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

Duane, B., Croasdale, K., Ramasubbu, D. et al. Environmental sustainability: measuring and embedding sustainable practice into the dental practice. Br Dent J 226, 891–896 (2019).


Sustainability within Dentistry is a key and current issue that needs to be addressed with climate change approaching faster than first predicted. International support is growing around this topic with the FDI recently publishing a sustainability policy statement and the BDA supporting sustainability with the involvement in national sustainability groups and publications. Dental practices can make an important change to embedding sustainable practices in a measurable and time efficient manner. This paper suggests 8 steps of increasing sustainability in practice using ‘Kotter’s change management theory’, highlighting potential barriers to change and suggests facilitators to help overcome these.

1. Create Urgency

The dental team need to feel inspired to act and understand the need to change. Embedding sustainability as part of the patient’s overall treatment and part of their duty as healthcare professionals, where the dental team think about sustainability not as something separate but as part of the everyday functioning of the practice.

2. Form a powerful Coalition

The Sustainable Development Unit recommends the NHS trusts to identify a practice sustainability lead who would: direct and enact the change, support sustainable local external community events and communicate with the dental team and facilitate ideas to making the practice more sustainable. A sustainability suggestion box could be implemented – This would be a suitable solution in ensuring the personal values and solutions are shared.

3. Creating vision for change

The practice team should work together to draft a mission statement to outline achievable goals, actions and timescales – ‘SMART’ goals.

4. Communication of the vision

Includes internal and external communication of sustainability information – on the practice website, social media and within the waiting room. Further suggesting success stories can be displayed graphically – Figure 2.

5. Overcoming barriers and enhancing facilitation/empowering others

Barriers include financial constraints, resource limitations and lack of support and cooperation (possibly due to a knowledge gap). The paper suggests sustainability ‘enablers’ needing to enhance and encourage the adoption of principles with education. Financial incentives such as subsidies on solar panels, cycle to work schemes and energy saving LED lights.

6. Creating short-term wins

Suggest using a dental team approach to create ‘quick wins’ such as replacing incandescent light bulbs, using the waiting room display to promote sustainable messages and insulating the water tank.

7. Building on the change

Building upon the changes made with apply for awards (NHS sustainability award) and publicly celebrating achievements, acts as both an internal and external motivator towards the dental team, other teams and the public – acting as a ‘role model’ of others.

8. Anchoring the change

The final step involves long term changes being implemented into organisational policy and procedures to ensure that it becomes part of the day to day running of the practice. This involves the measuring of sustainable improvements using quantitative or qualitative data such as the Sustainable Development Assessment tool (SDAT) which aligns with the UK sustainable development goals (SDGs). Tracking this progress could be beneficial towards the NHS in developing future sustainability plans as well as saving money and the environment.


The Sustainable Development Unit suggests that working with others whether this is with the other members of the dental team or other dental professionals, builds wider healthcare workforce that cares for our planet. Highlighting your practice as an ‘early adopter’ of sustainable change could influence upstream funding and policy change.

Research Summary Written By: Florence Mai, Queen Mary University London – BDS5

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