How can I make my dental practice more sustainable?

Maya Samuel explains how dental teams and practices can play their part in a more sustainable futureMaya Samuel explains how dental teams and practices can play their part in working towards a more sustainable future. 

Sustainable, green, eco-friendly, ecological – words you may hear thrown about almost every day. Individuals everywhere are increasingly conscious of what they can do in every day life to become greener, which is a fantastic start. But how about taking it one step further by expanding these positive changes to your workplace?

Going paperless

Perhaps one of the initially costlier and more time-consuming options would be to consider going paperless. We are fast approaching a digital era. Paper notes are a thing of the past. Not only are they a nightmare to store but traipsing through pages and pages of dental records to find information is incredibly tedious. Information stored on computers is not only more secure but is easier to access. It also less space and resources such as paper.

Some dental softwares allow you to manage your business almost entirely electronically. From medical histories and treatment planning to gaining written consent – all without the need for paper. Dentally, for example, is essentially a cloud-based system that allows patients to update their medical histories from the comfort of their own home. Otherwise, consider Clinipads to sign relevant documents, where they are then transferred to your dental software.

Waste management

Healthcare faces a huge waste management challenge. One of the biggest steps dental practices can take is to segregate waste correctly. Be mindful of what you dispose of into which bin by labelling them correctly. Place them strategically. For example, larger recycling bins in reception areas where paper usage is likely to be higher. Or again, a larger recycling bin and a smaller general waste bin in your clean area of the decontamination room. This can encourage staff to recycle where possible.

Ensure you keep clinical waste separate to reduce incineration pollution, recycle sterile plastics, cardboard and paper. Dispose of non-contaminated waste into general waste. It is very easy to simply throw away all your waste into clinical bins throughout the day due to time restraints. And yes, also laziness. However, this will massively increase your disposal costs and it’s not environmentally friendly.

Energy consumption and radiographs

One of the easiest energy – and money – saving changes is switching from halogen bulbs to LED lights. LEDs are generally 70% more efficient resulting in less maintenance, longer lasting and thus creates the opportunity for huge savings. Similarly, a lot of dental professionals still rely on halogen operator lights. They can heat up very quickly, posing a burning risk to patients and staff.

Frequent replacements means they’re also not cost effective. They don’t produce a clear pattern of light as LEDs do. Making the switch is not only safer and cheaper in the long run but it also offers improved visibility for clinicians and remains out of patients’ eyes.

Digital x-rays have become one of the most important advances in the medical profession. Conventional x-rays are labour intensive and more costly in the long run (constant repurchasing of film developer and fixer solutions for example). Additionally, they result in a higher radiation exposure and produce toxic chemical waste (including silver and lead) that has fatal environmental impacts.

Lead foil, a by-product, is held in the topsoil where it can remain for up to 2,000 years. Eventually it enters our food system as it is readily picked up by plants. Let me remind you, lead is a neurotoxin. However, besides being more eco-friendly, one of the biggest benefits of going digital is time saving. Images are produced within the second and viewed immediately. In comparison, conventional films take several minutes to process. In today’s fast-paced world, this is incredibly inconvenient.

Antibiotic usage

The over prescribing of antibiotics has been a hot topic for several years. It leads to mass antibiotic resistance, resulting in an increased difficulty in treating disease. But there has been less focus on the environmental impact. The pharmaceutical industry leaves an astronomical carbon footprint, bigger than the automotive production sector in terms of greenhouse gas emissions. However, this produces significant amounts of wastewater, which then end up polluting the ecosystem.

Wastewater treatment plants do not fully filter out pharmaceutical compounds. Many of these chemicals reach natural habitats where they can be potentially very harmful. Incorrectly disposed medications (down the toilet or sink) end up damaging nature the very same way.

Professionals must work together and take care by prescribing only where absolutely necessary. Treatment plants must be equipped with the correct filtration and degradation systems. The public can take more care to dispose of their unused or expired medications correctly. The best way to do this is to return them to your pharmacy or chemist.

Single use items and plastic use

Plastic has become a safe, hygienic, cheap and widely available material in dentistry – hence its growing popularity. But it only takes a minute to think about the sheer quantity we use of it daily. From gloves to disposable aprons to plastic barriers to pouches for sterilised instruments. Now you might argue that all this is needed to treat patients safely. I agree – but can you say with confidence that you then dispose 100% of your waste correctly? If something is not contaminated, does it really need to go into an orange clinical bag? It all comes back to being a little more mindful during your day.

To reduce the risk of cross contamination, single-use items were created thanks to HTM 01-05. Unfortunately, as a result of this document, all environmental considerations were thrown out the window. This is only more recently coming to light. Now I appreciate some items are single use and that will never change. On the other hand, there are single use items currently on the market which do have a more sustainable alternative available.

Reusable

In my humble opinion, it is up to us, the dental professionals, with extensive clinical knowledge and experience to take the initiative. We need to use our clinical judgement to research and consider investing in autoclavable options once more where possible. Many once re-usable items are easily replaced with single use. Metal impression trays, metal syringes, metal or biodegradable rinsing cups, and metal instrument trays. Sensing a pattern yet?

Other ways to keep plastic consumption down may include limiting the use of multiple gloving (be prepared!), limit the use of plastic barriers to when necessary or consider biodegradable alternatives. Bulk buy necessities to reduce packaging in shipping, use absorbable or biodegradable patient bibs, and eliminate plastic dappens pots. Simply use your reusable paper tray liner or a glass pot. These are simple changes which anyone can introduce and are relatively straightforward, so I would start with a practice meeting where you can liaise with your colleagues in a way that viable for everyone.

PPE

Personal protective equipment (PPE) is a standard part of uniform for most medical professionals. Amidst the middle of a pandemic, the advice is to take extra precautions in the form of extra PPE in order to safely treat patients. This, unfortunately, comes at a cost both financially and environmentally. It hit businesses hard. The question weighing on most people’s shoulders is: How long before we resume normality?

For this reason, I’ve noticed a divide in the type of PPE purchased – reusable vs single use. For example, washable gowns and FFP3 respirators in contrast to single session FFP2s or FFP3s and disposable gowns. So I feel a better question to ask in these current circumstances is: ‘Is this the new normal? In which case, is disposable really the best way forward?

As we move towards a more sustainable future with eco-friendly options becoming more readily available, I would strongly encourage you to make this a priority. The more people show an interest in it, the more pressure these companies will feel to meet demands. They will be more likely to increase the product range to become attractive to buyers. It’s a win-win.

Opt for the reusable option where possible which I appreciate is a dearer investment. However, it will keep waste disposal costs down, environmental impacts down and in the long run, be more financially viable. Realistically, if we keep going the way we are, future generations to come won’t have an earth to live on.

Make sustainability a trend. People will follow and we will have a fighting chance of saving our planet.

References:

Arora, S., Mittal, S. and Dogra, V., 2017. Eco-friendly dentistry: Need of future. An overview. Journal of Dental and Allied Sciences, 6(1), p.22.
Greeni, P., Ancona, V. And Barra Caracciolo, A. (208). Ecological effects of antibiotics on natural ecosystems: A review. Micro chemical Journal, 136, pp.25-39
Belkhir, L. (n.d.). Big Pharma emits more greenhouse gasses than the automotive industry [online] The Conversation

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