme radiográfico, tratamento das soluções processadoras no consultório, destino final dos resíduos e uso correto do gerenciamento como ferramenta de marketing. Resultados: Verificou-se que 35,0% da amostra relatou lançar o revelador e o fixador em esgoto comum sem antes neutralizá-los. A maioria dos participantes (67,5%) afirmou acreditar no potencial poluidor da água de lavagem do filme durante o seu processamento, embora 65,0% deles relataram descartar o material diretamente em esgoto comum. Com relação à segregação dos resíduos sólidos, 37,5% dos dentistas disseram não separar os componentes do filme radiográfico. A maior parte deles (90,0%) afirmou ter conhecimento sobre desenvolvimento sustentável, 95,0% tentavam preservar o meio ambiente quando descartavam os resíduos do seu consultório e 70,0% acreditavam que a destinação apropriada dos resíduos poderia se mostrar economicamente viável. Conclusões: A maioria dos profissionais afirmou ter conhecimento de desenvolvimento sustentável e tentar preservar o meio ambientequando descartavam os resíduos produzidos no consultório. Há dificuldade, por parte dos cirurgiões-dentistas, no descarte dos efluentes líquidos, mas grande parte consegue classificar e segregar adequadamente os resíduos do filme radiográfico.

Amalgam use and waste management by Pakistani dentists: an environmental perspective.

To assess amalgam use and waste management protocols practised by Pakistani dentists, a cross-sectional study was made of 239 dentists in Islamabad and Rawalpindi, recruited by convenience and cluster sampling. Amalgam was the most frequently used restorative material, with the choice dictated by patients' financial constraints. While 90.4% of dentists perceived amalgam as a health risk, only 46.4% considered it an environmental hazard. The majority disposed of amalgam waste in the trash, down the sink or as hospital waste. Very few (5.9%) had an amalgam separator installed in their dental office. Amalgam waste management protocols and mercury recycling should be introduced in Pakistan.

Dental solid and hazardous waste management and safety practices in developing countries: Nablus district, Palestine.

This study investigated the dental waste management practices and safety measures implemented by dentists in the Nablus district, Palestine. A comprehensive survey was conducted for 97 of the 134 dental clinics to assess the current situation. Focus was placed on hazardous waste produced by clinics and the handling, storage, treatment and disposal measures taken. Mercury, found in dental amalgam, is one of the most problematic hazardous waste. The findings revealed that there is no proper separation of dental waste by classification as demanded by the World Health Organization. Furthermore, medical waste is often mixed with general waste during production, collection and disposal. The final disposal of waste ends up in open dumping sites sometimes close to communities where the waste is burned. Correct management and safety procedures that could be effectively implemented in developing countries were examined. It was concluded that cooperation between dental associations, government-related ministries and authorities needs to be established, to enhance dental waste management and provide training and capacity building programs for all professionals in the medical waste management field.

Amalgam waste management.

Dental amalgam has been extensively used as a tooth filling material for many decades and has beyond doubt saved millions of teeth that otherwise would have needed to be extracted. The release of amalgam particles into dental office wastewater is a matter of particular concern as amalgam particles could then be discharged into the environment. Amalgam waste discharges contribute to mercury in the environment through direct wastewater discharge, incineration, land-filling and sewage sludge incineration, although the discharge from dentistry is probably responsible for less than 1% of the total mercury discharged annually into the environment as a result of human activities. Nevertheless, dentists, by being producers of amalgam waste, have a responsibility and a duty of care for the proper management of this waste within their practices. Appropriate measures should be taken to minimise the amount of waste where possible or take action to ensure that all generated waste is disposed of in accordance with environmental legislation.