Do Good: Sustainability in Dentistry by Scott Anderson

Examining the costs and benefits of ecologically responsible practices

by Scott Andersen

As participants in the dental industry, we’re uniquely positioned to capitalize on the opportunities offered by the growth and development of sustainability principles. Humans have long been exploring the balance between a desire to increase their quality of life and stewarding their natural resources.

In 1987, the United Nations’ Brundtland Commission conducted a formal study of the factors that could contribute to this balance, which led to the development of sustainability principles and this definition of sustainability: “Development that meets the needs of the present without compromising the needs or the ability of future generations to meet their own needs.”¹ Sustainability is also the organizing principle for the United Nations’ “17 Sustainable Development Goals,” crafted in 2015.²

Building on the UN’s goals, in 2017 the World Dental Federation adopted a set of voluntary, consensus-based global standards for the implementation of sustainability principles in dentistry. These standards encouraged all dental industry participants to apply principles of sustainability in the operation of their clinical practices and the development of new products and services.³

With the advent of new standards for sustainable dentistry, you may be asking about the clinical and business case for implementing its principles. Sustainable dentistry can take many forms, with a common goal being to contribute to the health and well-being of the economy, society and the environment.⁴ It’s also an approach that appreciates the opportunity to contribute to the realization of the UN’s Sustainable Development Goals.⁵ There also are strong business cases for including sustainable approaches in your organization and certifications that verify you’re enacting these approaches.^{6, 7, 8}

Let’s discuss some of the benefits of sustainability for your organization’s respective stakeholder groups.

Patients
Recent global consumer research conducted by Cone Communications included the responses of more than 10,000 consumers in nine of the largest economies in the world. The research found that 93% of consumers would look positively on companies that addressed social and environmental concerns; 90% would be more likely to trust; and 83% would be more likely to be loyal to such companies.

According to a Harvard Business Review article, by expanding your business model to include sustainability principles, you’ll be more likely to align with and earn the trust and loyalty of your patients for the long term, resulting in reputation enhancement and the associated benefits of internal patient referrals, which could decrease your marketing costs.⁹

Team Members
In another Harvard Business Review article, experts in the field of organizational development agreed that to attract, retrain and actualize the best talent, it’s essential for companies to offer their teams the opportunity to serve a higher purpose, such as social, environmental and economic sustainability, and to contribute to goals that use the full range of their skills and talents.¹⁰

The benefit to a company that creates a mission, vision and values-oriented culture is a highly creative, engaged team that genuinely cares about creating exceptional customer experiences and strategies that enable a company to adapt to changing market conditions.¹¹ Dividends such as reduced absenteeism and decreased apathy are of additional value.¹²

Operations
Significant cost savings are available through established best practices associated with energy, water and waste reduction, and efficiencies associated with digital imaging and electronic medical records. Patient and team member health can be further enhanced through the use of nontoxic cleaners, paints, adhesives and furniture. (Editor’s note: The online version of this article includes a half-dozen websites that make great resources to consult when evaluating and implementing these operational practices.)

Suppliers
There are increasing opportunities to select products from manufacturers and distributors that offer innovative products with sustainable features.¹³ Pioneering distributors such as The Raw Office14 have developed their own proprietary rating systems for evaluating the overall sustainability of everyday office products.

Community
There are many different ways to cultivate mutually beneficial partnerships with nonprofit and governmental groups that may also strengthen your relationship with key stakeholders such as patients, team members and suppliers. Two examples in our practice that involve multisector partnerships:

• The Artisan Dental Recycling Program, a collaboration with the City of Madison recycling department, Tom’s of Maine, TerraCycle and area nonprofits.¹⁵
• The Artisan Dental Wellness Series enables our patients, their friends and our team members to attend a quarterly complementary wellness event offered by a local health expert.¹⁶

Planet
Being stewards of the environment that our children, grandchildren, nieces and nephews will live in has innumerable benefits. We have the opportunity to demonstrate this stewardship through established resource management approaches discussed in the Operations section above. We can accelerate the adoption of renewable energy systems when we install renewable energy generation systems in our business or purchase renewable energy from our local utility. We can also choose to purchase carbon offsets for the nonrenewable energy we use.¹⁷

Financial performance evidence base
Numerous empirical studies illustrate the correlation between environmental social and governance (ESG) factors and financial performance. A recent meta-analysis of 2,200-plus studies conducted by the University of Hamburg and Deutsche Asset & Wealth Management Investment illustrated there was a consistent correlation between ESG variables and a company’s financial performance across all regions of the world.¹⁸

Brand enhancement
One of the more noteworthy benefits of implementing sustainability principles is the opportunity to further define your company’s brand through internal and external communications with stakeholders. These communications offer stakeholders an opportunity to deepen their appreciation for your evolving business model and learn about the merits of sustainable approaches they can use in personal or professional settings.

Certifications
You may also be interested in more formally recognizing and verify your sustainability efforts through an independent, third-party certification. Certifications provide your business with a higher level of credibility when communicating with stakeholders, which in turn enhances your ability to create and maintain loyal trustworthy relationships with them.

One of the most highly regarded certifications for businesses incorporating sustainability principles is to become a Certified B Corporation¹⁹; other sustainability reporting frameworks include Global Reporting Initiative²⁰ and the International Integrated Reporting Council.²¹ Depending on your geographic location, you may also be able to participate in state or local sustainability- oriented programs or certifications. When looking at the business community as a whole, there is widespread use of some form of sustainability reporting, as evidenced by the fact that 93 percent of the world’s largest corporations report on their sustainability performance.²²

Summary
There are a multitude of benefits associated with incorporating sustainability principles, together with an abundance of mutually reinforcing opportunities connected with their integrated implementation. Several of the more noteworthy advantages include:

• Exceptional customer experiences.
• A cohesive, genuinely caring team supported by a culture that values excellence, growth and innovation.
• Sustainably oriented suppliers you may collaborate with to further each of your organization’s respective missions.
• Evidence-based cost savings associated with waste reduction and operational efficiencies.
• Creative community partnerships that steward the vibrancy of your community and the environment’s precious resources.
• It’s highly likely that stakeholder trust, loyalty and creative collaboration will be enhanced. On macro and micro scales, the conditions enabling greater individual and collective flourishing will be set in motion for all those whose lives you will influence.

References

1. Oxford: Oxford University Press. World Commission on Environment and Develop-ment (Brundtland Commission): Our Common Future [Internet]. 1987. Available from: http://www.un-documents.net/our-common-future.pdf.
2. United Nations. Transforming our world: the 2030 Agenda for Sustainable Develop-ment. Resolution adopted by the 80 General Assembly on 25 September 2015. A/RES/70/1. General Assembly, Agenda items 15 and 116, 81 2015 [Internet]. Availa-ble from: http://unctad.org/meetings/en/SessionalDocuments/ares70d1_en.pdf.
3. World Federation of Dentistry, Sustainability in Dentistry Standards: https://onlinelibrary.wiley.com/doi/full/10.1111/idj.12369
4. World Federation of Dentistry, Sustainability in Dentistry Standards: https://onlinelibrary.wiley.com/doi/full/10.1111/idj.12369
5. United Nations. Transforming our world: the 2030 Agenda for Sustainable Develop-ment. Resolution adopted by the 80 General Assembly on 25 September 2015. A/RES/70/1. General Assembly, Agenda items 15 and 116, 81 2015 [Internet]. Availa-ble from: http://unctad.org/meetings/en/SessionalDocuments/ares70d1_en.pdf.
6. The Harvard Business Review. The Comprehensive Business Case for Sustainabil-ity. https://hbr.org/2016/10/the-comprehensive-business-case-for-sustainability
7. Journal of the American College of Dentists. The Business Case for Sustainable Dentistry. In press.
8. Inc. Magazine. How to become a Benefit Corporation. https://www.inc.com/guides/201106/how-to-become-a-benefit-corporation.html
9. Harvard Business Review. The Comprehensive Business Case for Sustainability. https://hbr.org/2016/10/the-comprehensive-business-case-for-sustainability
10. Harvard Business Review: How to Help Your Team Find Their Higher Purpose. https://hbr.org/2018/07/creating-a-purpose-driven-organization
11. Conscious Capitalism. John Mackey and Rajendra Sisodia, January 7th, 2014.
12. Start With Why. Simon Sinek. Portfolio, December 27, 2011.
13. Henry Schein. Global Reflection Program: http://www.nxtbook.com/nxtbooks/henryschein/globalreflections_2018q1/
14. Rawoffice. Product evaluation methodology https://cdn.shopify.com/s/files/1/1013/9279/files/EcoEbook.pdf?11095919631214491144
15. Artisan Dental Recycling Program. https://artisandentalmadison.com/recycling-program/
16. Artisan Dental Wellness Series. https://artisandentalmadison.com/artisan-dental-wellness-series/
17. Carbon Fund. https://carbonfund.org/
18. Journal of Sustainable Finance & Investment. ESG and financial performance: ag-gregated evidence from more than 2000 empirical studies. file:///Users/scottandersen/Downloads/SSRN-id2699610.pdf
19. Certified B Corporations. https://bcorporation.net/
20. Global Reporting Initiative. https://www.globalreporting.org/Pages/default.aspx
21. International Integrated Reporting Council. http://integratedreporting.org/
22. The KPMG Survey of Corporate Responsibility Reporting 2017. The Road Ahead. Blasco, J., King, Adrian., (2017) 1-58. https://assets.kpmg.com/content/dam/kpmg/xx/pdf/2017/10/kpmg-survey-of-corporate-responsibility-reporting-2017.pdf

Scott Andersen of Artisan Dental recaps
some of the best ways to get started
Top Practices and Products

Top Sustainable Operational Practices

Amalgam separators
Dental offices continue to be the largest contributors to mercury levels in local water systems—up to 14% in one study. Reduction of mercury can also be supported by using mercury-free materials such as porcelain, composites, glass and gold. Late in 2017 the EPA issued a final regulation regarding the handling of dental amalgam waste. The new federal rules will require most U.S. dental offices to use a qualifying amalgam separator and comply with industry best management practices to reduce amalgam waste before 2020.

Paperless digital patient workflows
Including electronic record systems, claim submission, automated appointment reminders and confirmations together with email or online scheduling requests can result in significant cost savings associated with reductions in paper and plastic office supplies, and team member time managing the retrieval and storage of paper charts. Plus, there can be an increase in effectiveness when coordinating clinical care, treatment planning and after-care follow-up. Digital patient-intake forms online and in office with tablet or signature pads enhance the patient experience and can align with the expectations of younger members of your practice accustomed to electronic forms of communication.

Waterless vacuum systems
Dental vacuum systems can be large consumers of water on a daily basis. Wet dental vacs in dental offices use approximately 2 gallons per minute, or 200,000 gallons per year. Advanced dry vacuum systems can be used to markedly reduce total water consumption—and doctors benefit from reduced water costs that could average several thousand dollars or more per year.

Simple recycling and water reduction programs
All dental offices can participate in local curbside or commercial recycling programs. Paper or plastic drinking and mixing vessels can be replaced with reusable glass or steel products. TerraCycle offers a personal oral-products recycling program that offices can in turn invite their patients and the general public to participate in, increasing exposure to their office and generating goodwill.

Digital X-rays
Transitioning from conventional X-ray systems to digital imaging technology eliminates toxic chemicals, paper, plastics and lead foils, in addition to exposing patients to 70–90% less radiation. Annual operational savings also include reductions in team member time processing and prepping X-rays, together with reductions in harmful chemical exposures.

Top Sustainable Operational Products

BeeSure Naturals Face Masks
Made with up to 60% biodegradable cellulose components that are dye- and chemical-free. Compact packaging is made out of 80–100% recycled material, which reduces overall carbon footprint of the product.

SafeGauze Green Nonwoven Sponges
SafeGauze Green is made from two natural fibers, including organically grown cotton and Lyocell, which is made from wood pulp and certified by the Forest Stewardship Council to ensure that each tree taken to manufacture the fiber is replaced with a new one. 100% biodegradable. 

Sani-Treet Green
A multipurpose enzyme concentrate that is a nontoxic, noncaustic, foam-fighting, biodegradable cleaner that uses enzymes instead of dangerous chemicals. 

Hager Stainless Steel High- and Low-Volume Surgical/Endodontic Suction Tips
Can be used as an alternative to disposable plastic suction tips, resulting in less landfill waste, less packaging material and fuel used in transporting a disposable product, together with material supply cost savings. hagerworldwide.com

Earthcare from Paradise Dental Technologies
The Earthcare program includes recycling old or used dental instruments from any manufacturer. After dentists send in 12 scalers or curettes, Paradise Dental Technologies will send them a free instrument—and also will recondition any salvageable instruments and donate them to dental/hygiene missions throughout the world. All instruments are packaged in 100% recycled material that is 100% recyclable.