Green Scene

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Green Smiles

Author: Ina Pockrass
July, 2013 Issue
In 2003, Transcendentist, the dental practice my husband I founded in Berkeley, became certified by the Bay Area Green Business Program. Once we received certification, we started getting calls from dental colleagues around the world asking how they could make their practices greener. In response, we began collecting data on the substantial environmental impact of dental practices and quickly recognized that patients and practitioners alike could benefit from objective standards for what constitutes a green dental office. We decided to share the expertise we gained, so in 2008, we founded t he Eco-Dentistry Association (EDA), making it easy and cost-effective for the dental industry to shift to green practices and educating the public about the benefits of eco-friendly dentistry.

Environmental impact of dentistry

While 50 percent of U.S. dental offices self-identify as “mercury-free,” the EPA tells us that dental offices remain the number one contributor of mercury to our local wastewater treatment facilities, dumping as much as 3.7 tons of this material each year. Many of these treatment facilities are ill-equipped to manage toxic mercury waste, and the sludge can end up in agricultural fertilizer, which can potentially compromise our food supply. According to the National Institute of Health, mercury (in its elemental form) is a potent neurotoxin, especially hazardous to the developing brains of children.
What’s more, commonly used infection control methods, while critical to protecting patients and practitioners, send 1.7 billion sterilization pouches and 680 million chair barriers, disposable lab coats and patient bibs into landfills each year. And conventional x-ray systems, still used by almost 60 percent of dental offices, result in the disposal of 4.8 million lead foils and 28 million liters of toxic x-ray fixer per year. And that doesn’t include all the paper used for charts, faxes and insurance filings—almost 20,000 sheets per year for an office still using paper charts and paper scheduling and billing.
Several manufacturers now offer waterless vacuum systems, which save between 350 and 500 gallons of water per day, per dental office—enough to fill three average-sized swimming pools in a year. If every U.S. dental office installed a waterless vacuum system, we’d collectively conserve as many as 9 billion gallons of clean, drinkable water annually—water we’re now, literally, pouring down the drain.
Fortunately, it turns out that almost every high-tech innovation in dentistry also has environmental benefits. Take computer-aided design and computer-aided manufacturing (CAD/CAM), which lets dental offices create range of dental restorations in-house, including: crowns, veneers, inlays and onlays. The advantage of single-visit restorations means patient travel is reduced by half. CAD/CAM systems also eliminate the need for disposable impression materials and the freight and transportation impacts associated with sending restorations back and forth to a lab.

The certification process

The GreenDOC certification program provides a road map for implementing more than 180 green initiatives. It’s a comprehensive program for dental offices and independent hygiene practices that rewards eco-friendly initiatives in the areas of dental processes and procedures; office administration and marketing; and office design, furnishings and construction. A program manager assists an office in navigating how-to guides, action plans and worksheets to document eco-friendly practices. After an office’s green initiatives have been tracked and verified, they’re able to achieve bronze, silver or gold certification based on the number of initiatives they’ve implemented.
When the EDA was founded in 2008, the initial response was slow, but an increasing number of consumers are selecting service providers and products based on their green values, and forward-thinking dentists are adapting. Moreover, practitioners are beginning to understand how their practice affects their communities and the environment. Key components of our message to dentists is that they likely already have many green initiatives in place—they just don’t realize it—and that “greening” their practice isn’t difficult.
The EDA has developed high-quality educational content, from online courses, to its annual Green Dentistry Conference, to webinars. It connects environmentally conscious consumers, practitioners and industry representatives, and it creates standards for the industry, both for practitioners and dental products.
The strategy is proving to be successful. Currently, there are more than 800 EDA members in 45 states and 16 countries worldwide, close to 25 certified offices and a very active social media following. North Bay members include Dr. Gila C. Dorostkar, DDS, PC, at Pediatric Dentistry and Dr. Eric Zaremski, DDS, at Smilemarin, both in Greenbrae; Dr. Gabriela Garcia-Rojas, DDS, in Mill Valley; and the Petaluma Dental Group.
“As the country’s first privately funded, LEED-certified pediatric dental specialist, we continually strive to minimize our environmental impact,” says Dr. Dorostkar. “The EDA has proven to be a   valuable partner in helping us achieve our environmental goals on a day-to-day basis. We appreciate the support and are grateful for the membership benefits we’ve received.”

What’s next?

The dental industry’s first Green Dentistry Conference, which took place in May, was dentistry’s first carbon-neutral conference and showcased the information and products dental professionals need to create and maintain state-of-the-art green practices. The conference offered panels on everything from building and financing a high-tech, green dental practice to creating a successful green hygiene program. A secondary emphasis was promoting the overall health and well-being of the dental team by offering optional morning yoga and meditation for all attendees and presentations focusing on the importance of work-life balance to support personal and professional success.
Other upcoming projects include an expansion of continuing education offerings. The EDA recently became an authorized continuing education provider from the Academy of General Dentistry (AGD). Also on the horizon is developing a network of certified speakers on green dentistry to help expand the adoption of green practices.
Ina Pockrass is an intellectual property attorney who founded Transcendentist in Berkeley with her husband, Dr. Fred Pockrass. The couple co-founded the Eco Dentistry Association in 2008.


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