Environmental sustainability: measuring and embedding sustainable practice into the dental practice.

This final paper within the sustainability series focuses on creating a framework for embedding sustainability within a dental practice and builds upon sustainability principles and practices explored in the preceding papers. The dental practice could be a high street dental practice, a community setting or a trust.

Environmental sustainability and travel within the dental practice.

A significant amount of dentistry's carbon emissions originate from travel (64.5%). Dental-associated travel affects air quality, releasing over 443 tonnes of nitrogen oxides (NOx) and 22 tonnes of particulate matter (PM2.5) annually. This reduction in air quality reduces over 325 quality-adjusted life years (QALY) per year. Wider health impacts associated with noise and traffic incidents doubles the impact on health in QALYs. Dental procedures that require shorter appointment times have disproportionately higher emissions due to patient travel. The dental team can reduce appointment times by combining visits for family members or combining operative procedures, or reducing appointment frequency based on patient risk. Community oral health programmes and preventive programmes reduce travel emissions. The number of physical dental appointments can be reduced using information technology such as global positioning systems (GPS), telemedicine and teleconferencing. The mode of travel is important, with the air and carbon emissions generated by active travel negligent compared to a private car. Travel plans can help encourage active travel, as can flexible working hours, cycle to work schemes, cycle racks and shower facilities. Practices should consider purchasing locally sourced or sustainably transported goods and, ideally, use local dental laboratories.

Environmental sustainability and waste within the dental practice.

This paper forms part of a series of papers, seven in total, which have been requested by colleagues to help them as clinicians understand sustainability as it relates to dentistry. This paper focuses on waste and how the dental team can influence how waste is processed and disposed of. It is the authors' hope that this series of papers stimulates interest, debate and discussion and, as well as being economically responsible, ultimately motivates and inspires the dental team to be more socially and environmentally sustainable which in turn will help promote health and illness prevention.

Environmental sustainability and procurement: purchasing products for the dental setting.

Sustainable procurement, when applied to dentistry, is the practice by which the dental surgery addresses environmental, social and ethical considerations when purchasing goods or services. This paper focuses on procurement and how the dental team can influence what is purchased in order to become more sustainable. It is the authors' hope that this series of papers will stimulate interest, debate and discussion and, as well as being economically responsible, ultimately motivate or inspire dentistry to be more socially and environmentally sustainable which in turn will help promote health and illness prevention.