Can preventive dentistry also be good for the environment?

DATE: October 2020
AUTHOR: Louise Sinclair

As the general public become more conscious of their environmental impact, dentistry is also taking steps to implement more sustainable practices. Much of the focus is on how we can minimize the impact of dental treatment itself – for example, recycling materials, safely disposing of waste and conserving water. Here, we discuss how dental students can use preventive dentistry to help reduce the need for restorative treatment in the first place, reducing our environmental burden along with it.

Dentistry and the environment

According to the Bulletin of the World Health Organization (WHO), dental caries is one of the most prevalent public health issues worldwide and has resulted in the widespread need for restorative care. Recurring caries and the need over time for more extensive restorations exacerbates the problem.

Restorative care involves the use of several dental materials. Dental amalgam, for example, is a durable and cost-effective restorative treatment for dental caries, and its use for restorative care has been widespread. However it is composed of up to 50% mercury by weight resulting in environmental concerns. In the placement and removal of dental amalgam, the mercury in dental amalgam can enter the environment and pose a risk to plants, animals, and humans. In addition, if traditional film X-rays are used for caries detection, silver used in radiographic fixer, along with the lead found in radiography film packets, must be carefully disposed of following regulations. As Dr. Margot Hiltz, MSc, DDS, points out in this Journal of the Canadian Dental Association (JCDA) article, 'we must recognize that some of the materials and procedures we use to provide dental health services may present challenges to the environment.'

The Minamata Convention on Mercury cites phasing down the use of dental amalgam as one of its priorities in its efforts to protect human and environmental health. The Convention’s primary recommendation is: “Setting national objectives aiming at dental caries prevention and health promotion, thereby minimizing the need for dental restoration.” This highlights the role of prevention in environmental stewardship.

The value of prevention

Despite its high prevalence, dental caries is a preventable disease. It goes without saying that prevention means better oral health outcomes for our patients. By reducing the need for restorative care, we can also reduce the environmental burden associated with dental caries. That includes not just the use of dental materials, but also the additional resources used to provide restorative treatment, such as local anesthetics, single-use disposable devices including sharps, single-use disposable PPE, water and energy.

The role of fluoride

The American Dental Association (ADA) recommends home use and in-office topical fluorides for individuals at risk for dental caries. Safe, affordable and effective, fluoride is known to help prevent demineralization associated with acid attacks, and to promote remineralization. It helps to prevent, arrest and reverse dental caries. For your patients at low risk of developing dental caries, it is recommended that they brush twice-daily with a fluoride toothpaste, such as Colgate Total. For individuals age 6 and over at increased risk for dental caries, use of a prescription-level fluoride toothpaste is recommended, such as Colgate PreviDent 5000 Plus. In addition, the in-office application of 5% sodium fluoride varnish, such as Colgate PreviDent Varnish, is recommended for patients of all ages.

Reducing dental caries through preventive dentistry clearly offers benefits for patients by contributing to improved oral health. By reducing the need for restorative care, preventive dentistry also benefits the environment.