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The sustainable practice - dentistry on the cusp

Dentistry, a profession with significant environmental impact, finds itself today on the cusp of a growing demand for a more sustainable world. However, dentistry has been slow to embrace this worldwide movement for several reasons, not the least of which is confusion over terminology. 

Many words, one goal

An entire vocabulary has sprung up within the movement toward protecting the planet that can create unnecessary confusion. Some of the more common phrases are environmentalism, green, eco-friendly, climate change, global warming and many more. The vocabulary often creates problems because the words' connotations can make the topic seem political, social, economic and even spiritual in its focus.

There are certainly people and groups with a variety of goals for the movement. Dental offices, meanwhile, have two distinct goals: providing excellent dental treatment to their patients and managing the business of the practice to ensure a financial profit. Successfully reaching each goal is necessary to sustain the practice and enable the staff to continue providing patient care.

Without minimizing the usefulness of words such as “eco-friendly” and “green”, the word “sustainability” may best articulate every word, individual and group's aggregate goal.  The United Nations’ defines sustainability as “meeting the needs of the present without compromising the ability of future generations to meet their own needs.” This definition sets a high standard that all can agree is worthwhile to strive for and one day achieve.

The three-pronged challenge dentistry faces

The goal of sustainability intersects in a very tangible way each day in the private practice of dentistry. The goals of protecting the planet, providing excellent and affordable dental care, and financial profitability collide with everyday clinical practice.

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Prominent in discussing an environmentally friendly dental office is that two-thirds of greenhouse emissions are related to patients’ and staff's travel. Most dental offices could reduce this contribution to their carbon footprint by making two changes. 

First, completing more procedures during longer appointments would decrease the number of times patients need to travel to the office. Taking this step also reduces the cost of many items such as PPE and helps offset infection control's rising costs due to COVID-19. Secondly, extending the workday and shortening the number of workdays each week would save the staff travel time and decrease greenhouse emissions. 

Every day dentists must balance the treatment provided to patients and the health of the patient. An example of this is whether an x-ray is essential to detect an open margin on a restoration or a root tip left after an extraction. Balancing the added radiation exposure to the patient and staff with the image's possible benefit requires skill, experience, and knowledge of all the contributing factors.

Some technological advances make these decisions even more challenging such as Cone Beam radiography. CBCT machines are becoming commonplace and seen as the new standard of care for particular clinical situations. However, this comes at a cost both in terms of finances and radiation exposure to the patient. It also presents an ethical and environmental dilemma for practitioners in some circumstances. 

Digital radiography decreases radiation pollution and is a significant step toward a sustainable world. Manufacturers continue to improve imaging machines and techniques such as optical coherence tomography, which can detect incipient caries with no radiation exposure to patients or staff.

Dental offices seek to provide safe and affordable dental care for patients today and protect future generations' quality of life.  However, equally important is a financial profit that keeps the office doors open. Fortunately, dental practices can make a positive impact on the environment and their bottom line.

Profiting the world and your practice

The task of making your office “green” may seem too daunting even to attempt. It may seem easy to neglect the planet and focus on patients and profit. However, dentistry has a professional and social obligation to become less hazardous and more sustainable. This transformation can benefit not only the planet but also the profitability of your practice with a few simple steps.

  • Go paperless. Don't let this change's initial expense stop you because recouping this cost takes only a few months. With the costs of all paper products rising, going paperless can save thousands of dollars each year. Paper products adversely affect the environment in many ways, including deforestation, greenhouse gases emitted from logging trucks, air pollution from its manufacture, and a detrimental effect on landfills.
  • Digital x-rays. Transitioning to digital radiography eliminates the need to handle and dispose of hazardous chemicals harmful to the environment. Not only will you save money on x-ray film and chemicals, but you will also benefit from the many clinical advantages of digital images.
  • Waterless vacuum system. Dental vacuum systems use hundreds of gallons of water each day. You can save on your water bill while doing your part to alleviate the worldwide water crisis with an eco-friendly vacuum system. These also use much less electricity, saving you even more in monthly utility bills.
  • Lighting. There are several advantages to switching from traditional incandescent light bulbs to compact fluorescent lightbulbs (CFL).  Over time, you can save up to 50% on lighting while making your office more comfortable with reducing heat generated by incandescent bulbs.
  • Infection control. This is one area that presents formidable challenges to environmentally safe practices. Research and development continue to offer dental products that reduce and often eliminate hazardous chemicals and waste. 

The way forward

People around the world are becoming increasingly aware of how businesses treat the environment. Dentistry is not exempt from these rising expectations. As the status quo changes, dental practices must make essential changes to meet their obligation of treating the planet in a manner that makes life sustainable for future generations.

The dental profession continues to make progress and must continue to advance toward a sustainable world. Successful attainment of this goal includes:

  • Education. Dental schools and professional organizations must promote an understanding of the increasing fragility of the planet and dentistry’s role in sustainability.
  • Research. Just as dentistry is committed to finding the best restorative materials, endodontic files and implant materials, we must also devote the money and other resources to discovering the most environmentally friendly products and day-to-day dental practice methods.
  • Policy. Organized dentistry must work to implement policies that promote sustainability in dentistry.
  • Encouragement. Encouraging individual practitioners while they transition their offices toward sustainability is critical to dentistry’s success today and future generations. This includes offering the help needed to make the small but necessary steps toward this goal.

Dentistry is on the cusp of the movement toward sustainability. As a profession, we have always demonstrated the highest level of responsibility in taking care of our patients' oral health with excellent dental treatment. We are now called to an even more enormous task as we seek to maintain this high level of affordable care while making necessary changes for the health of the planet. 

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