Sustainable Dentistry How-to Guide: Equipment and Supplies

The manufacture and distribution of any object has an environmental impact, requiring input of raw materials and energy, often accompanied by release of pollutants to air, land and water as well as changes to land use and biodiversity. These impacts are often not visible to us at the point of use, whether of paper, plastic packaging, instruments or dental restoration materials. However, for the NHS in England, for example, supply chain emissions make up 57% of the total carbon footprint.

Dental teams can influence the environmental impact of their equipment and supplies by reviewing routine practices to ensure that items are only used when they are really necessary, looking for environmentally friendly alternatives and by engaging with suppliers to develop more sustainable practices.

In this section… How to:

Paper and timber procurement

Reducing the quantity of the paper the practice procures can be achieved by double sided printing/photocopying, and using digital media such as email or text messages to communicate with both patients and staff.

Ensuring both the paper and timber you procure meets the Government Buying Standards (GBS) via their checklists can help to guarantee the sustainability and legality of the products you purchase, with specifications on the minimum recycled content of paper products and best practice being highlighted. GBS are voluntary but are best practice for dental practices.

How to reduce plastic purchasing and waste

Dental practices produce huge amounts of waste plastic from plastic cups, disposable syringes, gloves, single use instruments, oral hygiene products, stationary and more.

Finding ways to limit the purchase of plastic and plastic-packaged items, encouraging plastic recycling and liaising with manufacturers about their plastic use and sustainability will help to reduce the plastic ‘burden’ and may reduce costs to your practice.

Actions to reduce dentistry plastic purchasing and waste

  • Consider putting out plastic cups for patients to rinse only when needed (rather than as standard)
  • Avoid single use devices where appropriate: use stainless steel impression trays, prophy cups and suction tips
  • Use glass/stainless steel pots vs. plastic ‘Dappens’ pots
  • Carry out an audit to see how much plastic your practice is using and whether all recyclable plastic is being recycled
  • Share information and communicate your plastic reduction efforts to patients
  • Advertise alternative, non-plastic oral hygiene products e.g. bamboo toothbrushes
  • Liaise with dental product manufacturers about the sustainability and recycling potential of their products

How to reduce chemical waste

Many chemicals are used daily in dental practice, including dental materials such as amalgam, cleaning and disinfectant products, radiography equipment and Nitrous Oxide for sedation.

There is an abundance of legislation surrounding the use of hazardous substances in healthcare. COSHH (Control of Substances Hazardous to Health Regulations) requires all dental employers in the UK to control exposure to hazardous substances to prevent ill health. The ‘Minamata Convention on Mercury’ effective from August 2017 encouraging the phase down of amalgam use has been designed to protect human health and the environment from anthropogenic emissions and releases of mercury and its compounds

Actions to to reduce chemical waste in dentistry:

  • Be aware of the legislation surrounding use of hazardous substances in the dental practice
  • Use less toxic and more sustainable/eco- friendly cleaning products
  • Use amalgam alternatives for dental restorations when possible and clinically appropriate
  • If using amalgam, use encapsulated amalgam and an amalgam separator
  • Use digital radiography equipment to avoid the use of toxic processing chemicals
  • If providing inhalation sedation with Nitrous Oxide, train staff on the health and environmental risks associated with its use; use the minimum effective dose possible; use correctly fitting face masks for patients; monitor airborne concentrations of waste gas; check equipment for faults or leaks; ensure adequate ventilation; consider purchasing a unit which converts waste gas into a less harmful product

How to engage your suppliers to be more sustainable

Engaging with suppliers and developing a questionnaire for assessing their sustainability practices when procuring goods is a good way to establish whether the products and their delivery are as environmentally sustainable as they can be and can also encourage suppliers to develop more sustainable practices.

  • Create a Sustainability questionnaire (see example) and use this when engaging with suppliers to assess their commitment to sustainable practice
  • Ask all suppliers if they have a sustainability statement and ask if you can be emailed a copy

How to optimise stock inventory management

Stock wastage has a huge environmental and financial impact. Out of date chemicals, dental products and stock often are disposed of in landfill or require specialist collection. Regular stock audit scan ensure that products nearing the end of their shelf life can be identified and used and wastage is minimised.

In larger facilities like hospitals, adopting the GS1 standards (Global Standards designed to improve efficiency, safety and visibility of supply chains) can also help to improve patient safety, by identifying stock which has reached dangerously low levels.

  • Audit stock monthly to identify any that is close to its expiry date and to inform ordering
  • Reduce the frequency of orders once stock requirements can be more accurately predicted