Nicole Simms, CSHS Staff
In an encouraging development on the sustainable dentistry front, the issue of dental waste has recently been taken up at the University of Manitoba, where dental hygiene students in the newly formed Student Environmental Group are seeking ways to reduce the amount of pre-clinic, clinic, and general waste produced at the Dr. Gerald Niznick College of Dentistry in the Rady Faculty of Health Sciences. These students note the challenges of reducing dentistry’s environmental impact while still having “to follow provincial and national guidelines on things like infection prevention and control” – a sentiment echoed by UofT’s Carlos Quinonez in his recent editorial for the Ontario Dental Association’s Ontario Dentist Journal. In “IPAC Versus the Planet?” Dr. Quinonez discusses the tension between the profession’s new Infection Prevention and Control (IPAC) guidelines and the need to address “the amount and environmental impacts of the plastic and other solid waste produced by dental practices every day and every year” – especially in light of the severity of the impending climate crisis.
In calling on a variety of actors to address this apparent impasse, including policymakers, regulators, associations, and manufacturers, Dr. Quinonez draws attention to the systemic changes needed to support the emergence of a more sustainable health system in Canada – this isn’t something individual practitioners can accomplish on their own, though immediate, permissible changes to practice that enhance sustainability remain an important part of the solution. The role these – and other – actors can play in the requisite multifaceted approach to sustainable dentistry is explored in a newly published paper in the Journal of Dental Research co-authored by our own Dr. Fiona Miller. The work also emphasizes the need to embed environmental sustainability into the dental curriculum and to prioritize research that facilitates evidence-based sustainable practices.
The need for a multifaceted approach to sustainable healthcare has actually been acknowledged by the Canadian Dental Association (CDA) since at least 2009, when it was one of twelve national organizations that signed a joint statement titled “Toward an Environmentally Responsible Canadian Health Sector” alongside the David Suzuki Foundation. The statement included the following calls to action:
That government at all levels understand and address links between health and the environment and incorporate these links into policy decisions through legislative and budgetary actions.
That health care organizations pledge to minimize the negative impact of their activity on the environment and to seek solutions to existing barriers.
That individuals working in the health care sector both model and advocate for environmentally responsible approaches to delivering health care without compromising patient safety and care.
Don Friedlander, then-president of the CDA, offered support for what he termed “the protection of the environment in the context of health care,” noting that the CDA “encourage[s] change in consumption patterns and best practices of ecologic stewardship. After all, this stewardship is in the best interest of everyone’s health.”
While the CDA’s recognition that dentistry has a role to play in mitigating the environmental impacts of the health sector demonstrated foresight, Canada currently lags behind several other countries when it comes to promoting and establishing sustainable dentistry practices. In the UK, for example, where significant resources are devoted to facilitating a shift toward sustainable healthcare, resources on sustainable dentistry abound: the British Dental Journal has published series of papers on the topic, and the Centre for Sustainable Healthcare’s 2018 Sustainable Dentistry: A How To Guide for Dental Practices offers practical information on how the profession can best approach travel, equipment and supplies, energy, waste, biodiversity and greenspace, and measuring and embedding sustainability.
The joint statement that the CDA signed back in 2009 acknowledged the difficulty of efforts like these; this is why it included a pledge to “seek solutions to existing barriers.” That these solutions would involve education, research, and collaborations with policy-makers, vendors, and others was also clearly articulated. As more Canadian dental students and practitioners contribute to the growing body of academic and policy work calling for and crystallizing the logistics of this type of multifaceted approach to sustainable healthcare, we hope to see it increasingly operationalized in this country. A shift toward sustainable dentistry is a necessary component in the realization of that 2009 vision to which the CDA was a signatory: a green Canadian health sector in which “minimizing negative impact on the environment [is] a priority for all organizations and individuals in their day-to-day practices and at all levels of decision-making.”