Abstract
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.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Dictionary.com. Sustainability. Available at https://www.dictionary.com/browse/sustainability (accessed March 2019).
Zero waste international alliance. Home. Available at www.zwia.org (accessed March 2019).
Gautam V, Thapar R, Sharma M. Biomedical waste management: incineration vs. environmental safety. India J Med Microbiol 2010; 28: 191-192.
Nzihou A, Themelis N J, Kemiha M, Benhamou Y. Dioxin emissions from municipal solid waste incinerators (MSWIs) in France. Waste Manag 2012; 32: 2273-2277.
Viel J F, Floret N, Deconinck E, Focant J F, De Pauw E, Cahn J Y. Increased risk of non-Hodgkin lymphoma and serum organochlorine concentrations among neighbors of a municipal solid waste incinerator. Environ Int 2011; 37: 449-453.
Fiordelisi A, Piscitelli P, Trimarco B, Coscioni E, Laccarino G, Sorriento D. The mechanisms of air pollution and particulate matter in cardiovascular diseases. Heart Fail Rev 2017; 22: 337-347.
Duane B, Steinbach I, Ramasubbu D et al. Sustainability and travel within the dental practice. Br Dent J 2019; In press.
Legislation.gov.uk. The Hazardous Waste (England and Wales) Regulations 2005. Available at http://www.legislation.gov.uk/uksi/2005/894/contents/made (accessed March 2019).
Legislation.gov.uk. Environmental Protection Act 1990. Available at http://www.legislation.gov.uk/ukpga/1990/43/section/34 (accessed March 2019).
Legislation.gov.uk. The Controlled Waste (England and Wales) Regulations 2012. Available at http://www.legislation.gov.uk/uksi/2012/811/contents/made (accessed March 2019).
Legislation.gov.uk. The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment (Amendment) Regulations 2011. Available at http://www.legislation.gov.uk/uksi/2011/1885/contents/made (accessed March 2019).
Allen R. Disposing of clinical and dental waste. BDJ Team 2014; 1: 14038.
Environmental Protection Agency: Greenhealthcare. Reducing Waste in Irish Healthcare Facilities. 2014. Available at https://www.epa.ie/pubs/reports/green%20business/Reducing-waste-in-Irish-Healthcare-Facilities-waste-guidance-booklet-reduced-size.pdf (accessed March 2019).
Royal College of Physicians. Less waste, more health: A health professional's guide to reducing waste. 2018. Available at https://www.rcplondon.ac.uk/projects/outputs/lesswastemorehealthhealthprofessionalsguidereducingwaste (accessed March 2019).
Grose J, Richardson J, Mills I, Moles D, Nasser M. Exploring attitudes and knowledge of climate change and sustainability in a dental practice: a feasibility study into resource management. Br Dent J 2016; 220: 187-191.
R, Grose J, Manzi S, Mills I, Moles D, Mukonoweshuro, R, Nasser M and Nichols A. What's in a bin: A case study of dental clinical waste composition and potential greenhouse gas emission savings. Br Dent J 2016; 220: 61-66.
KS Environmental Group. The many colours of waste recycling! Available at https://ksenvironmental.com.au/waste-and-recycling-colours/ (accessed March 2019).
XE. Currency Converter: GBP to EUR. Available at https://www.xe.com/currencyconverter/convert/?Amount=1&From=GBP&To=EUR (accessed March 2019).
Royal College of Nursing. Freedom of information report on waste management. Available at https://www.rcn.org.uk/professional-development/publications/pub-004108 (accessed March 2019).
Duane B, Ramasubbu D, Harford S et al. Sustainability and procurement within the dental practice. Br Dent J 2019; In press.
Sustainable Development Unit. International pharmaceutical and medical device guidelines. 2012. Available at https://www.sduhealth.org.uk/areas-of-focus/carbon-hotspots/pharmaceuticals.aspx (accessed March 2019).
Mapping Greener Healthcare. West Kent Primary Care Trust: Paper Policy. 2009. Available at http://map.sustainablehealthcare.org.uk/west-kent-primary-care-trust/paper-policy (accessed March 2019).
Information Commissioner's Office. Guide to the General Data Protection Regulation (GDPR). 2017. Available at https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/ (accessed March 2019).
Environmental Paper Network. Paper Calculator. Available at https://c.environmentalpaper.org/home(accessed March 2019).
Siu J, Hill A G, MacCormick A D. Systematic review of reusable versus disposable laparoscopic instruments: costs and safety. ANZ J Surg 2017; 87: 28-33.
Eckelman M, Mosher M, Gonzalez A, Sherman J. Comparative life cycle assessment of disposable and reusable laryngeal mask airways. Anesth Analg 2012; 114: 1067-1072.
Overcash M. A comparison of reusable and disposable perioperative textiles: sustainability stateofthe-art 2012. Anesth Analg 2012; 114: 1055-1066.
BOC. Medical nitrous oxide: essential safety information. 2017. Available at http://www.bochealthcare.co.uk/internet.lh.lh.gbr/en/images/HLC_506820-MGDS%20Medical%20nitrous%20oxide%28web%29409_57651.pdf (accessed March 2019).
Public Health England and Centre for Sustainable Healthcare. Carbon Modelling within dentistry: towards a sustainable future. 2018. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/724777/Carbon_modelling_within_dentistry.pdf (accessed March 2019).
Sustainable Development Unit. Carbon footprint from anaesthetic gas use. 2013. Available at https://www.sduhealth.org.uk/documents/publications/Anaesthetic_gases_research_v1.pdf (accessed March 2019).
Medclair. Available at http://www.medclair.se/en/start/ (accessed March 2019).
Gadani H, Vyas A. Anaesthetic gases and their global warming: Potential, prevention and future of anaesthesia. Anesth Essays Res 2011; 5: 5-10.
Medicvent. Available at http://medicvent.se/en/ (accessed March 2019).
Duane B, Berners Lee M, White S, Stancliffe R, Steinbach I. An estimated carbon footprint of NHS primary dental care within England. How can dentistry be more environmentally sustainable? Br Dent J 2017; 223: 589-593.
Oral Health Group. A Buyers' Guide to Dental Vacuum Systems. Available at https://www.oralhealthgroup.com/features/a-buyers-guide-to-dental-vacuum-systems/ (accessed March 2019).
British Dental Association. Antimicrobial resistance in dentistry. Available at https://bda.org/amr (accessed March 2019).
Health Care Without Harm. How doctors can help: reduce pharmaceutical pollution. 2014. Available at https://noharm-europe.org/sites/default/files/documents-files/3026/HCWH%20Europe%20-%20%20Pharma%20Leaflet%20for%20Doctors.pdf (accessed March 2019).
Ford A T, Fong P P. The effects of antidepressants appear to be rapid and at environmentally relevant concentrations. Environ Toxicol Chem 2016; 35: 794-798.
Medicine Waste. Only Order What You Need. Available at http://www.medicinewaste.com/help (accessed March 2019).
United States Environmental Protection Agency. Reducing and Reusing Basics. Available at https://www.epa.gov/recycle/reducing-and-reusing-basics (accessed March 2019).
Warp It. NHS Case Study. Available at https://www.warp-it.co.uk/nhs.aspx (accessed March 2019).
The Freecycle Network. Available at https://www.freecycle.org/ (accessed March 2019).
Gumtree Website. Available at https://www.gumtree.com/freebies (accessed March 2019).
Dentaid. Equipment Donations. Available at https://www.dentaid.org/overseas/equipment-donations/ (accessed March 2019).
UK Government. Waste and environmental impact: hazardous waste. Available at https://www.gov.uk/browse/business/waste-environment (accessed March 2019).
Department of Health and Social Care. Management and disposal of healthcare waste (HTM 07-01). Available at https://www.gov.uk/government/publications/guidance-on-the-safe-management-of-healthcare-waste (accessed March 2019).
House of Commons Environment, Food and Rural Affairs Committee. Food waste in England: Eighth Report of Session 2016-2017. 2017. Available at https://publications.parliament.uk/pa/cm201617/cmselect/cmenvfru/429/429.pdf (accessed March 2019).
Hospitals for a Healthy Environment. H2E 10-Step Guide to Composting in Healthcare Facilities. Available at https://practicegreenhealth.org/pubs/composting.pdf (accessed March 2019).
Chartered Institution of Wastes Management. Pre-Acceptance Waste Audits: A guidance document for large healthcare waste producers in England. Available at https://www.ciwm.co.uk/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=QoR7FzWBtisamYEcWSfL6SxAJRLAPT9vl3Da9d0xu%252fWr4juDf%252fzlVvle74nKSJ5jD3ttQpDLVdfSjBhxHW1ywrc0pA9%252ffReYInCyHlpTeykJKBrJ7%252b1XKUjADS5eB7a5vqOr6rhuKrut%252fccP0kXBmzzlmfxV3kAK5yTAvQmnm2hgddJSYiGxkg%253d%253d (accessed March 2019).
Environmental Protection Agency Green healthcare. Howtoguide: Undertaking a Bin Placement Survey. Available at https://www.greenhealthcare.ie/wp-content/uploads/2014/05/HowToUndertakeaBinPlacementSurvey-revised.pdf (accessed March 2019).
Wrap. Barriers to recycling: A review of evidence since 2008. 2014. Available at http://www.wrap.org.uk/sites/files/wrap/WRAP%20Barriers%20Synthesis%20Full%20Report%20final%20121214%20PUBLISHED%20-%20PDF.pdf (accessed March 2019).
Repak. Prevent & Save: Best Practice Guidelines in Waste Management. 2016. Available at https://www.repak.ie/wp-content/uploads/2016/08/PS_HotelCaseStudy_Consolidated.pdf (accessed March 2019).
Resource Efficient Scotland. Reduce your office carbon footprint with our green office guide. Available at https://www.resourceefficientscotland.com/guide/green-office (accessed March 2019).
McKenzie-Mohr D. Fostering Sustainable Behavior: An Introduction to Community-Based Social Marketing. 3rd ed. Gabriola Island, BC: New Society Publishers, 2011.
Grose J, Burns L Mukonoweshuro R et al. Developing sustainability in a dental practice through an action research approach. Br Dent J 2018; 225: 409-413.
Legislation.gov.uk. The Environmental Permitting (England and Wales) Regulations 2010. Available at https://www.legislation.gov.uk/ukdsi/2010/9780111491423/contents (accessed March 2019).
e-Learning for Healthcare. e-Den. 2016. Available at https://www.e-lfh.org.uk/e-den/ (accessed March 2019).
Academy of Medical Royal Colleges. Protecting Resources, Promoting Value: a doctor's guide to cutting waste in clinical care. 2014. Available at https://www.aomrc.org.uk/wp-content/uploads/2016/05/Protecting_Resources_Promoting_Value_1114.pdf (accessed March 2019).
Pietzsch N, Ribeiro J L D, de Medeiros J F. Benefits, challenges and critical factors of success for Zero Waste: A systematic literature review. Waste Manag 2017; 67: 324-353.
Legislation.gov.uk. The Environmental Permitting (England and Wales) Regulations 2007. Available at http://www.legislation.gov.uk/uksi/2007/3538/contents/made (accessed March 2019).
European Commission. Waste, Electrical and Electronic Equipment. 2019. Available at http://ec.europa.eu/environment/waste/weee/index_en.htm (accessed March 2019).
Legislation.gov.uk. The Waste (Scotland) Regulations 2012. Available at https://www.legislation.gov.uk/sdsi/2012/9780111016657/contents (accessed March 2019).
Sustainable Development Unit. Reporting on Sustainability. Available at https://www.sduhealth.org.uk/delivery/measure/reporting.aspx (accessed March 2019).
CODA. The Mobius Loop: Plastic Recycling Symbols Explained. 2016. Available at https://www.coda-plastics.co.uk/blog/themobiusloopplasticrecyclingsymbolsexplained (accessed March 2019).
Isopharm. Hazard Waste Segregation, Storage and Disposal. Available at https://www.isopharm.co.uk/dental/hazardouswastesegregationstorageanddisposal0 (accessed March 2019).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Duane, B., Ramasubbu, D., Harford, S. et al. Environmental sustainability and waste within the dental practice. Br Dent J 226, 611–618 (2019). https://doi.org/10.1038/s41415-019-0194-x
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41415-019-0194-x
This article is cited by
-
Towards environmentally sustainable surgery: a comparison of robotic surgery with other approaches
Updates in Surgery (2026)
-
How do dental professionals perceive sustainable dentistry? A qualitative study
BMC Medical Education (2025)
-
Environmental costs in healthcare system: the case studies of Greece health care
BMC Health Services Research (2025)
-
A narrative review on the multifaceted impacts of climate change on oral health: a call for sustainable practices
Discover Public Health (2025)
-
A scoping review exploring carbon emissions in dentistry—a step towards sustainability
BMC Oral Health (2025)


