Even the most routine of dental procedures e.g. a root canal treatment (RCT), can adversely impact on the environment. Life cycle assessments (LCAs) are an effective way to understand the cradle to grave impacts of day-to-day dental activities. LCAs highlight the various points we can act to improve practice sustainability and address climate change.
In RCTs, large numbers of single use, disposable instruments and materials are used. Other products not initially considered include water, paper, electricity, medicinal products (e.g. sodium hypochlorite) and medical devices. RCTs are often longer appointments, requiring multiple visits, increasing patient travel requirements.
An LCA of a typical RCT carried out by Duane et al. (2020) showed the following areas negatively impact on the environment:
1. Production, use, disinfection, sterilisation, paper/cardboard/plastic packaging/disposal of all disposable and single use instruments.
2. Production, washing and drying and disposal of dental clothing. Dental clothing contributes significantly to ozone layer damage.
3. Water and energy use associated with the disinfection and sterilisation of instruments, use and disinfection of the dental unit and staff hand washing.
The average RCT contributes to at least 4.9kg of carbon dioxide equivalent emissions, or a 30km drive in a car!
If patient and staff transport, building construction, manufacture of dental units, computers and larger machines were included, the true environmental impact would likely be significantly larger.
Electricity use was the single biggest contributor, with single use stainless steel dental instruments (endodontic files), soaps, and detergents from disinfection procedures, contributing respectively. Transportation of goods used in the procedure contributed to significant environmental harm.
Six simple actions for change:
1. Ensure dishwashers and autoclaves are run filled to maximum capacity. This ensures fewer uses, reducing electricity, water and detergent use.
2. Switch to recycled, unbleached paper. Replace paper towels with a warm air hand dryer.
3. Switch to reusable dental bibs.
4. Consider more environmentally friendly alternatives to current disinfectants and detergents.
5. Switch to a sustainable energy provider. Consider utilising renewable sources including solar or wind power.
6. Increase focus on preventative or vital pulp therapy treatments. Reduce number of patient visits to reduce travel need.
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