Conduct Waste Audit to identify largest sources of waste and target reduction and/or redirection of this waste stream
- Set a time to collect waste bags produced from either an average day of operations, or over the course of a standard number of patients.
- Complete a consumption analysis of individual products (gloves, masks, protective barriers, disposable products), measuring items by either weight, volume, or item number. Due to the small size and light weight of many dental products, we recommend conducting your analysis based on either volume or by counting individual items.
- Identify the largest sources of waste based on this analysis.
Regulate Hazardous Waste
Reduce overuse of hazards and sharps containers.
- To reduce overuse of hazards and sharps containers, assess the appropriate disposal of waste contaminated with body fluid.
- Make these smallest and furthest away in the room to prevent the unnecessary use of these special waste containers.Sharps, Medical Hazardous Waste (body fluids, blood contamination) , Amalgam (nation vs state by state)
- General waste from hospitals or other health-care facilities (e.g., dental practices or clinical/research laboratories) is no more infective than residential waste. The majority of soiled items in dental offices are general medical waste and thus can be disposed of with ordinary waste.Examples of regulated waste found in dental-practice settings are solid waste soaked or saturated with blood or saliva (e.g., gauze saturated with blood after surgery), extracted teeth, surgically removed hard and soft tissues, and contaminated sharp items (e.g., needles, scalpel blades, and wires) (13). (page 27 of MMWR Guidelines)(Guidelines for Infection Control in Dental Health-Care Settings – 2003. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR). December 19, 2003;52(RR17):1-61. Consolidates previous recommendations and adds new ones for infection control in dental settings.)
- Evaluate the current method of metal disposal. Ideally, the dental clinic should have segregated recycling bins for metals from any amalgam scraps, extracted teeth containing amalgam fillings, lead radiograph foils, etc. as these are very toxic and can leach into waste. If metals are found in the regular waste stream during the waste audit, a special recycling bin must be implemented.
Utilize products to the full potential, and purchase products that support sustainable choices
- Follow manufacturer directions for material usage to ensure the accurate mixing of chemicals and limit material waste.
- Ensure sterilizers and cleaning units are full to reduce the number of cycles per day.
- Use products made from recycled materials, such as paper towels or the ECOtip HVE suction tip mentioned above
- Chose products packaged with recycled materials and packaging that contains more items per product (ie. purchasing gloves in boxes of 200 rather than 100).
- Maintain proper inventory control to reduce the waste of expired dental materials. Rotate the oldest products to the front line and utilize a clear system of tracking inventory.
Implement Process for recycling as much as possible. Contact local recycling facility to clarify and maximize what can be recycled
- Contact the local recycling facility to clarify and maximize what can be recycled.
- Gather information about the items that were found to create the largest amount of waste in the waste audit (gloves, masks, sterilization pouches, etc.) and communicate with the local recycling facility about what/how these items can be recycled.
Identify partners/vendors willing to recycle unique waste items (e.g. reusable sharps containers, disposable gloves, broken or damaged dental instruments)
- Depending on what your local recycling facility can process, reach out to other vendors who will recycle unique waste items. Below are a few ideas:
- “Zero Waste Boxes” from the company TerraCycle offer many ways to recycle unique items such as disposable gloves, personal protective equipment (safety glasses and masks), and even oral hygiene products. For example, recycled nitrile and/or latex gloves will be sent back to the company in a pallet to be cryogenically frozen and processed into a powder which can be used to make new plastic products such as park benches and container bins.
- Participate in the Hu-Friedy Environdent program, where for every even increment of 12 instruments you recycle, you can select 1 Hu-Friedy instrument, absolutely free.
- As an alternative to the incineration of medical waste, many companies have developed ways to compact and sterilize medical waste.
- Sterilis Medical offers a system to effectively and efficiently transforms full sharps containers, scalpel blades, surgical drapes and capes, glass ampules, suture kits, and all other forms of regulated medical waste into sterile solid waste in less than 60 minutes in a machine the size of a photocopier. http://www.sterilismedical.com/practicetypes/oralsurgeons.htm
- Red Bag Solutions also offers cost effective treatment technology that simultaneously grinds and sterilizes medical waste “onsite.” The waste is rendered unrecognizable, volume is reduced up to 90% and weight by up to 30%, which in turn reduces the amount of waste going into the landfill. https://www.redbag.com/about-red-bag-solutions
- Consider moving to reusable sharps container systems, instead of buying disposable sharps containers that go into the infectious waste stream and drive up waste costs while also requiring ongoing replacement. Full containers are collected by a service provider who mechanically empties, cleans, and disinfects the containers and returns them for reuse. Containers are often used hundreds of times, driving down both waste and replacement supply costs.
Utilize reusable materials (i.e. stainless steel suction tips and air/water syringe tips, washable bibs, reusable protective eyewear for staff and patients, etc.)
- To replace disposable bibs, consider using washable OR cotton towels as patient bibs, or moving from 2-ply to 1-ply disposable bibs.
- Consider moving to autoclavable stainless steel suction tip and air/water syringe
- Also consider alternatives to plastic products, such as these ECOtip HVE Tips made from renewable, sustainable paper, and designed to withstand moisture absorption and fraying
- Use reusable protective eyewear which can be washed with soap and water or wiped down between patients.
- Consider stocking each chair with multiple cleaned glasses so there is no disruption in the turnover of patients, and clean all of the used glasses together at the end of the day
Use digital dentistry (digital radiographs, digital charting, CAD/CAM systems to reduce waste and minimize chemical usage
- Convert all x-ray imaging to digital radiographs
- Transitioning from paper charts to electronic health records, can save a significant amount of paper.
- Utilize CAD/CAM systems to streamline the process of taking impressions, making models, and fabricating restorations.
Consider dry vacuum system to minimize water usage
- Contact with air techniques (Dr. Fluent has email connection)– also ask them about sustainable compressors
- Wet vs dry vacuum system (regarding suction)
- Dry uses A LOT less water
- This would save money on the water bill
- Look into if air driven or electric handpieces are more sustainable
Implement Process for proper disinfection of patient areas to reduce use of disposable barriers (i.e. paper covers, blue tape, head covers)
- If the clinic uses paper barriers on surfaces for infection control, reduce use of paper barriers on “housekeeping surfaces,” only protecting clinical contact surfaces.