Innovating for impact: Student leadership in sustainable dental school waste management

Dentistry's environmental impact is significant, with a single check-up generating over 25 waste items, such as soft plastic barriers, disposable tips, gloves, gowns, and disinfectant wipes. While these items are crucial for adhering to infection control practices, they inadvertently add to dentistry's ecological carbon footprint.1 Effective management of dental waste is essential, and the application of the “Reduce, Reuse, Recycle, and Rethink” strategies can help minimize our environmental impact.2 The American Dental Association provides a comprehensive guide titled “80 Ways to Make Your Dental Practice Green,” which offers advice on sustainable waste management practices, including the judicious use of disposable barriers.3 Given the increasing importance of environmental conservation, implementing sustainable practices in dental waste management is more crucial than ever.4, 5 This paper introduces the “Green Teeth,” a pioneering student-led initiative launched at the University of California San Francisco (UCSF) in 2020. The initiative aims to promote sustainable waste management practices in dental education and help reduce the carbon footprint of dentistry (See Figure 1) The Green Teeth initiative, also known as the Oral and Climate Health Coalition, emphasizes the link between oral health and climate change. This initiative combines educational outreach and practical sustainable waste management services to integrate climate health into the predoctoral dental curriculum and promote sustainability at UCSF School of Dentistry. The Green Teeth initiative has integrated dental practice sustainability into the first-year dental curriculum. This program educates students about sustainable waste management and climate-related health issues, ensuring they are well-informed before beginning their clinical practice. The curriculum covers topics such as medical waste handling, the rise in health problems like asthma due to pollution, and the amount of landfill and recyclable materials generated by an average dental office annually. This enhancement to the curriculum is timely, as the significant increase in plastic waste from COVID-19 pandemic-related personal protective equipment (PPE) has underscored the urgency of efficient dental waste management. The Green Teeth initiative introduced the implementation of the “soft plastics recycling program” at the Dental Radiology clinic in 2021. This program encourages dental students to dispose of plastic barriers in designated bins, effectively separating recyclable plastic waste at its source (Figure 1). By optimizing the recycling process, this initiative not only contributes to environmental sustainability but also instills a culture of sustainability in dental education through hands-on experience in eco-friendly practices. The Green Teeth initiative has made commendable progress in its educational and sustainability programs. First-year dental students are now well-versed in sustainable waste management practices. However, further studies are necessary to fully assess the effectiveness of the educational component of the Green Teeth initiative. The soft plastics recycling program demonstrated significant success, recycling 40 gallons of soft plastic daily and reducing waste by 1,200 gallons over five months in 2022. According to the School's Assistant Director of the Recycling and Waste Reduction Program, the initiative has had a substantial environmental impact. It reduced 7.13 cubic yards of landfill waste, which was redirected to recycling, saving $16,000 in landfill waste disposal costs. Combined with the monthly cost of recycling 1.5 cubic yards of landfill, this resulted in about $25,000 in savings for the School of Dentistry over a five-month period. In its first year, the program was estimated to result in savings of approximately $3 per patient visit. Today, with the increased waste management costs in San Francisco, an additional 10–15% savings is estimated. However, it is important to consider that there are also costs associated with implementing such a recycling program. These include the collection, sorting, and transportation of soft plastics to recycling facilities, as well as any fees charged by the recycling processor. While these costs were not the primary focus of this study, to provide a more comprehensive assessment of the program's financial benefits, further analysis of potential additional costs is recommended. This could involve conducting a cost-benefit analysis that considers factors such as transportation costs, processing fees, and any other relevant expenses to gain a more accurate understanding of the program's overall financial impact. It is important to note that the expansion of the Green Teeth initiative as a model to different locations could be influenced by the diverse recycling regulations across various regions, states, or countries, affecting both the feasibility and the strategic approach of the programs. The initiative's adaptability to diverse regulatory environments is crucial, emphasizing the importance of researching local regulations and forming partnerships with local agencies. Continuous monitoring and adaptation to regulatory changes are vital to ensure the initiative's ongoing success in new areas. Currently, the Green Teeth initiative is operational only within the Dental Radiology clinic, but plans are underway to extend these activities to other departments. The school's leadership is dedicated to supporting this expansion, addressing challenges such as space constraints and cost, and promoting the adoption of these practices in additional clinics. The UCSF School of Dentistry is committed to embedding eco-dentistry principles throughout the school, providing training on sustainable waste management, and broadening the implementation of sustainable practices in clinical settings. Adopting sustainable practices not only benefits the environment but also attracts eco-conscious patients, enhancing both the practice's environmental impact and its reputation. Millennials, in particular, are known to value services that are environmentally responsible, highlighting the importance of eco-friendly dental waste management and the need for a better understanding and implementation of sustainable practices.5 Sustainability is an ongoing journey that demands continuous education and reflection. Each success and challenge acts as a milestone, driving further commitment and innovative strategies to develop a dental practice that is resilient and deeply committed to environmental stewardship. The authors would like to thank Daniel Chau, Assistant Director of Recycling and Waste Reduction Program at UCSF, for his contribution. The authors declare no conflict of interest.