Teaching

When Dr. Les Kalman learned of the dental industry’s global initiative to develop a statement on sustainability for the oral health-care profession, he felt the call to contribute. “I think we can all agree that human activity has negatively affected the planet, resulting in climate change and environmental pollution,” said Kalman, professor of restorative dentistry at Shulich Medicine & Dentistry. Kalman was part of the FDI World Dental Federation (FDI) industry-wide team of health-care professionals, academic experts, legislators and associations who created the Consensus Statement on Environmentally Sustainable Oral Healthcare. Completed in March 2022, the statement outlines the challenges and solutions to improving sustainability in dentistry without compromising patient welfare. Spurred by the United Nations Sustainable Development Goals (SDGs), the document outlines opportunities for more sustainable practices based on the four Rs: reduce, recycle, reuse and rethink. It also points out significant reductions that can be made in the waste generated from manufacturing processes, packaging, the high use of single-use plastic products, and CO2 associated with transport. Pursuing sustainability in the oral health-care industry would require significant changes. The daily global water usage from cleaning our teeth is equivalent to 6,400 Olympic swimming pools per day, in addition to water used throughout the supply chain. A U.K. study calculated that 14.4 tonnes or two billion single-use plastic items per year are used in routine adult primary care dental procedures. In North America, the total remake rate of dental prostheses has been documented to reach up to 11 per cent. “The urgency for change in the industry is paramount, and the time to act is now,” Kalman said. Passion for the planet Kalman’s passion for Earth’s well-being stemmed from reading the National Geographic at an early age and capturing nature through the camera lens. This interest led him to a BSc in environment and resources management in geography at Western. “The program illustrated many of the challenges we are currently facing. After entering dentistry, it was clear the profession could use some environmental tailoring,” Kalman said. Consequently, much of his research has been in the medical device space, focusing on improving the accuracy, efficiency and cost of treatment with novel digital workflows that simplify treatments, save time and increase accessibility, with potentially less environmental impact. It was a perfect background for developing a blueprint for industry-wide change. But introducing more sustainable practices could be hindered by the complexity of dentistry, which varies dramatically across the globe in accessibility and standards of care. “As humans, we seem to be set in our ways and resistant to change,” said Kalman. “The dental profession seems to have these same barriers to change. It’s also a challenging profession, and change may seem even more daunting to those being challenged.” Education first Educators have an important platform from which to increase awareness, disseminate information and be drivers for change, Kalman said. “As we train the dentists of tomorrow, we must educate them with current, evidence-based research so they can be leaders in their communities in embracing these new practice strategies,” said Kalman, who plans to propose a sustainability elective for students. As academic lead for continuing dental education, Kalman is also developing a continuing dental education course for practitioners. Research opportunities that include environmental impacts will also continue to be an important factor in the development of sustainable devices and approaches, he added. Kalman is optimistic about the positive impact of the consensus statement and its ability to change the dental industry. “We’ve seen remarkable collaboration and communication with the sharing of information and best practices during the pandemic,” he said. “We need that same approach with sustainability.” Success will require strong and transparent collaboration and communication with all players in the industry, from regulatory bodies and policymakers to the public, he said. “In my opinion, success is the provision of dentistry that meets regulatory guidelines in a manner that doesn’t negatively impact the environment. I am enthusiastic and optimistic to see what changes our dental profession can adapt to preserve our delicate planet.”