Your NHS dentistry and oral health update

November 2021 (Issue 31)

Special focus on dentistry and the environment 

An update from Sara Hurley and Dr Nick Watts

Dear colleague,

As world leaders gather at COP26, one message is clear - the climate crisis is all our business. Right now, with the response to COVID-19 at the centre of our work, thinking about this area can be difficult. However, the response to climate change often directly improves the health of our patients and the consequences of not addressing the climate crisis are severe for all us - flooding, heatwaves, and even the epidemic spread of infectious disease will become more frequent and more severe.

The NHS as a whole is taking action - we are the first health service in the world to commit to reaching net zero carbon emissions. Since 2010, efforts across the health service have resulted in NHS emissions being cut by 30%. This is already improving care, as well as the health and wellbeing of our patients. Decisions have been made to invest in greener medicines, greener transport, greener buildings, and greener energy consumption.

Despite this progress, there is still more to be done. The carbon impact of dentistry cannot be ignored. Analysis published in the BDJ in 2017 found that the carbon footprint of NHS dental services is 675 kilotonnes of CO2e each year, the same as powering over 610,000 UK homes. 

Together, with the help of staff across the NHS, we hope to achieve even more. With more people involved, we stand every chance of meeting our target of becoming a net zero health service by 2040, improving the health outcomes of current and future generations.

In this bulletin, we discuss what reaching net zero carbon means for dentistry.

There is more to be done and we look forward to working with the NHS dental team on taking this agenda forward.

For those celebrating yesterday, we hope you had a very happy Diwali.

Best wishes and thanks,

Sara and Nick

A Greener NHS: Healthier Planet, Healthier People

In October 2020, NHS England became the world’s first health service to commit to reaching net-zero carbon. We know that around 9 in 10 NHS staff support the NHS taking action to reduce its carbon footprint, but we also know that there are barriers to taking action, such as conflicting priorities, lack of awareness and understanding, and feeling overwhelmed by the challenge.

Did you know?

• The science of climate change is well established, and human activities are the leading cause of rising global temperatures; we need to cap global warming at 1.5°C.
• The Environment Agency states that rising sea levels across the UK means defences are having to work harder to protect a growing population.
• The delivery of healthcare makes a significant contribution to the international carbon footprint: if the global healthcare sector was a country, it would be the 5th largest greenhouse gas emitter on the planet. To carry on delivering healthcare in such a carbon intensive way would be hugely detrimental to the health of the planet.
• Climate change has the potential to undermine the last 50 years of global gains in public health, disproportionately affecting communities least responsible for climate change and those who are most vulnerable in society.
• The carbon footprint of dentistry is a result of the products we buy, the waste we produce, and the way patients access our services.
• We have a duty to provide a standard of care to manage patients’ dental health with the aim of improving their overall health and wellbeing whilst considering the environmental impact of this provision of care.

With COP26 shining a light on the climate crisis, the Greener NHS team have launched a campaign to educate, inform and inspire NHS staff about the ambition to reach Net Zero, and the incredible work in the system that is already underway to achieve this.

The full suite of campaign assets is available to download here. We would warmly welcome your support, as a practice or as an individual, in raising awareness by sharing these assets across your channels.

What is ‘sustainable dentistry’?

Sustainable dentistry considers how to ensure oral health for all fits within the context of limited natural resources, rising global temperatures, and increasing waste and physical pollution. It builds upon promoting equitable oral health and the prevention and control of dental diseases evident in public health dentistry. Sustainable dentistry involves providing dental care to patients within the wider context of health, environment and finances at the population level.

The FDI World Dental Federation:

• Encourages the prevention of oral disease as the most sustainable way of providing optimal oral health with the least impact on the environment.
• Recommends minimising consumption, consideration of whether to use single use products if other options can be used which don’t compromise patient safety or health policies, and the use of low power and low pollution technologies.
• Empowers the dental industry as a whole to apply the principles of sustainability for product production and life cycles, the development of materials and technologies, and to promote continuing professional development in sustainability for both industry and individuals.

Click here to read about purchasing products for the dental setting while considering environmental sustainability.

How-to guide for best practice

Here are some examples for dental teams wishing take action to make their practice more sustainable, taken from Sustainable Dentistry: How-to Guide for Dental Practices, published by the Centre for Sustainable Healthcare.

• Travel: Sign up to the Government’s ‘Cycle to Work Scheme’ – let staff know that it applies to e-bikes too – and install secure cycle parking.
• Equipment: Adhere to Government Buying Standards to ensure procured goods meet legal and sustainable standards, such as paper with a 75% recycled content, or sustainably-sourced toilet paper.
• Plastic: Consider reusable alternatives to disposable products, such as impression trays, prophy cups, Dappens pots and suction tips. Liaising with your suppliers and dental product manufacturers about the sustainability of their products nudges innovation and helps to add gravitas to consumer concerns.
• Energy: Investing in clean energy generation isn’t accessible for everyone, so consider switching to a clean energy supplier, calibrating temperatures using a thermostatic system, and monitoring consumption using a smart meter. Insulating inefficient buildings is one of the most cost-effective ways to improve energy efficiency.
• Waste: With many different waste systems, producing a simple waste guide for staff to clarify disposal categories can change the type, amount and cost of waste disposal for practices. Creating a recycling policy, contracting green services, and regular audits can all improve waste disposal and save money.
• Recycling: The TerraCycle Oral Care Recycling Programme accepts any brand of toothbrushes and toothpastes, along with their packaging, for the production of new recycled products. Click here to find your nearest drop-off location. There is also a scheme accepting dental aligners and cases for recycling, click here to learn more.
• Biodiversity and green space: Waiting in well-ventilated areas has never been more pertinent. Providing green outdoor areas with native, insect-friendly plants instead of manicured lawns and tarmac helps the local ecosystem and has proven mental health benefits for patients and staff.  

For more information, download the document in full here and look out for the evidence-based book Sustainable Dentistry, due for publication in spring 2022.

Conference of the Parties Glasgow 31 Oct – 12 Nov 2021

The 26th annual Conference of the Parties, known as COP26, brings together almost every country on earth for global climate summits to accelerate action towards the goals of the Paris Agreement and the UN Framework Convention on Climate Change. World leaders have arrived in Glasgow, Scotland, alongside tens of thousands of negotiators, government representatives, businesses and citizens for twelve days of talks on tackling climate change.

The COP26 Green Zone is open to the public at the Glasgow Science Centre. Youth groups, civil society, academia, artists, business from across the UK and all over the world will be hosting events, exhibitions, cultural performances, workshops and talks. With over 100 exhibitors, 200 events and 11 sponsors taking over the space, there are amazing opportunities to listen, learn and celebrate climate action.

You can join virtually by subscribing to the COP26 YouTube channel.

By Word of Mouth ... the colleagues we're all talking about!

Steve Mulligan is a practicing dentist based in South Yorkshire and part time academic researcher within the School of Clinical Dentistry at The University of Sheffield alongside Professor Nicolas Martin as his main collaborator. His research includes investigating the environmental impacts of dental materials, integrating sustainability into oral healthcare, including sustainability in the dental undergraduate curriculum, and investigating the attitudes and opinions of the public to sustainability within oral healthcare.

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Previous NHS dentistry and oral health bulletins 

Previous bulletins can be accessed by clicking on the links below:

NHS primary care bulletin

The NHS primary care bulletin provides resources on health policy and practice and we encourage you to sign up for this, too. It is aimed at teams across general practice, dentistry, community pharmacy and optometry. 

COVID-19 advice, guidance and resources

Communications resources for NHS dental practices

Click on the links below to view and download useful communication resources:

• Click here for social media image cards and patient leaflets
• Click here for social media assets and posters explaining IPC requirements
• Click here to download website/social media copy and scripts for answer machine message, text message and emails.

NHS updates to the profession 

Key letters from the Chief Dental Officer and the NHS dentistry and oral health team are online here. 

Transition to Recovery: Dentistry's standard operating procedure

The latest version was published on Friday 16 July 2021. Changes to the previous SOP are in yellow. You can read the SOP online here. 

COVID-19: infection prevention and control dental guidance

The guidance is an appendix to and should be read in conjunction with the national guidance on infection prevention and control for COVID-19 . You can read the general guidance and the specialist dental appendix online here.

Avoidance of doubt note: provision of phased treatments

This document is to support dental professionals, and to clarify where it might be appropriate to provide phased treatment spanning over several courses of treatment (CoT). You can read it online here.

Health and wellbeing support