Steps toward a sustainable practice
Catherine Paulhamus, MA
Dental hygiene care, in many ways, follows the patient home. Practitioners are concerned about their patients' home care habits, diet, chronic health conditions, medications, and other issues that impact (or are impacted by) oral health. Once they leave the office, patients live in an ecosystem that continually influences their well-being—and one major influence is the health of the environment.
In general, dental practices are viewed as contributing to environmental problems, both through waste production and energy/water consumption. However, dental practitioners also have a long history as trusted professionals who take pride in their communities—and preserving their natural resources is the next step in caring for their patients. As consumer focus shifts to sustainability, dental teams are joining in by implementing eco-friendly products and practices.
"Caring for patients means not only for their teeth and gums, but also for their whole-body health," says Katie Schiller, RDH. "There have been huge advances in technology and patient care, which includes being eco-friendly and conscious about what we're doing to the planet."
"I think if an office publicized its use of ‘going green,' it would definitely attract patients," says Ashley Leavitt, RDH, who practices in Atlanta, Georgia. "A lot of people are passionate about reducing their level of waste, and they would be proud that their dental care providers are working to do the same."
Schiller is practicing in upstate New York, an area she says was already conscientious about preserving the environment; disruptions from the pandemic underscored that need. When people began to go outside again, after sequestering, "we saw so much litter—gloves and masks—lying along the sides of our beautiful roads," she says. "People became concerned about how much is being used and discarded. Dentistry has been a challenge for that reason because it's so disposable, which has its pluses and minuses. We don't have to worry about sterilizing disposable items, but we are filling landfills with all this garbage. If we have the opportunity to make a difference, we should really take it."
Innovations and Opportunities
Dental practices may be concerned that, with all the other pressures on practice workflow and cashflow, environmental initiatives will be costly and require too much effort. "I have worked in many offices across the country, but I have never been in one that has any type of green initiative," Leavitt says. "Someone has to start proposing ideas to implement change. As more offices become involved, the demand for green products will rise, and this will also lower the cost."
Some manufacturers provide "environmentally friendly" lines of dental products. These are promoted with features such as biodegradable, recycled (or recyclable), multi-use, energy- or water-saving, and other advantages. Products can be constructed from renewable resources, such as bio-based polyethylene made from sugar cane, used to make a saliva ejector. Disposal products can be designed using biodegradable materials; for example, dental cups made of non-toxic bamboo fibers. Although the expense for environmentally safe products may be much higher initially, often the cost averages out over time for multi-use (for example, a re-usable sterilization pouch that can be used more than 200 times).
Schiller says that her patients have noted the use of disposables in the operatory: "‘It's such a shame that you have to throw these away after each time,' they tell me. So I have a few patients that bring their own little re-usable cup to appointments."
Before deciding how many initiatives (and which ones) to implement, Leavitt recommends beginning with an office energy audit to find out how much energy is being used and waste is being created. Then develop a plan and a budget to decide where the office can afford to make (sometimes small) changes. Leavitt mentions options such as switching to air polishing from traditional polishing; using re-usable air/water syringes and X-ray holders vs disposable; and turning off the vacuum system, which averages 360 gallons of water per day. For initiatives that are essential but costly, one option is to add a small fee to every appointment for a "going green" program.
Finally, the design and maintenance of the office should be considered. Some buildings are more resource-efficient in their construction. Even if your practice had no input into building features, there are interior design, equipment, and maintenance choices that conserve energy and water, lessen indoor pollution, and often reduce operation costs.
Each community has different guidelines for general recycling, which can make maintaining an office program difficult. In some places, recycling must be sorted and dropped off at a center by an employee. These efforts quickly become too time consuming, unless someone in the office is dedicated to the program.
However, dental-specific opportunities are available nationally, such as dental instrument recycling programs. The companies sort through instruments that have been sent in, to see if any can be salvaged for use. These instruments may be provided to organizations such as dental mission groups. Those that can't be salvaged are melted down to make new products.
In another example, a glove recycling program provides offices with "zero waste bins" for gloves that are safe enough to be recycled (ie, if they are not a biohazard). However, some of these programs are not cost effective for practices; the expense would need to be factored into the budget.
Awareness and Synergy
Going green at the office can carry over to other situations, and model behavior for your patients. For example, reducing single-use plastics could increase awareness of plastics outside the practice, multiplying your efforts and impact. "A practice can become more sustainable, to start, through education," Leavitt says. "You have to be passionate about wanting to preserve the environment, and you can only do this if you learn. There is a vast range of ways to go green, and finding which ones make you most excited is a great way to begin."
"With so many possibilities, we can think bigger and better for our environment," Schiller says. "Dental practices could initiate an Earth Month, for example, during which we would all try something new to preserve our natural resources. The combined impact could make quite a difference. We all have a common goal of saving the planet, even if it's one little task at a time."
80 Ways to Make Your Dental Practice Green
The ADA has compiled 80 green tips, many of which are free or inexpensive, grouped in categories such as "Be Proactive" and "Educate Your Staff and Patients." Choose one idea to implement immediately, as even one small change can have an impact.