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The Green(er) Dental Office

So another week has gone by and we are still thinking about teeth. For a dentist, every day is another day to think about teeth. The other day I was taking a trip to the dump, oh I mean transfer station, to drop off another couple of dozen bags of office waste and started thinking about how much trash a dental office actually produces.

The experts tell us medical waste (which includes dental waste) makes up more than a fifth of all waste that ends up in the landfill. Of course, this does not include sharp items like needles which are incinerated by a licensed operator. How is all of this trash made? Consider this simple fact for a minute: In my dental chair, I see about 20 patients in a day. My two hygienists each see 8 or so additional patients. Typically for each patient, I wash my hands with surgical scrub, dry my hands with paper towels, and put a pair of gloves on. Next, I anesthetize (freeze) my patient. Now I take off my gloves and go down to the hygienist’s room and wash all over again, dry my hands and put on another pair of gloves. After doing a checkup for my hygienist’s patient, I throw away those gloves and go back to my treatment room. I wash up again with surgical scrub and put on a new pair of gloves after drying with paper towels. Sometimes the patient isn’t completely anesthetized so I place more freezing and do another hygiene checkup. I do this twenty times a day. You can see that if everything goes perfectly (everyone freezes up on the first attempt), I wash with surgical scrub 60 times a day, and my assistant washes 40 times a day (she doesn’t do hygiene checkups). My hygienist washes up, dries and puts gloves on only 8 or 10 times a day (and there are two hygienists). Latex gloves will not slide on if there is any moisture on the hands so 7 or 8 paper towels are needed each time the hands are washed. (60 X 7) + (40 X 7) + 2(8 X 7) So you can see that if everything goes perfectly, 812 paper towels and 232 latex gloves are used each and every day we are open. Then there are other items like sterilization bags, at least one per patient, sometimes several, and cotton gauze, patient bibs, and general packaging for everything that comes into the office. That’s a lot of garbage, and little can be done to reduce it. However, there are other items that also impact the environment that can be controlled better.

Take a look at radiographs (x-rays). Film based radiographs require lead shielding in each film package, individual packaging, and disposal of toxic developing and fixing solutions. The lead and the solutions are not kind to the environment. Digital radiographs, on the other hand, use no developing or fixing (or any other) solutions. They require no disposable lead backscatter shielding, and they deliver the same image with only one tenth of the radiation needed for a film radiograph. This is an area that can be greener than in the past by using current technology.

As well, across Ontario dentists are required to use an amalgam separator in our waste water to separate out at least 95% of the silver amalgam that is sucked down the suction system. The systems are not cheap and require ongoing maintenance. Even though all dentists are required to use a separator, our regulatory body says only about 80% of the dental offices in Ontario are actually using one. Part of silver amalgam is mercury which when deposited in a town’s waste water is very difficult if not impossible to remove. Before this regulation went into effect, we were told that about 10% of all mercury ending up in waste water supplies across the country was placed there by dental offices. With an amalgam separator, this is also an area where an up to date dental office is greener than it was even just a couple of years ago. Ask your dentist about what is being done to reduce waste at the office.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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