P2: Dental Practices P2 Opportunities

P2 opportunities for the dental industry include saving money, limiting waste, and managing dental amalgam. The easiest ways to save money, while being environmentally conscious, are to reduce energy and water consumption. Limit waste by reducing, reusing and recycling. Manage dental amalgam by properly storing and handling it, following best management practices, installing amalgam separators and recycling all amalgam (both contact and non-contact).

• Reduce Energy Consumption
• Reduce Water Consumption
• Limit Waste
• Manage Dental Amalgam

Reduce Energy Consumption

Lighting

• Replace halogen and incandescent lighting with compact fluorescents (CFLs), energy efficient fluorescents, or light emitting diode (LED) lights.
• According to the Eco Dentistry Association, the average dental office can save 2645 kilowatts of electrical energy every year by switching to energy efficient fluorescents. This could cut CO2 emissions by 1,375 pounds per year.
• The Alliance to Save Energy states that not only do CFLs use about a fourth of the amount of energy as incandescents, but they also last up to seven times longer, produce more light and stay cooler. Cooler bulbs can help keep air conditioning costs down.
• Clean bulbs and fixtures, and make sure they are free of dust and debris.
• Use task lighting rather than increasing lighting to an entire room.
• Install motion sensors to automatically turn lights on and off in restrooms and seldom used areas.
• Open blinds to benefit from natural lighting. Close blinds to cut out unneeded sunlight and heat.
• Turn off lights at night, on weekends, and in rooms/areas that are not in use.
• Replace T-12 bulbs with T-8 or T-5 bulbs.

Dental Equipment

• Use ENERGY STAR appliances, where applicable (washer, dryer, dishwasher, refrigerator, etc). These can cut energy bills up to 30 percent.
• Turn off equipment at night, on weekends, and when not in use.
• Unplug equipment when it is not in use. Up to 70 percent of energy is consumed when equipment is in the off mode (to operate clocks, standby, or other unnecessary tasks).
• Avoid starting up all equipment at once. Shift high-energy tasks to avoid peak energy costs.

HVAC

• Clean air-conditioner filters and coils. According to the Alliance to Save Energy, dirt build-up on indoor AC coils is the single most common cause of poor operating efficiency.
• Install a programmable thermostat (and program it) to turn the heat down or the air up at nights and on weekends (when the building is not occupied).

Computers

• Replace cathode ray tube (CRT) monitors with liquid crystal display (LCD) monitors.
• Energy consumption can be reduced by one-half to two-thirds.
• Air-conditioning bills can be lower because LCDs also produce less heat.
• Turn off computers at night, on weekends and when not in use. They should also be unplugged when not in use, or turned completely off by using a power strip that can be shut down.

Reduce Water Consumption

Toilets and Faucets

• Install low-flow faucets. This can cut water consumption in half, from 3 GPM (gallons per minute) to 1.5 GPM.
• Install low-flush toilets. According to the EPA, most toilets installed before 1992, use about 3.5 GPM. Low-flush toilets can use as little as 1.3 GPM.
• Leaks should be fixed immediately. According to Greentooth Dental Environmental Consultants, leaky faucets and toilets can waste 150 to 200 gallons of water per week.

Vacuum Pumps

• Wet dental vacuum pumps should be replaced with dry dental vacuum pumps.
• Dry vacuum pumps eliminate the need for water.
• They should be used with an oil-free air compressor to eliminate oil from dental offices.

Landscaping

• Do not over-water plants, flowers or lawns. This not only weakens the landscaping, but necessitates more frequent mowing.
• Mow lawn at 3 inches to shade out broadleaf weeds and lower the need for irrigation.
• Sprinklers with settings and water reducing heads should be used. The optimum time to water a lawn is from 6 to 8 am. A rule of thumb is that lawns do not need watering unless the grass does not spring back up after it has been stepped on. Visit University of Missouri Extension's Lawn Watering Guide for more information on how to maximize water use in lawn care.
• Choose plants that require less water in your particular climate. Visit University of Missouri Extension for Water Efficient Gardening and Landscaping ideas.
• Landscaping can be used to improve the energy efficiency of a building. Planting protective windbreaks to the north and northwest of the building can reduce winter fuel consumption. Planting deciduous trees to the south and southwest of the building creates needed shade in the summer, while the loss of leaves prevents the blockage of needed heat in the winter. Visit University of Missouri Extension for information on Landscape Planting for Energy Savings.

Limit Waste

Reduce

Paper

• Go paperless. Digital practice management software and a digital patient communication program can be used in place of paper billing, scheduling, and patient charting.

Regulated Medical Waste (Infectious Waste)

• Only place infectious waste in regulated medical waste, or "red" bags. Not everything that comes in contact with the patient is infectious waste. According to Practice Greenhealth, many medical facilities throw over 50 percent of their waste into red bags, which is 8 to 10 times more costly to dispose of than solid waste.
• For more information on how to identify and reduce infectious waste, visit Practice Greenhealth's 10 Steps to Reducing Regulated Medical Waste.

Digital X-Rays

• Use digital x-rays. The Eco Dentistry Association states that digital x-rays have 75 to 90 percent less radiation exposure for patients.
• Digital x-rays eliminate waste, such as fixer, developers and photochemical cleaners.
• Lead products, such as aprons, bite wings and foils are also eliminated.
• Water previously used to develop film is saved.
• Images from digital x-rays have better quality, are available instantaneously, and are easily enlarged and modified. These help aid the dentist's patient diagnosis.

Toxic Emissions

• Steam sterilization can be used, instead of chemical. It does not require any external ventilation and eliminates the need for a hazardous waste permit (for the disposal of toxic chemicals into the water supply).
• Replace chemical vapor solutions, which can be considered hazardous waste, with non-toxic, hospital grade disinfectants.
• Replace Volatile organic compound (VOC) paints with non-VOC or low-VOC latex paints.
• Use non-toxic floor varnish.
• Decorate the office with oxygen-producing live plants.

Reuse

Reusable Items

Disposables can be replaced with cloth patient bibs, lab coats, chair and tray barriers, and light handle covers. These can be laundered on site with Energy Star laundry equipment for further savings and when needed, they can be sterilized with the dental equipment. When using reusable products, as with disposables, it is important to follow guidelines for infectious disease control. For detailed information, see the Guidelines for infection control in dental health care settings from the Journal of the American Dental Association.

• Glass cups or ceramic mugs can be used in place of plastic cups for mouthwash.
• Stainless steel is the best choice for items such as prophy cups, saliva injectors and suction tips.

Recycle

Office Supplies

• Implement an office recycling program. Train and encourage all employees to recycle.
• Paper, plastic, cardboard and metals are usually easy to recycle in most communities.
• Use items made from recycled material, such as chlorine-free, high post-consumer recycled paper towels.

Promotional Items

• Use eco-friendly promotional items, such as toothbrushes made from recycled plastics, eco tongue scrapers, and organic cotton bags.

Mercury

• Dental Amalgam (see "Manage Dental Amalgam") should always be recycled by a licensed recycling company.
• According to ENERGY STAR, CFL light bulbs contain about 4 milligrams (the amount that would cover the tip of a ballpoint pen) of mercury, and should also be recycled properly. Many stores that sell CFLs, such as Home Depot, have programs where used CFLs can be dropped off for recycling.

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