Building Evidence for Environmentally Sustainable Dentistry:
What Dental Professionals Need to Know
(Nasser, 2026)
Why Is This Article Important?
Sustainability is becoming an increasingly important consideration in healthcare, including dentistry. While much attention has focused on the environmental impact of dental amalgam and restorative materials, sustainable dentistry examines the entire dental care pathway and the environmental impact of everyday clinical and operational decisions.
As the profession seeks to reduce its environmental footprint, clinicians need evidence that helps them balance environmental responsibility with optimal patient care. This editorial article discusses the importance of incorporating environmental sustainability into evidence-based dental practices.
The Aim
The editorial argues that sustainability should be evaluated using the same rigorous scientific approach applied to clinical effectiveness and patient outcomes. The goal is to encourage researchers and clinicians to consider the full environmental impact of dental interventions rather than relying on isolated measures of sustainability.
Key Messages
The editorial highlights several important developments within dentistry. These initiatives provide valuable guidance, but they address only part of the broader sustainability challenge.
- World Health Organization's guideline on environmentally friendly and less invasive approaches to caries management.
- NIHR-funded review on the environmental impacts of dental amalgam and alternative restorative materials.
Sustainable dentistry extends far beyond choosing one restorative material over another. Dental practices can influence their environmental footprint through:
- Energy-efficient technologies and equipment
- Water conservation measures
- Sustainable procurement practices
- Waste reduction strategies
- Staff training and operational protocols
- Prevention-focused approaches that reduce treatment needs over time
These decisions can benefit not only the environment but may also improve practice efficiency and reduce costs. Sustainability should be evaluated across the entire care pathway.
The author proposes a framework for future research that includes four interconnected domains:
- Patient outcomes such as clinical effectiveness, benefits and harms, patient acceptability, and quality of life.
- Resources used during treatment delivery, including materials, energy, water, consumables, and staff time.
- Life-cycle environmental impacts, including manufacturing, transport, emissions, toxicity, and disposal.
- Long-term consequences, such as restoration longevity, failures, retreatment, and additional appointments.
Environmental outcomes should be incorporated routinely into clinical trials and practice-based research alongside traditional clinical outcomes. Evidence can then be generated to help clinicians weigh environmental considerations against patient benefits.
Case Example
The article discusses a study comparing silicone impression techniques, which found differences in material waste. Researchers found that automixing systems generated less waste than traditional hand-mixing methods. At first glance, this might suggest that automixing is the more environmentally sustainable option.
However, the reality is more complex. While less material was wasted during the procedure, the study did not account for additional factors such as:
- Manufacturing impacts
- Transportation requirements
- Single-use mixing tips and cartridges
- Waste disposal
- Clinical effectiveness
- Patient comfort
- Need for repeat procedures
This example illustrates an important principle: reducing one environmental metric does not automatically translate to a lower overall environmental impact. The picture is bigger.
Key Clinical Takeaways
✅ Sustainability should not be assessed solely by the amount of material used or wasted during a procedure. A broader perspective is needed to understand the true environmental impact of care.
✅ Decisions about products, equipment, infection control practices, and office operations can significantly influence a practice's environmental footprint.
✅ Preventive and minimally invasive approaches may support sustainability goals by reducing the need for restorative interventions, replacement cycles, and repeat appointments.
✅ Patient outcomes must remain central to decision-making. Environmentally sustainable care should enhance, not compromise, clinical effectiveness, safety, or patient experience.
✅ Shared decision-making remains essential to long-term treatment success.
Conclusion
Environmental outcomes should be evaluated alongside clinical and patient-centered outcomes, using a comprehensive framework that considers patient benefit, resource utilization, life-cycle environmental effects, and long-term treatment consequences. By building this evidence base, dentistry can move beyond interventions that merely appear environmentally friendly and toward care that is demonstrably both clinically effective and environmentally responsible.
Prevention may be one of the most sustainable interventions in oral healthcare. By preventing disease before restorative treatment becomes necessary, clinicians have the potential to reduce material consumption, waste generation, energy use, retreatment, and additional patient visits while simultaneously improving oral health outcomes. Although further research is needed to quantify these benefits, prevention and minimally invasive care naturally align with the goals of environmental stewardship.
Ultimately, this editorial calls on researchers, educators, and clinicians to build a stronger evidence base that demonstrates not only what is clinically effective, but also what delivers lasting value for patients, practices, and the planet. Through this lens, prevention emerges as a key strategy for achieving both oral health and environmental sustainability.
This summary of a scientific article by Nasser (2026) is presented by Heather Wong, MSDH, RDH, TePe USA Professional Relations Manager.
Reference:
Nasser M. Building the evidence for environmentally sustainable dentistry. Evid Based Dent. 2026 Sep;27(3):45. doi: 10.1038/s41432-026-01265-5. PMID: 42668300.
Article can be read using the link below.
Building the Evidence for Environmentally Sustainable Dentistry - PubMed
