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The medical industry can hardly be excused for their participation in plastic waste production. Medical facilities are notorious for creating plastic waste on a daily basis, and in exorbitant amounts.

As a dentist, the role I play in creating waste does not escape me. It’s a fact that has never sat well with me, and I’ve found it an unsettling part of my profession that does not align with my personal values. If I am being honest, some of the waste that we produce is unnecessary.

The need for disposable items for the sake of sanitation is a fallacy. It’s a shame that patients expect disposable and replaceable medical tools in order to feel safe. But where do you think plastic suctions and mirrors are made? Factories? Stored in plastic bags? Shipped in boxes on a truck? Placed into drawers? Pulled out for your visit.

Sanitary? Hardly.

But it is expected.

What if I told you that we can create a safe, sanitary dental office that is more sustainable by using re-usable instruments that are properly sterilized? What if the key to creating a cleaner tomorrow lies in changing patient perception?

Education lies in the hands of dentists and doctors dedicated to creating eco-conscious offices. We can show patients it is more sanitary to use an auto-clavable, heat-sterilized metal suction than pulling a plastic straw suction from a drawer. Likewise, the driving force for change lies in the patients asking for alternatives to plastic from their providers.

I have a vision.

I haven’t implemented it yet because between the zero-plastic bakery, helping with building an all-sustainable Hard Rock hotel on a zero-waste island in the Maldives, working six days of dentistry a week, dog-sitting for pets in need of a home, and writing here, I just don’t have the time.

But today, I’d like to share the vision that I have for a more sustainable practice, in hopes that other dentists would aspire to it, too.

Why?

Healthcare facilities in the United States generate 14,000 tons of waste per day. Up to 25% of this waste is composed of plastic products, including packaging of disposable items. In my office, we have the problem of an overflowing the trash bin and recycle bin with waste. We have been cited by the city multiple times, but with the patient pool that we are seeing, we are creating more waste than the current bins can hold. This cannot continue.

With environmental awareness rising, the issue of medical waste has never been more pertinent. We are a dump-and-cover society but we can’t stop from knowing that plastic never disappears. It can only break down into micro-plastics that end up in landfills and oceans and then enters our food chain which then affects not just the environment and other species, but us as well.

Can medical care exist without waste?

Maybe not completely, but we can definitely get closer.

We HAVE to get closer.

WHO?

We need to do this not for ourselves, but for the younger generations of tomorrow. Young people today are overwhelmed by the daunting task of cleaning up after past generation’s messes. We need to alleviate that pressure from them, and it needs to start now.

Practitioners can educate their patients on what cleanliness really means. Explain to them your efforts in going zero-waste. Millennials will support sustainable efforts. They will come to your office if you advertise yourself as doing more than taking care of their health. If they see that you care about the environment, it will show them your character, and if you care for the environment, how much better care will you be able to provide for your patient?

My friend recently opened a dental practice in Irvine called Blue Brush Dental and his new patient and recall patient goody bags are all organic cotton tote bags that a patient can re-use for their market needs. Imagine what that says to a new patient. The value of your practice is tied to the values that you portray. A practitioner making efforts to create a cleaner tomorrow speaks volumes. Younger generations will appreciate that you care about THEM.

Patients, on the other hand, need to demand zero waste practices. Say “NO” to those free plastic toothbrushes. Ask for alternatives. Opt for recyclable, biodegradable, and compostable toothbrush options such as Bogobrush, and don’t be afraid to start a conversation and ask the office to get them. Deny goodie bags made of plastic.

We need to work together. We are all responsible.

WHAT?

A sustainable dental practice begins with a physical office, and the best office is a LEED certified building. LEED stands for Leadership in Energy and Environment Design and it was implemented in 1993 to promote sustainable design in architecture. There are four levels of LEED certification, based on a points system wherein points are awarded for different categories.

LEED certified buildings:

reduce usage fees by 40% in energy and water bills
are good for the environment and occupants
have higher occupant rates and higher lease rates per square foot
have increased visibility in the community

LEED buildings implement a number of structural and architectural designs that decrease energy consumption. Skylights and wide windows in operatories allow for more natural light which then reduces the need to use electricity during the day. Some buildings use geothermoregulation via flooring systems. The use of LED lights also reduce energy consumption and is an easy change that offices can start implementing TODAY. Likewise, using tile carpeting makes it fairly cost-effective to switch out high traffic areas with a new tile rather than redoing the entire flooring all together.

Check out this pediatric dentist’s LEED certified practice, for inspiration.

HOW?

Having an eco-conscious practice is not only what building we work in but also how we do our work.

Digital technology has allowed for the removal of much of the materials that we used to use in dentistry.

Digital x-rays eliminates the need for film, and the chemicals needed to produce the film which sit in plastic cups and are purchased in plastic containers.
Digital scanners eliminate the need for impression material, plastic cartridges, plastic tips, impression trays, and packaging used to send models to and from the lab.
A Cerec Milling Machine eliminates the need for a second appointment (which would need another chair set up and more head rest covers, bibs, suctions, and syringes), as well as a model and a temporary crown.
Clinical notes on a computer eliminates the need for paper charts and filling forms out online prior to the appointment rids us of paperwork to be scanned.
Signature pads record consent directly on the computer.
Text appointment and recall reminders eliminate the need to mail postcards.
Social media eliminates the need for physical marketing strategies.
Digital reading material can replace paper magazines in the lobby.

On top of going digital, we can substitute alternatives that use less plastic overall. Sometimes, instead of looking to new gadgets, the trick lies in using old school stuff. Below is a list of examples, both old and new:

Sterilization Casettes and Enviropouches eliminate disposable sterilization pouches.

Cloth head covers and bibs are alternatives to plastic head rest covers and water resistant bibs. Not even having head covers and simply using Cavicide between each patient is also an option.
Sterilizable metal suctions and water -syringe tips instead of disposable plastic ones are the dental equivalent of metal straws instead of plastic straws.

White coats instead of disposable clinical gowns are an option, depending on the extent of your treatment.
Wood wedges instead of plastic wedges for composite restorations are the way to go. Some argue the contacts are better with the plastic versions, but they now make flared wooden wedges that fit fine, even with isolated matrices.

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Paper Dri-Angles instead of plastic ones can be used. Even though the plastic version can isolate for twice as long and requires less triangles, the plastic itself will NEVER disappear from this Earth. The paper versions will degrade, even if there are twice as many.

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Reusable prophy angles that can latch onto a slow-speed hand-piece can reduce plastic disposable versions from entering the landfill.

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Prophy paste in ten flavors individually wrapped in plastic tubes increase plastic waste. Why not buy prophy paste by the tub in a limited number of flavors, such as mint or cherry? These tubs will last a VERY long time.

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Installing a water distiller in the office for the water lines instead of having distilled water tubs delivered to the office every week is an option. It will not only save the Earth from plastic gallons, but also from emissions related to a water delivery service.
Disposable scented nitrous oxide gas masks are nice for kids, but why not try sterilizable gas masks with a touch of essential oil for the scent.
Reclaimed, Recycled or Up-cycled furniture for the lobby is preferred over brand new furniture. Try to choose sustainable materials such as wood instead of plastic chairs and tables.
Wooden toys for the kid’s toy box in the lobby are an aesthetic AND sustainable touch.
Avoid plastic goodie bags after hygiene appointments. Try paper bags! Better yet, recyclable market totes made from organic cotton like this one from BlueBrush Dental give goodie bags a lasting purpose.

Biodegradable and compostable toothbrushes for patients to take home are becoming more popular among patients.
Use reusable eye protectors rather than disposable glasses during treatment.

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Other ways in which we can commit to reducing waste in our dental offices.

Walk or bike to work. Find a job close to home and nix the commute. Carpool, if you must, with your co-workers.
Bring your lunch in Tupperware rather than dining out. Bring a reusable water bottle or coffee mug from home.
Implement the use of a water fountain instead of a Sparklett’s water station.
Don’t allow for disposable utensils, plates and cups in the break room. Choose metal utensils and durable, washable tableware.
Instead of a Keurig machine that uses coffee pods, invest in an old school coffee machine with paper filters. Buy coffee beans in bulk and grind them yourself.
When you buy a dental practice, don’t gut the place entirely and renovate the whole thing. Use the existing cabinets and give them a paint job. Changing artwork? Use the existing frames and swap out the paper images. You get the drift. Don’t be in a rush to buy everything BRAND NEW.

These are just some basic ways in which we can create change. Most of these we can do immediately. Some of these may take months to get to. But it’d be great if we all start working towards it.

I’m not saying do ALL of these. But I ask you implement one or two new things every few months. Work towards a more eco-conscious practice. We won’t get to zero-waste, but if someone can try to create an All-Sustainable Hotel built on a Zero-Waste island, why can’t we get close with a dental office?

Want more? Here are 80 ways to make your dental practice go green!