Strategies for Reducing Material Waste

In daily dentistry, practices produce waste. If not properly disposed of, some of this waste can have adverse effects on the environment.

Waste takes other forms. What you order and how much produces waste. How the materials you use are packaged produces waste, too. Even the light bulbs you choose or the paper you recycle (or do not) produces waste. This article looks at problems with material waste in dentistry, ways of employing green policies, and strategies for reducing waste in your practice this year.

Wasted Dental Materials

Taking advantage of purchasing deals on materials you use often makes sense for your bottom line. However, for products with an expiration date, buying more than you can use before that date can backfire. You probably have thrown out some of that product you got for “free” before you could use it; if not, you probably know someone who has. Avoiding that problem starts with how much you order and when.

Another area where material waste occurs is package sizing. Sometimes leftover material in these larger packages or tubes goes unused and is thrown out. The American Dental Association (ADA) recommends buying sealants, adhesives, and other restorative materials in package sizes that ensure use of all the product during the procedure to avoid this problem.¹

Dental Amalgam

One of the most significant areas of concern regarding dental material waste is dental amalgam. Dental amalgam contains mercury, a toxic and bioaccumulative material. Therefore, it is essential to manage dental amalgam waste properly. A European journal had the following suggestions for dental practices:

1. Reduce waste by limiting the amount of dental amalgam used in procedures. Consider alternative materials like resin, ceramic, or other metal alloys when suitable.
2. If you do need to employ amalgam material, use precapsulated dental amalgam to avoid spills and clinic contamination from liquid mercury.
3. Install chairside filtration devices and secondary filters in vacuum pumps to trap larger amalgam particles and prevent contamination. Chairside traps remove around 68% of amalgam particles, whereas vacuum filters are around 40% effective.
4. Use these filtration devices to separate fine particles generated during procedures, preventing their release into wastewater.
5. Treat collected mercury and amalgam waste as hazardous waste, ensure staff are trained in disposing of it, and use protective gear. Store contact and noncontact amalgam waste separately.

1. Collect waste storage containers for reclamation by a registered agency, aiming for recycling, although not all agencies can do this.
2. Avoid flushing contaminated wastewater down sinks, rinsing chairside traps or vacuum filters in sinks, or disposing of amalgam material in general waste. These practices release mercury into the environment, undermining efforts to reduce mercury contamination.²

The Full Picture on X-Ray Waste

Material waste occurs when using traditional x-rays and related chemicals. There are concerns regarding silver and lead pollution. Silver can get into the water system with improper disposal of dental x-ray fixer and into landfills through disposal of undeveloped film. When thrown into the general waste system, the lead foil around the x-ray film can leach lead into the landfills. In both cases, using an approved waste carrier or switching to digital x-rays can avoid these problems.³

In addition to the risks with silver and lead, the constant exposure to radiographic developer and fixer solutions in dental settings can pose potential health risks to dental personnel. These solutions contain chemicals like hydroquinone, acetic acid, and glutaraldehyde, known for their volatile and irritating properties. Continuous exposure to these chemicals, as mentioned in the Material Safety Data Sheets, may lead to respiratory tract irritation and aggravate preexisting asthma conditions. Additionally, some components, like hydroquinone, are linked to chromosome breakage, although the human risk is uncertain. Furthermore, the incompatibility warnings, such as the release of sulfur dioxide or ammonia when in contact with acids or bases, respectively, raise concerns.³

These chemicals, which operate together in the same x-ray developer apparatus, are poured in and out of containers. Given the small, confined spaces of x-ray developer rooms, repeated exposure, even with proper ventilation, may pose long-term health risks over a span of 20 years. The cumulative effects of exposure to these volatile and potentially harmful chemicals warrant careful consideration for the safety and health of dental personnel—and perhaps switching to a digital radiography option.³

Areas of Waste You Might Not Notice

Problematic areas also include energy waste and chemical waste. There are other ways in which a dental practice can create waste, such as multiple shipments from the same supplier in a given week or not recycling products when appropriate.

In Hand Dental, a dental monitoring app company that allows dentists to monitor their patients remotely, had the following suggestions for reducing waste in your dental practice:

• Use a dimmer system for lights to save energy. It adjusts light based on how much natural light is already in the room. Add motion detectors and timers to turn off lights when no one is around.
• Instead of chemicals, use steam to clean and sterilize items.
• Dental offices produce lots of trash with single-use products. Try using stainless steel trays and reusable items like glass irrigation syringes and cloth bags. Use disposable barriers only when necessary.
• Switch to a vacuum without water and with a special trap for amalgam.
• Ask suppliers to pack orders together to make fewer delivery trips. Reuse the boxes.
• Look into aligners made from reusable plastic. Some companies reshape them so they can be used 3 times.
• Recycle as much paper, aluminum, and plastic as possible using bins. Some services recycle shredded medical paper.
• Try going paperless. Use software to manage appointments, bill patients, and keep records without printing anything.⁴

In addition, there are things your staff can do to reduce waste and conserve energy in a dental practice, including the following:

1. Choose products with minimal packaging.
2. Use reusable plastic containers for cleaning and disinfecting solutions to reduce waste.
3. Opt for products made from recycled or partly recycled materials like cotton or wool rolls, and paper towels.
4. Install energy-efficient lighting to reduce energy consumption.
5. Regulate office temperature effectively to conserve energy.³

Old equipment is another area of opportunity regarding waste in a dental practice. When you replace a broken or aging dental equipment component, it can be tempting to dump the old one. However, instrument company ProDent® USA encourages dental practices to recycle (ie, pass on) old equipment instead.⁵

For example, outdated dental equipment, like an x-ray machine, does not have to end up in a landfill. Explore programs that accept old equipment and repurpose it to set up dental clinics in developing nations, like World Health Dental Organization, or experts in dental equipment recycling and decommissioning, like TechWaste Recycling.

By partnering with such initiatives, you can dispose of your outdated machine responsibly while giving it a new life to serve communities in need. This allows your office to upgrade to modern equipment and reduces landfill waste. Moreover, when you donate functioning equipment that the organization can ship to a clinic that needs it, your contribution aids in providing essential oral care to vulnerable populations worldwide.⁵

Surprising Facts Regarding Recycled Paper

These suggestions might seem like small things and many are. However, small does not mean insignificant. Small changes accumulate into big impacts.

For example, it might seem like a small thing to have those blue bins for recycling paper. But the impact the cumulative contents of those bins can have might surprise you. Recycling 1 ton of paper saves trees, conserves resources like water and oil, reduces air pollution, and prevents landfill space consumption. It also saves

1. 17 trees from being cut down,
2. 380 gal of oil,
3. 3 cu yd of landfill space,
4. 4000 kW of energy,
5. 7000 gal of water,
6. This represents a 64% energy savings, 58% water savings, and reduces 60 lb of air pollution.³

Moreover, the 17 saved trees can collectively absorb 250 lb of carbon dioxide from the air annually. By contrast, burning a ton of paper releases approximately 1500 lb of carbon dioxide.³

There are a few things you can do to reduce paper usage in the practice, per the ADA. Ask to stop receiving unwanted office mail. Choose recyclable options for letterhead, envelopes, fax paper, and business cards and send appointment reminders via email or text message. Also, consider going paperless by using a virtual system for patient records, billing, and x-rays. In addition, reduce the number of printers in the practice and print double-sided when feasible. Reuse shredded paper as packaging material.¹

References

1. 80 ways to make your dental practice green. American Dental Association. Accessed December 7, 2023. https://www.ada.org/en/resources/practice/practice-management/office-design/80-ways-to-make-your-dental-practice-green

2. Muhamedagic B, Muhamedagic L, Masic I. Dental office waste - public health and ecological risk. Mater Sociomed. 2009;21(1):35-38. doi:10.5455/msm.2009.21.35-38

3. Farahani A, Suchak M. Eco-Friendly Dentistry: The Environmentally-Responsible Dental Practice. University of Waterloo. April 3, 2007. Accessed December 7, 2023. https://ecodentistry.org/wp-content/uploads/2014/12/eco-friendly_dentistry_jcda.pdf

4. 10 tips to help your dental practice produce less waste. In Hand Dental. June 29, 2023. Accessed December 7, 2023. https://inhanddental.com/10-tips-to-help-your-dental-practice-produce-less-waste/

5. Mughal, H. (2022) Tackling Dental Office Waste and Recycling, ProDentUSA. Available at: https://prodentusa.com/tackling-dental-office-waste-and-recycling/ (Accessed: 8 December 2023).