Yiannis Kotoulas talks to Brett Duane about his pioneering drive to make the dental profession more sustainable.
The BDIA Dental Showcase is a focal point in the dental calendar, offering delegates the opportunity to discover the latest technology and materials that the dental trade has to offer. Last year’s event was more than just an exhibition though, boasting an impressive programme of lectures and presentations to further enhance delegates’ opportunities to understand the changing world of dentistry. One of the presentations was by Brett Duane, a dentist and associate professor of dental public health. Brett discussed the subject of environmental sustainability and the difference the dental profession could make to the world. Brett’s talk was enlightening and I met up with him shortly after Showcase to discuss the matter in more detail.
Ideology
As an ardent environmentalist myself I am aware of some of the stereotypes that exist, with a cadre of ‘tree
hugging’ radical protestors all too often being seen as the majority within the movement. Brett however is a great example of the growing number of rational and reasonable skilled professionals who believe in the cause of sustainability and want to work pragmatically towards the implementation of sensible reforms.
Brett began our conversation by explaining his background, “I did a master’s degree in public health and then went on to do a PhD which concentrated on sustainability. I'm currently an associate professor in dental public health at Dublin Dental University Hospital, but I don’t have a background in environmentalism or carbon foot-printing, those are just things I learnt to do. Sustainability was a part of my public health masters and I just thought it was so important. You have disposable gloves, you have excessive packaging, and as a profession we churn out all of this disposable plastic waste which we definitely don’t need to be generating. I’ve been interested in sustainability since I was a child and I think that just made me that much more perceptive of all the waste.”
As part of his talk at Showcase, Brett presented a poster which elaborated on the environmental impact of dental services. In England alone, dental services produce 675,706 tonnes of carbon-dioxide emissions annually, and this figure does not detail the amount of waste that ends up in land-fills or, much worse, in rivers and seas. However, much of this carbon footprint and waste could be argued to be essential; disposable gloves, for example, are disposable because cross-infection is a threat to patient safety. Emissions from patients and staff travelling to dental practices are also essential to a degree, as no dental practice runs without staff or patients. A public health expert himself, Brett made sure to clarify that he does not advocate for environmentalism at the expense of high standards of patient care or patient choice.
He said, “Something like re-assigning patients to dental practices closer to them is really problematic because then patients lose the ability to choose. And we all know that gloves can’t be re-used. But we can do things to mitigate excessive carbon footprints such as thinking more sustainably about the centralisation of healthcare. These large multi-surgery practices are being built all the time but they’re Not necessarily as environmentally efficient than they’re made out to be. If every time there was an instance of health services being centralised there were questions being asked about environmental impacts and travel audits being done then that would be clearer. And that’s to say nothing of the environmental impact of building a whole new building. There’s easy to use geo-optimisation software that can process patient addresses to suggest the most efficient placement of surgeries but it’s not being used in most cases.
Obviously gloves have to be disposable, but some companies will have something produced in China and then move it through multiple countires and distribution centres before the final product reaches the UK. It would be really interesting to see whether, for a little more, dental practices would be willing to pay for gloves that were produced in Britain. Encouragingly, I did recently speak to Henry Schein and the BDIA about sustainability.
Environmental sustainability encompasses a broad range of approaches, methods and philosophies, and changes do not have to be radical. However the common business model existing in dental practices is both a blessing and a curse. For example, if a principal dentist is supportive of the sustainability concept he can adopt changes quickly within his or her own practice. However, given that practices are relatively small and independent, there needs to be much wider support and a real collective will shown for changes to be seen nationally. Despite this though, Brett remains optimistic about the future. He elaborated, “All of my goals are long-term. Making dentistry fully sustainable will take between 15 and 20 years. I’ve been promoting sustainability in dentistry for the last six years but it’s only really within the last six to 12 months that the doors we’ve been pushing at all along have started to open. Sara Hurley, England’s CDO, has been very supportive of what I’ve been doing and invited me to talk at the CDO Zone at Showcase. I’ve been approached by people from the GDC offering their help and the BDA is interested in determining wich sustainable ideas it can incorporate into its good practice scheme. I’d love for sustainability to one day be at the level cross-infection is at now, where various organisations govern what is acceptable practice.”
Influencing organisations like the GDC and the BDA to recommend sustainable practices is a long-term goal for Brett, but more immediately he utilises his position as a lecturer at Dublin Dental University Hospital to imbue new dental students with an interest in practising while considering the environment.
Practicality
Sustainability in the dental practice need not be an expensive endeavour, and perhaps the most important part Brett’s message is that being green can have benefits other than simply helping the planet. He said, “There are a lot of environment-friendly things you can do as a practice that are financially beneficial too. Sustainability can be a part of your brand that will attract patients, who are increasingly environmentally aware. Lots of people go to certain supermarkets because they advertise their green credentials and this could apply to dental practices too. Digital workflow is another example of something that not only makes things easier and more cost-effective for you, but benefits the environment.
This is how progress has been made on sustainability so far, through the back door. I think the biggest issue at the moment is lack of research and available information, which is why we’re currently putting together a booklet that will lay out the top 10 things you can do to be more sustainable, alongside a certificate that practices could display in their waiting areas to show patients that they care about the environment.”
Brett is currently pioneering the idea of sustainability in the dental profession and is beginning to see the fruits of his labour, with more interest being shown in the last year and months than ever before. Implementing sustainability is at once both difficult on the macro level and simple on the individual practice level.
No-one expects, or wants, the dental profession to wake up tomorrow and begin hugging trees and protesting loudly in the streets, but every little counts and dental practices are in a great position to make a real impact by adjusting themselves to be more environmentally sustainable. And who knows, maybe if enough practices show that they care Brett’s green dream can become a reality.