Sustainable Dentistry – Is It A Green Dream?
But your dentist might.
Humans have never really been green. Maybe as foragers, but 3,000 years ago many parts of the world had really invasive farming going on. Forests were felled to plant food, there was land clearing for domestic and selective animal breeding.
We began degrading our relationship with the natural resources of the planet.
There’s an accelerated trajectory of human impact. It’s not a recent phenomenon; the current changes are just more drastic. Technology allows us to monitor and report it much faster, and more easily. And we have the data to study the implementations of ancient civilisations in the mitigation of water scarcity and deforestation.
All in all though, we’re really not very good learners. Were that the case, our history would disclose one war, one extinct species, and French novelist Gustave Flaubert could never have said, “Earth has its boundaries, but human stupidity is limitless.” British philosopher Bertrand Russell proclaimed that the fundamental issue is that, “…the stupid are cocksure, while the intelligent are full of doubt.”
It’s an interesting paradox. What does it say then, of Dutch author Matthijs van Boxsel, with his speculation that stupidity is a condition for intelligence? That blunders stimulate progress? And that failure is the basis for success?
It’s as ruminating as the meme that the letter “G” is just a spinning arrow…
In contemporary science, there is such focus on how the present is very different to the past; the counterweight to that is that humans have been facing these challenges for a long time. That in itself wipes out any idea of simple solution.
That we have greater access to more knowledge than any other time in our history and still there is little progress, seems to give credence to the “functional stupidity” that Swedish academic Mats Alversson describes.
It’s the adherence to meaningless meetings, and subscribing to accept and regurgitate supposedly innovative ideas that are complete nonsense. It’s troublesome to think for yourself. Functional stupidity alleviates stress – until it doesn’t.
The reason it doesn’t is because it’s an enormous waste of energy and resources.
And that’s exactly what sustainable dentistry is addressing.
A major challenge of the 21st century is climate change – the unequivocally proven cause of unprecedented global weather events – unless you submit to some aspect of the aforementioned stupidity genre. (To which there is no judgment. In fairness to the schematics of stupid, one person’s ignorance is another’s rationale.)
In short, the first climate change risk assessments (CCRA) carried out for the UK in 2012 predicted heat waves, flood-prone winters and higher air pollution. Since the mid 20th century, human activity was deemed the dominant cause, with increasing energy demands burning greater amounts of fossil fuels, which in turn release amounts of greenhouse gases far beyond the neutralising capabilities of Earth’s natural eco-systems. Consumerism depletes these systems, and excessive exploitation of resources creates more toxic pollutants and the cycle continues.
Whether it was the mellifluous tones and tenets of David Attenborough, the enforced navel-gazing of the pandemic, the wake of the woke or the searing horror of 3 billion native animals killed or displaced in the inferno that was Australia in 2019/20, there is no doubt that environmental awareness has intensified.
It translates into a global movement of ‘green’ transformations with ambitious, positive objectives or attributes for the environment. By researching and developing tools and policies for sustainable health practices, dentistry can reduce its impact on natural resources, and incorporate sustainability principles to reduce carbon emissions, chemical pollution and minimise waste.
‘Green’ or ‘eco-friendly dentistry’ has been described by world-renowned Specialist Orthodontist and academic Dr Ali Farhani 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.”
Inherently, dentistry is electronic equipment, voluminous water usage, biomaterials, radiation, and hazardous waste that includes mercury, lead, noble metals and chemicals. It is a profession of significant environmental load whether in treatment, construction, reconstruction or disposal.
Long-term, there is the professional obligation and social responsibility for dentistry as a whole to transform its day-to-day practices to sustainable ones, by adopting and integrating two underlying principles: resource efficiency; and the minimisation and elimination of pollutants. With this, is the important alignment of social values, community care, stakeholder engagement, economic benefit, and the development of policies and leadership in the conversion of concept to reality.
The equivalent of medical pharmaceuticals in dentistry are biomaterials and of these, are three categories: polymers, metals and chemicals. The environmental impact encompasses the emissions of businesses that manufacture and transport these products, their impact during and post clinical use, as well as their end-of-life disposal. These complexities have lead to the ‘Five Rs’ – Reduce, Reuse, Recycle, energy Recovery and molecular Redesigning.
Polymer products are necessary in dentistry; be it a bonding agent or impression material, or the packaging in which these materials are supplied. Metal instruments and wires are also a mainstay of dentistry. Toxic by-products start with the mining and refining of resources, through to their continued leaching into the environment after their disposal. Certainly instruments are sterilised and constantly reused; but reusing or recycling orthodontic brackets, bands and wires is a highly contentious issue fraught with significant clinical, financial, ethical and legal issues. Chemicals, radiation, indoor air quality, the operatory environment, paper and electronic processes significantly contribute to the environmental impact of caring for the oral health of the community.
The American Dental Association (ADA) has 80 recommendations and six categories for sustainable dentistry:
• Be proactive
• Install energy-efficient products
• Switch to green products
• Reuse and recycle
• Conserve energy resources and water
• Educate patients and staff.
It’s not easy being green.
Energy-efficient products include water-saving toilets, solar panels, garbage compactors and reflective glass windows.
In ‘greening’ the ADA further proposes glass irrigation syringes, biodegradable cups, and clinic fixtures and furnishings of recycled or reclaimed materials. A plastic-free clinic is not entirely possible – but a plastic-reduced one is.
Add ‘Rethink’ to the ‘Five Rs’.
According to the Eco-Dentistry Association, every year practices dispose of approximately 680 million chair barriers, light-handle covers and patient bibs, along with 1.7 million sterilisation pouches. Other disposables that also don’t easily decompose include gloves, masks, suction tips, saliva ejectors and needles.
Along with this eye-opening annual waste tally are 4.8 million lead foils, 28 million litres of toxic X-ray fixer, and 3.35 tonnes of mercury.
Blind Freddy can see dentists are not the champions of the world when it comes to protecting the environment. Yet. Managing waste is crucial to green dentistry.
Paper lab coats can be replaced with laundered ones because even with the consumption of power and water that takes, it’s still less of an environmental cost than disposal; further minimised by organic scrubs and biodegradable nitrile gloves. Bulk supplies reduce packaging and transport. Electronic health records and appointment reminders make the transition to a paperless clinic.
Cost constraints and lack of regulations mean environmental accountability is largely voluntary. Environmental standards would create a more centralised approach and uphold the high standards of patient care that is expected by both the profession and the public.
Education is what finds the common ground, and resonant workable solutions. People want good oral health. What they don’t want is the planet to pay a heavy price for that.
Smiling broadly at a world that’s dead and poisoned seems pretty stupid. The most advanced digital smile design will be in demand like never before – but it will all be virtually fake.
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