Sustainability without compromise

Sustainability is an increasingly important topic both within and outside the healthcare arena. Sustainability has been defined as “meeting the needs of the present without compromising the ability of future generations to meet their own needs”, and for dental practices, this means minimising adverse effects on the environment and helping to conserve natural resources[i].

The provision of healthcare in dentistry and the management of waste arising from this has to operate under both regulatory guidelines and legally enforceable laws. Protecting the public from communicable infectious diseases and the management of cross-infection control means that in some circumstances healthcare and sustainability might be at odds.

In healthcare environments clinical outcomes are key and cannot be compromised in favour of sustainability in the short term. However, there are many ways in which dental practices can adopt a more sustainable approach while maintaining the highest standards of patient care.

What is net zero?

There’s a lot of talk about the term ‘net zero’, but what does it mean? Put simply, net zero refers to the balance between the amount of greenhouse gas that is produced and the amount that is removed from the atmosphere[ii]. It can be achieved through a combination of emission reduction and emission removal.

In October 2020, the NHS became the first healthcare provider in the world to commit to delivering a net zero health system. This means improving healthcare while reducing harmful emissions and investing in efforts that remove greenhouse gases from the atmosphere[iii].

Currently the health and care system in England, which includes dentistry, is responsible for an estimated 4-5% of the UK’s carbon footprint[iv]. For direct emissions the aim of the NHS is to reach net zero by 2040, while for emissions the NHS can influence, the target is 2045[v].

 

Sustainability and clinical standards

In dentistry, single-use, disposable items are used daily for most procedures and are essential for compliance within the clinical setting. Their use is largely governed by legislation and standards including, HTM 01-05, CQC, SHTM 01-05 and other relevant local guidelines.

Disposables are used for a reason and there can be no compromise on efficacy in chemical formulations. Infection control products in particular must go through rigorous accreditation and there is always a delicate balance between choosing materials that preserve the efficacy and compliance of the product while limiting its environmental impact.

The problem of greenwashing

With the growing consumer demand for sustainability, brands across all sectors, including dentistry, want to present an image of environmental friendliness and authenticity. However, this has led to some questionable marketing practices that can mislead consumers about environmental claims.

‘Greenwashing’ is an unsupported claim intended to deceive consumers into believing that a company’s products are environmentally friendly or have a greater positive environmental impact than is the case[vi]. As these practices become more widespread and sophisticated, the dental profession and dental industry must be committed to communicating sustainability efforts clearly and avoid any misleading claims.

Sustainable procurement

Sustainable procurement in dentistry is about addressing environmental, social and ethical considerations when purchasing goods and services. This includes consideration of how products are made, the use of resources, the supply chain and prioritising products with a low carbon footprint wherever possible without compromising on efficacy.

As a UK manufacturer, sustainability has always been an important priority for Dentisan. As part of Getinge, a global company with wider environmental aims, we are committed to promoting sustainability in all parts of the business with a global aim to be carbon neutral by 2025, a process that Getinge began back in 2010.

As part of Dentisan’s sustainability pledge, it aims to help practices become more sustainable by creating products, many of which are pH neutral with fully biodegradable formulations and packaging that uses recyclable materials where possible, but without ever compromising on efficacy.

Packaging

Dental teams should always consider how manufacturers manage both packaging and recycling and manufacturers should provide easy-to-follow recycling information for the goods and equipment they produce.

Packaging can be key in ensuring a medical device reaches the end user in a usable state and which means it is suitable for the duration of its shelf life. However, this may dictate restrictions in the materials used for packaging.

At Dentisan we must always guarantee the efficacy of our products and therefore we use recyclable packaging rather than recycled packaging wherever possible. Recyclable items can be turned into raw materials that can then be used to make new items without the need to create completely new resources.

Packaging made from recycled items, on the other hand, such as plastic bottles, will naturally have an inherent level of contamination and contain chemicals which can leach out of recycled plastics and into the product itself, potentially affecting the formulation within.

Dentisan has produced a Product Sustainability Chart detailing each of the products manufactured and supplied by Dentisan with each product’s sustainability credentials listed, including the product’s immediate packaging and outer packaging.

Improving immediate and secondary packaging using only the amount needed to protect the product helps to reduce environmental impact. The use of recyclable card and recyclable high-density polyethylene (HDPE) that is non-porous and impervious to chemicals wherever possible also helps minimise landfill waste.

Greener formulations

Cleaning and detergent products used in dental practices are traditionally alkaline and primarily made up of phosphates, silicates and caustic compounds. Alkaline cleaners contain surfactants, which are molecules with both hydrophilic (water-attracting) and hydrophobic (water-repelling) regions. These surfactants help to emulsify grease and oils by surrounding oil droplets with their hydrophobic tails, while their hydrophilic heads interact with water molecules[vii].

In infection control, enzymatic detergents such as DentiZyme are now increasingly used in dental practices because of their ability to break down stains, proteins and other debris using natural enzymes. These pH neutral, concentrated enzymatic detergents, which are fully biodegradable, provide increased cleaning power with limited environmental impact.

Products that are pH neutral rather than alkaline are not just kinder to the environment, they are also kinder to instruments. The more alkaline the cleaner, the more likely instruments will corrode if there are no rust inhibitors within the formulation.

Products that can be produced as concentrated formulations also help reduce packaging by being supplied in smaller containers, which has an knock on impact on haulage and transportation costs, as well as the frequency of ordering by practice staff.

An informed choice

In order to become a more sustainable business, practice owners and managers need to take environmental, social and ethical considerations into account when purchasing goods or services and question manufacturers regarding the sustainability of their products. By making an informed choice, dental practices can improve their own sustainability, and in doing so, encourage others to become more socially responsible.

One important way to encompass sustainably into daily practice is to select suppliers with a reputation for environmental and sustainable policies. Choosing to work with UK-based companies that promote the more efficient use of resources, recyclable packaging, more efficient transportation and who create cost-effective, sustainable products with proven environmental credentials can help to bring about a positive change.