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Combining evidence-based healthcare with environmental sustainability: using the toothbrush as a model

British Dental Journal volume 229, pages 303–309 (2020)Cite this article

Abstract

Introduction Healthcare professionals should consider environmental sustainability when recommending medical devices to patients, although there is currently little quantitative data available. The toothbrush is a widely recommended healthcare device worldwide. The aim of this study was to compare the sustainability of different types of toothbrush.

Materials and methods Four types of toothbrush were studied: a traditional plastic and electric toothbrush, as well as a plastic manual toothbrush with replaceable heads and a bamboo manual toothbrush. Life cycle assessment (LCA) methodology was applied to quantify the environmental impact of these toothbrushes over five years.

Results The electric toothbrush performed consistently poorly compared to the three manual toothbrush types and had the greatest impact in 15 out of 16 environmental categories. The bamboo and replaceable-head plastic toothbrushes had the lowest impact in all categories. The climate change potential of the electric toothbrush was 11 times greater than the bamboo toothbrush.

Discussion Switching toothbrushes from the traditional toothbrushes to bamboo or replaceable-head plastic is more environmentally sustainable. These results could be used to inform individual consumer choice, oral health recommendations, procurement of toothbrushes for public health programmes and toothbrush manufacturers. LCA methodology can be used to make healthcare more sustainable.

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Authors and Affiliations

  1. Department of Paediatric Dentistry, Eastman Dental Hospital, 47–49 Huntley Street, London, WC1E 6DG, UK

    Alexandra Lyne

  2. Paediatric Dentistry, UCL, 256 Gray’s Inn Road, London, WC1 X8LD, UK

    Paul Ashley

  3. Botany, Trinity College Dublin, College Green, Dublin, Ireland

    Sophie Saget

  4. Bangor University, Bangor, LL57 2DG, UK

    Marcela Porto Costa

  5. Eckington Dental Care, 2 High Street, Eckington, S21 4DN, UK

    Benjamin Underwood

  6. Trinity College Dublin, Department of Child and Public Dental Health, Dublin, Ireland

    Brett Duane

Authors
  1. Alexandra Lyne
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  2. Paul Ashley
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  3. Sophie Saget
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  4. Marcela Porto Costa
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  5. Benjamin Underwood
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  6. Brett Duane
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Contributions

AL collected the data and drafted the paper; PA co-initiated the collaborative project, monitored data collection and revised the draft paper; SS and MC refined the bamboo cultivation dataset, monitored data analysis and revised the paper; BU revised the paper; BD co-initiated the collaborative project, carried out all data analysis and revised the paper. All authors give their final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Alexandra Lyne.

Ethics declarations

This study was funded by the Eastman Dental Institute (University College London). The authors declare no conflict of interest.

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Lyne, A., Ashley, P., Saget, S. et al. Combining evidence-based healthcare with environmental sustainability: using the toothbrush as a model. Br Dent J 229, 303–309 (2020). https://doi.org/10.1038/s41415-020-1981-0

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  • DOI: https://doi.org/10.1038/s41415-020-1981-0

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