Green Dentistry: A Review

Abstract

In today’s modern world, it is utmost necessary to understand the importance of being ecofriendly in every aspect of our lives, which also includes dental practice as it has a big impact on the environment and ecosystem due to the large amount of waste produced by various dental procedures along with excessive use of water and electricity, which specifically emphasis the need to move towards ‘Green dentistry’. Green dentistry does not only mean environment friendly but is an innovation that reserves time as well as money by means of waste reduction, energy conservation and pollution deduction with the use of latest techniques and procedures thereby protecting the environment and the human from the menaces of rapid urbanization in developing countries.

Full text

Remedy Publications LLC.
Journal of Dentistry and Oral Biology
2018 | Volume 3 | Issue 6 | Article 1144
1
Introduction
Eco-friendly dentistry is a new upcoming emerging trend in dentistry. It involves a high-tech
approach, which reduces the environmental impact of dental practices in moving towards an
ecologically sustainable health care system. It also encompasses a service model for dentistry that
supports and maintains wellness. Eco-friendly dentistry is an approach to fulll the necessities of
patients and succors dental professionals to safeguard planetary and community well – being as well
as nancial health of their practices [1].
e color green helps in enhancing vision, stability and endurance. It also has healing power and
is considered to be the most soothing and relaxing color [2].
e vital concepts of a green dental practice encompasses water and energy conservation, usage
of non-toxic products, waste reduction and management, and abolition of high risk contagions that
adversely aect the human race as well as the environment, and encourage ‘green’ products.
Components of Green Dentistry
e Eco-Dentistry Association (EDA) has developed a model for eco-friendly dentistry that
is environmentally conscious and wellness-based, helping dentists to protect the environment
although integrating dental practices that advance preventive dentistry and serving the needs of
green dentistry consumers. It includes four components [3]:
Reduces waste and pollution: Dental clinics generate a big number of biomedical waste
products, including blood soaked materials, syringes etc. e waste should be properly disposed
using color coding of waste categories.
e four procedures accountable for majority of the dental waste and contributing to pollution
are [3]:
1. Placement and eviction of dental amalgam restorations.
2. Conventional X-ray systems.
3. Infection control methods including disposable barriers, sterilization items and toxic
disinfectants.
4. Conventional vacuum saliva ejector systems.
Mercury is being used in the form of dental amalgam as a restorative material for more than
150 years [4]. Dental amalgam is 50% mercury with silver, tin and lead and other minerals that
can contaminate the environment [5]. Once mercury enters water or soil, bacteria convert it into
Green Dentistry: A Review
OPEN ACCESS
*Correspondence:
Sumit Bhateja, Department of Oral
Medicine & Radiology, Manav Rachna
Dental College, Faridabad, Haryana,
India, Tel: 91-9891353960;
E-mail: bhateja.sumit@gmail.com
Received Date: 23 Jun 2018
Accepted Date: 30 Jul 2018
Published Date: 31 Jul 2018
Citation:
Sachdeva A, Sharma A, Bhateja S,
Arora G. Green Dentistry: A Review. J
Dent Oral Biol. 2018; 3(6): 1144.
ISSN: 2475-5680
Copyright © 2018 Sumit Bhateja. This
is an open access article distributed
under the Creative Commons Attribution
License, which permits unrestricted
use, distribution, and reproduction in
any medium, provided the original work
is properly cited.
Review Article
Published: 31 Jul, 2018
Abstract
In today’s modern world, it is utmost necessary to understand the importance of being eco-
friendly in every aspect of our lives, which also includes dental practice as it has a big impact on
the environment and ecosystem due to the large amount of waste produced by various dental
procedures along with excessive use of water and electricity, which specically emphasis the need
to move towards ‘Green dentistry’. Green dentistry does not only mean environment friendly but is
an innovation that reserves time as well as money by means of waste reduction, energy conservation
and pollution deduction with the use of latest techniques and procedures thereby protecting the
environment and the human from the menaces of rapid urbanization in developing countries.
Keywords: Green dentistry; Eco-friendly dentistry; Waste management
Akshat Sachdeva1, Aditi Sharma1, Sumit Bhateja2* and Geetika Arora3
1Dental Surgeon, Manav Rachna Dental College, India
2Department of Oral Medicine & Radiology, Manav Rachna Dental College, India
3Department of Public Health Dentistry, Inderprastha Dental College, India

Sumit Bhateja, et al., Journal of Dentistry and Oral Biology
Remedy Publications LLC. 2018 | Volume 3 | Issue 6 | Article 1144
2
methyl mercury, a potent neurotoxin that can cause brain, kidney and
lung damage in humans. As severe as the consequences of mercury
poisoning are, it’s way too easy for people to reach high levels of
exposure (Figure 1) [5].
Prevention from mercury pollution can be achieved by the
following ways [6]:
i. Usage of alternate substances like GIC, composite.
ii. Incorporation of an amalgam separator in clinics.
iii. Recycling waste amalgam.
All the conventional dental oces used traditional lm X-rays.
is technology has two signicant environmental hazards: silver and
lead. e source of pollution for silver is unused xer and unused
lms and for lead, it is lead foil in lm packet and lead apron/shield.
e dierent forms of waste generated as a result of X-ray
processing in the dental oces are as follows (Figure 2) [7]:
i. X-Ray equipment.
ii. Undiluted developer.
iii. X-Ray lm: lead and silver.
iv. Used xer contains silver.
v. Developer systems cleaner containing chromium.
Ways for preventing X-Ray waste pollution are [3]:
i. Shi to digital imaging.
ii. Usage of non-chromium system developer cleaners.
iii. Capture waste lead.
iv. Filter used xer.
According to the new updated color coding for Biomedical Waste
Management – 2016, waste should be disposed in suitable color bags
as under [8]:
1. Yellow: Collected in colored non – chlorinated plastic bags
or containers.
• Human anatomical waste: Human tissues, body parts, organs.
• Soiled waste: items contaminated with blood, plaster casts,
cotton swabs, bag containing residual or discarded blood.
• Expired or discarded medicines: pharmaceutical waste
including ampoules and vials.
• Chemical liquid waste: X-ray lm developing liquid, disposed
formalin, contaminated secretions, aspirated uids, liquid
from laboratories and oor washings.
• Microbiology, Biotechnology and other laboratory waste:
culture media, stocks or specimens of microorganisms, live
or attenuated vaccines.
2. Red: Collected in red colored non-chlorinated plastic bags
or containers.
• Polluted Waste resulting from use and throw articles such
as tubes, bottles, intravenous tubes, catheters, urine bags,
syringes etc.
3. White: Collected in puncture-proof, leak-proof and
tamper-proof containers.
• Needles, syringes having immovable needles, needles from
tip cutter or burner, scalpels, blades, or any other infected
needle-like object.
4. Blue: Collected in cardboard boxes with blue colored
markings.
• Glassware: Broken or discarded and adulterated glass
objects including medicine vials and ampoules except those
contaminated with cytotoxic wastes.
• Metallic body implants.
Saves water, energy and money: Conservation is the mantra of
future dentistry because it extends the life of our precious resources
and in addition enables us to save money. We should make sure that
when we leave the working premises next time, check and look for
those ubiquitous blinking lights emanating from electrical equipment
[9]. It can include computers, intraoral cameras, television, or lights
le on when no one is in the oce. By turning o these items, we
can conserve a lot of energy drawn by these items that are plugged
into the grid, but not in use [10]. An inspiring milestone in green
dentistry's future is the present day instigation of energy- and water-
saving dental equipment.
Figure 1: Shows dental amalgam waste products. Figure 2: Shows X-ray processing waste.

Sumit Bhateja, et al., Journal of Dentistry and Oral Biology
Remedy Publications LLC. 2018 | Volume 3 | Issue 6 | Article 1144
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Use of LED operatory lights, which reduce electrical energy
consumption by 70%, eliminating the need for expensive halogen
bulbs is the need of the hour. Currently, manufacturers have come
out with new waterless vacuum systems, which save about 360 gallons
of water per day [9,10]. If every dental oce is installed with one of
these waterless systems, we could collectively conserve as many as
nine billion gallons of clean, drinkable water a year [11,12]. Now
think how green dentistry can put more “green” into our pocket.
Reusable drinking cups and metal suction tips were used by 50% to
60% dentists. Its use should be promoted as this can be sterilized and
is more eco-friendly [13].
Is hi-tech: High-tech alterations play a key role in helping dental
professionals achieve their targets for waste deduction and resource
conservation. Digital technologies proer premature diagnosis,
preventive therapies, and education that aim to serve the needs of
wellness lifestyle patients committed to maintaining long-term
eudemonia and seeking to avoid unnecessary or expensive procedures
[14].
Here are some high-tech innovations that are part of dentistry's
green future [15]:
1. Digital imaging system.
2. CAD/CAM systems.
3. Steam sterilizers eliminating the use of chemicals.
4. Digital patient charting, scheduling, and billing.
5. Digital paperless patient communication system such as
E-mail appointments, reminders, and saving sta time.
6. Use of website to promote and as a primary marketing tool.
7. Switch to electronic patient record format.
8. Use of oil-free compressors.
Supports a wellness lifestyle: Wellness lifestyle dentistry engages
the extensive knowledge of dental professionals in assessing the
health of periodontal tissue as a window to overall health. e so-
called lifestyle illnesses have been linked in scientic research to an
out-of-balance immune response. e oral cavity is the window to the
body’s immune response [16]. Inamed, bleeding gums are a signal
that the body’s immune response is compromised and on the verge of
an ambush. Temporary bleeding or swelling might occur. Likewise,
when microorganisms in the mouth become disproportioned,
periodontal cells indicate the need for an immune system attack. If
the bacteria are not brought into the original state, the periodontal
tissue can become the site of chronic inammation. At the untimely
stages this condition is called gingivitis, and at subsequent stages it
becomes a state known as periodontitis or periodontal disease. It is
estimated that as much as 80% of the population may suer from
periodontal disorder [16]. If le unattended, our body’s own immune
system dismantles the periodontal tissue and bones that hold our
teeth in place. e unrestricted bacteria from the mouth can travel
to various systems in the body via the bloodstream leading to long
– standing disease in rest of the body organ systems as well. Orderly
assessment of periodontium by an expert dentist is the prime method
to make sure that our body is not in a chronic inammatory state.
Teeth’s cleaning by a professional is one of the most important steps
we can take to preserve total body wellness [16].
Tips for Maintaining Body Wellness through Dentistry [16]:
• Oral – bacterial equilibrium should be monitored by the
dental professional under the aegis of salivary diagnostic test.
• It is the responsibility of the hygienist to perform perio –
charting at each appointment, apprise you your results & thereby
applying them to enhance your home care.
• Be sure to consume foods, and take supplements containing
anti-oxidant and anti-inammatory properties.
• Visit your dental professional regularly as per your
recommended schedule.
• Follow your hygienists’ home care injunctions.
Benets of Green Dentistry
Green dentistry is a whole - earth initiative to tooth care that
diminishes the negative environmental impression of dentistry and
construct a caring environment for the human race. It is based on
the model of four R’s – Rethink, Reduce, Re-use and Recycle (Figure
3) [17].
By adaptation of high technology and the use of good common
sense, we can be a part of dentistry’s clean, green and highly protable
future. is can be achieved by following the use of these simple
things:
1. Sparingly use of energy - Dental procedures uses huge
amount of electricity which can be reduced by using latest technologies
such as motion sensors, turning o light and use of CFL in the clinics.
2. Sparingly use of water - Wastage of water should be avoided
by turning o the tap during washing hands.
3. Minimize radiation - Usage of digital X-rays rather than
conventional X-rays scales down the amount of radiation and the
quality of the images will also be more improvised.
4. Reprocessing - Many materials found in a dentist’s clinic
can be recycled, including paper cups, paper, magazines, general
waste and cloths which helps to reduce costs as well as waste.
5. Applying technology - Use of computers for the storage of
data in relation to patient records will not only eliminate the paper
usage but will be more accurate.
6. Reduced Chemical Contamination, Fewer Disposables
– Green dental applications also employ superior – quality,
Figure 3: Shows 4R principle.

Sumit Bhateja, et al., Journal of Dentistry and Oral Biology
Remedy Publications LLC. 2018 | Volume 3 | Issue 6 | Article 1144
4
biodegradable disinfectants and steam sterilization techniques that
minimize the requirement of ventilation for chemical vapors, or a
hazardous waste sanction for getting rid of toxic chemicals into a
water supply.
More tooth – colored materials, Less Heavy Metal Waste –
Eco-dentistry embraces the modern world’s metal – free dental
restoratives usingcomposite bondingor ceramic veneers andcrowns.
Conclusion
Green dentistry is an evolving approach to reduce the
environmental impact from dental practice.
Green dentistry indeed lessens supply taris by amalgamating
trending innovations, and multiplies productivity by methodical time
manipulation, reducing wastage and thereby intercepting pollution.
Ultimately patients get benetted by quality treatment with reduction
in treatment costs. So let us go green today and save mother Earth
from biohazards for a better tomorrow.
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