How are UK Dental Practices becoming more Eco-Friendly?
Record-breaking floods. Raging storms. Frequent heat waves. Melting glaciers. And warming oceans. Global climate change has already had prominent, observable effects on the environment, manifesting in a myriad of different ways. Since 1906, the global average surface temperature has increased by a whopping 1.6 degrees Fahrenheit (0.9°C) According to the Intergovernmental Panel on Climate Change (IPCC) Fifth Assessment Report (AR5), world temperatures could continue to rise between 0.3°C and 4.8°C this century.
These over-the-top numbers are bound to forge a para-dimensional shift in the world with grave consequences like the global effects on the sustainability of water, food supplies, ecosystems, coastal stability, and public health, ready to spring up shortly. Known as nature’s ultimate equalizer, today, we’re witness to the many cataclysmic side effects of the drastically rising global temperature, which, if left unattended can result in purgatory on planet earth.
As the media swiftly accelerates public awareness of climate change and the devastating impact of human activity on the planet, it is not out of the ordinary to direct the focus and angst on large industries (like energy and manufacturing) as a direct instigator of climate change. However, a report published in 2019 was able to identify that if the healthcare industry were a country, it would be the fifth-largest greenhouse gas emitter in the world.
To confront this impending crisis, many dental practices are integrating strategies for sustainable waste management and procurement in daily practice to help tackle the never-ending problems with environmental change.
DENTISTRY AND THE EFFECTS ON CLIMATE CHANGE
With the socio-ecological effects of climate change registering on a global scale, the Climate Change Act 2008 has set a legal abatement framework for the UK to cut down on greenhouse gas emissions to 80% below 1990 levels by the year 2050. This long-term approach to cutting emissions, although an aspirational goal, has been challenging nonetheless. Dentistry, in particular, is facing many peculiar obstacles to take on the issue of a UK CO2 target especially centred around decontamination, waste disposal, and the usage of single-use plastics.
In addition, the overall NHS carbon footprint is estimated to be around 22.8 million tonnes CO2e (tCO2e) per year. This makes it the largest public sector that is a direct contributor to carbon emissions in the UK. Dentistry, alongside other healthcare providers, has a major impact on the environment, with the NHS dental services emissions dangerously making up 3% of the overall carbon footprint of the NHS.
Widely accepted as the defining challenge of our time, the NHS has announced its vision to enable a ‘Net-Zero NHS’ whereby dentists and their teams working in the NHS are heartily encouraged to submit case studies to identify new opportunities for greening the NHS, claims the British Dental Association.
CARBON FOOTPRINT IN DENTISTRY
With the Centre for Sustainable Healthcare, Public Health England published a report in July 2018 called “Carbon modelling within dentistry: towards a sustainable future”. This report highlighted the major areas of carbon emissions for dentistry as travel, procurement, energy, nitrous oxide, waste, and water.
According to this paper, sustainability within dentistry has as much to do with delivering high-quality care while reducing invasive treatments, as it has to do with remedying in-house approaches such as improved stock control, renewable energy, efficiency audits, and the all-purpose ‘reduce, reuse, recycle’ philosophy.
This carbon footprint includes:
- Direct emissions, such as from energy generation heating the dental practice.
- Indirect emissions from electricity use, like powering the dental chair and light.
- Indirect emissions from the supply chain, travel, and waste disposal.
It is evident that major changes need to be made within the scope of dentistry in order to effectively reduce its effects on the environment, and subsequently the effects of climate change on the human body.
ECO-DENTISTRY OR GREEN DENTISTRY
The term “Green dentistry” or eco-dentistry has been described as:
‘An approach to dentistry that implements sustainable practices by keeping resource consumption in line with nature’s economy, by safeguarding the external environment by virtue of eliminating or reducing outgoing wastes and by promoting the well-being of all those in the clinical environment by conscious reduction of the chemicals in the breathable air.’
In other words, green dentistry is an environmentally friendly way to practice dentistry. It involves areas of change like using methods and machines to reduce waste, conserve energy, and decrease the environmental pollution. It is a service model that encompasses and greenlights dentistry that promotes wellness – both environmental and general.
Practising sustainable dentistry has very prominent impacts on the environment, economy and social culture, often dubbed as the “triple-bottom-line analysis”. These three categories help measure the impact of dental practice in its entirety.
- Environmental benefits: Demonstrating a more sustainable practice has obvious environmental benefits such as a vast reduction in service delivery and waste production.
- Economic benefits: Sustainable practices are more profitable in the long run, allowing practitioners to secure financial savings (for example considering energy costs and availability fluctuations).
- Social benefits: Attaining a green practice can have many social benefits such as prioritization of the patient’s wellbeing, having a fair salary system, providing a safe working environment for the employees, and being able to give back to the community.
WHAT ARE UK DENTAL PRACTICES DOING TO BECOME MORE ECO-FRIENDLY?
The dental industry is notorious for its gigantic carbon footprint, with procedures that are conducive to producing large amounts of greenhouse gas emissions. Travelling and transport of materials further add to the load along with more obvious areas of energy and water usage and clinical waste disposal.
A how-to guide published in the British Dental Journal in 2019 substantiates the impact of dentistry on the environment and has piloted a tried-and-tested approach to help create a more sustainable dental industry. By accessing this toolkit of information, dental practices around the UK can switch to making greener decisions for their sustainability.
The steps for sustainable practice management include five sections, namely:
A recent study commissioned by Public Health England calculated that the highest proportion of emissions in dentistry arises from travel (64.5%). This includes dental staff travel to work, patient travel to the practice, and travel whilst at work, for example, domiciliary care or lab service deliveries. Reducing travel by patients and staff have a significant impact on the environment and your health.
Auxiliaries at the dental clinic can be encouraged to decrease their individual (and therefore the practice’s collective) carbon footprint by adopting these simple schemes:
- Walking to work would contribute to the lowest carbon footprint and should be the first port of call for staff and patients alike.
- Cycling to work reduces carbon emissions and also eliminates the need for a car park. Providing secured bike storage or parking area can help motivate your staff to take on cycling to work.
- Making use of public transport can also significantly reduce unnecessary carbon emissions. For example, offer a loan for yearly passes at zero interest, or facilitate flexible working patterns to accommodate for public transport timings.
- Encourage your staff to choose car-pooling wherever possible.
- In case you provide domiciliary dental care, consider switching to an electric vehicle as your means of transport.
- Use local labs to minimize the travel distance for lab work and other services.
- Encourage your patients to book family appointments together where multiple interventions can be undertaken in a single sitting.
PROCUREMENT: EQUIPMENT AND SUPPLIES
Dentistry is particularly demanding in regards to the supplies and equipment required. The manufacture and distribution of these supplies can undeniably create waste. The packaging required for these products, the instruments themselves, or the dental restoration materials all create a substantial amount of waste. And quite inevitably, for the NHS in England, supply chain emissions make up 57% of the total carbon footprint!
In order to effectively reduce the impact of procuring raw materials and supplies for your dental practice, some of these recommendations can be implemented:
- Buy equipment and materials in bulk to save you money, just as long as the stock can be used before expiring. This will also consolidate the number of deliveries made and hence, reduce the carbon emissions.
- Purchase products that can be decontaminated and reused, where possible. Discarding or limiting the usage of single-use items can help lessen the environmental impact.
- Buy items locally where possible in order to reduce the delivery and transport mileage.\
- When purchasing equipment, use whole-life costing to factor in running costs (such as energy use and consumables) and lifespan. By liaising with suppliers, you can reduce the number of deliveries and the carbon footprint associated with each delivery.
- Optimise stock inventory to avoid products going out-of-date and creating more waste.
- If items are close to their expiration dates and you don’t think you’ll be able to use them in time, consider offering to swap with local practices or even donating to dental charities.
If you’re looking to create a wholly sustainable dental practice, you should also consider reducing water usage where possible. Using a water meter will make you more aware of water consumption and will allow you to properly monitor these levels. Other minor activities like avoiding leaking or open taps with running water and timely repairs of leaking water points can also help you eliminate expensive bills that are sure to rack up with incautious use of water.
By conserving water use, you will be able to put less strain on the environment and resources around you, thereby limiting wastage. Water conservation is a very crucial step towards greenifying your dental practice.
Buildings energy use makes up 15% of the carbon footprint of primary dental care, according to the CSH. Not only do these massive energy consumptions contribute to greenhouse gas emissions, but the energy generation from fossil fuels is also a primary source of air pollution. Reducing energy consumption and investing in renewable electricity generation can offer significant environmental, health, and cost benefits for dental practices in the UK.
- Buildings can be improved with insulation, energy, efficient boilers, and using LED lighting and timing sensors to help conserve as much energy as possible. Ensure heating is optimal by using thermometers and thermostats.
- Aim to reduce overall energy consumption by explaining the environmental and financial benefits to your staff. You may even use blinds to reduce overheating in the summer instead of full-time air conditioners.
- Use low carbon alternatives where possible. This can include solar panels as a form of environmentally friendly energy supplier.
With the gigantic measure of supplies comes a lot of waste. The most frequently disposed of items in a dental setting are tissues, sterile wrappings, gloves, 3-in-one tips, and syringe needles. In addition, the Harvard School of Dental Medicine highlighted in a report that plastic, mercury, lead, and silver waste are common within dentistry, and these pollutants can compromise food, water, and air quality.
Proper disposal of waste and contaminants could reduce environmental impact to a great degree. The impact can not only be reduced by lessening the waste products, but also by improving waste collection and by adhering to proper waste disposal regulations.
Some practical ways to reduce waste production are:
- Switch to digital radiographs and impressions.
- CAD/CAM and chairside production of restorations to eliminate the need for intermediate restorations.
- Use compostable or reusable sundries where possible.
- Reduce paper waste by using paper-free technology for prescriptions, medical histories, and consent forms to the patient.
- Repair and reuse durable goods.
Yes, the planet is warming, all the way from the North Pole to the South Pole and the impacts of the sweltering temperatures aren’t waiting for some far-flung future – we’re experiencing the effects right now. With an environmental movement pervading dentistry, dental professionals are obligated to look for newer and safer ways to deliver proper dental care to the patients while also being more conscious about our impact on the planet.
In our goal to become more eco-friendly, we’re continually looking for improved and heuristic ways to motivate fellow dental professionals to make their practices more sustainable and green.