Environmental Impact of a Tooth Extraction: Life Cycle Analysis in a University Hospital Setting

Abstract

Objectives: The global impact of health care on the human environmental burden is enormous, but medical care is currently not realising the potential of sustainable practice. Similarly, dentistry and the various forms of dental treatment are not provided in a sustainable manner. This study focussed on quantifying the environmental burden of a standard dental treatment, specifically a tooth extraction, and on identifying the environmental impact of the process.

Methods: A life cycle analysis was performed, simulating the entire process of a tooth extraction-including patient and staff travel, materials and washing/sterilisation procedures-using the software OpenLCA 1.11.0 and the database ecoinvent 3.9.1. The facilities, instruments and items used were those of Charité - Universitätsmedizin Berlin. For travel impact estimations, questionnaire data on travel modalities were gathered from patients and clinic staff. To evaluate possible approaches for more environmentally friendly processes, a change of the information/consent meeting from face-to-face to an online meeting was simulated.

Results: The greatest single contributors to the environmental impact of an extraction procedure were travel, the production of steam (e.g., for sterilisation), electricity, soap, and waste. After normalisation, the process impact was highest on the categories: human toxicity (cancer effects and non-cancer effects), freshwater ecotoxicity, resource use (energy carriers) and ionising radiation (human health). The total environmental impact was 13.8 kg CO₂ equivalents, which compares to driving a distance of 56.3 km with a gasoline-powered vehicle. The implementation of a digital consent process could reduce greenhouse gas emissions by 36.1% to 8.8 kg CO₂ equivalents.

Conclusions: Modelling the environmental impact of a dental extraction in a university hospital setting provided a detailed account of absolute and relative environmental impact contributions. The reduction of treatment-related travel is the most effective measure to reduce the environmental impact of dental practice.

Keywords: environmental footprint; green dentistry; life cycle analysis; life cycle assessment; sustainable dentistry; teledentistry; tooth extraction.