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Comparing the environmental impact of reusable and disposable dental examination kits: a life cycle assessment approach


Introduction The global climate crisis has increased the emphasis placed on the sustainability and environmental consequences of our actions. The dental examination accounts for a large portion of dentistry's carbon footprint, more specifically, the production, sterilisation, transport, use and disposal of the dental examination kit. An attributional life cycle assessment (LCA) was carried out to compare the impact of a reusable stainless-steel examination kit and that of a disposable plastic examination kit.

Materials and methods All inputs, outputs and processes across the life cycle were accounted for using Ecoinvent database v3.7.1 and openLCA software. Impacts were considered across 16 European-recommended environmental impact categories and eight human health impact categories.

Results The disposable kit performed worse across all categories of ecological and human health harm. Categories with most notable impact were climate change, metal-mineral and fossil fuel resource depletion and water scarcity. Impacts were primarily attributable to material processing, instrument production and sterilisation procedures.

Conclusion Healthcare is responsible for a significant proportion of greenhouse gas emissions. The single-use examination kit poses greater ecological and human health threat than does the reusable examination kit; this aligns closely with related research in the field. The dentist seeking to adopt more environmentally-conscientious practices should consider using a reusable, stainless-steel examination kit.

Key points

  • Disposable dental examination kits pose greater threats to environmental and personal health in comparison to reusable, stainless-steel examination kits.

  • The selection of more sustainable instruments is one of numerous measures which can be adopted to lessen the planetary burden of clinical dental practice.

  • There are plausible cost benefits associated with reusable, stainless-steel examination kits, although further studies using life-cycle cost analysis are required.

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  1. Karl T R, Trenberth K E. Modern Global Climate Change. Science 2003; 302: 1719-1723.

  2. United Nations. Climate Reports. 2019. Available at (accessed September 2020).

  3. Eckelman M J, Sherman J. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. PLoS One 2016; DOI: 10.1371/journal.pone.0157014.

  4. Tomson C. Reducing the carbon footprint of hospital-based care. Future Hosp J 2015; 2: 57-62.

  5. British Dental Journal. Sustainability: Dentists urged to reduce their carbon footprint. Br Dent J 2018; 225: 203-204.

  6. Sherman J, Raibley 4th L A, Eckelman M J. Life Cycle Assessment and Costing Methods for Device Procurement: Comparing Reusable and Single-Use Disposable Laryngoscopes. Anesth Analg 2018;127: 434-443.

  7. Ossebaard H C, Lachman P. Climate change, environmental sustainability and health care quality. Int J Qual Health Care 2021; DOI: 10.1093/intqhc/mzaa036.

  8. Saget S, Costa M, Barillic E et al. Substituting wheat with chickpea flour in pasta production delivers more nutrition at a lower environmental cost. Sustainable Product Consumpt 2020; 24: 26-38.

  9. Duane B, Borglin L, Pekarski S, Saget S, Duncan H F. Environmental sustainability in endodontics. A life cycle assessment (LCA) of a root canal treatment procedure. BMC Oral Health 2020; 20: 348.

  10. Lyne A, Ashley P, Saget S, Costa M P, Underwood B, Duane B. Combining evidence-based healthcare with environmental sustainability: using the toothbrush as a model. Br Dent J 2020; 229: 303-309.

  11. Unger S R, Landis A E. Comparative life cycle assessment of reused versus disposable dental burs. Int J Life Cycle Assess 2014; 19: 1623-1631.

  12. Google Maps. Available at,-95.677068:2z (accessed February 2021).

  13. Sea Rates. Available at (accessed February 2021).

  14. Air Miles Calculator. Available at (accessed February 2021).

  15. OpenLCA. Available at (accessed October 2020).

  16. Ecoinvent. Available at (accessed October 2020).

  17. European Commission. ILCD Handbook: General guide for Life Cycle Assessment - Detailed guidance. 2010. Available at (accessed October 2020).

  18. International Organisation for Standardisation. Environmental management - Life cycle assessment - Requirements and guidelines. 2006. Available at (accessed August 2022).

  19. Dutch National Institute for Public Health and the Environment. LCIA: the ReCiPe Model. 2011. Available at (accessed October 2021).

  20. European Environment Agency. Average CO2 emissions from new cars and new vans increased in 2018. 2019. Available at (accessed February 2021).

  21. Dental Sky. Categories. Available at (accessed March 2021).

  22. Henry Schein Dental. Supplies. Available at (accessed October 2020).

  23. China: Light-duty: Emissions. Available at,both%20gasoline%20and%20diesel%20vehicles. (accessed March 2021).

  24. Packsealer. Hulme Martin HM 2300 CD Impulse Heat Sealer. Available at (accessed March 2021).

  25. Duong T. Comparative life cycle assessment of energy and material recovery of cardboard in municipal solid waste. Finland: Lappeenranta University of Technology, 2017. Master's Thesis.

  26. Prepressure. Printing Processes. Available at (accessed February 2021).

  27. Azo Materials. Stainless Steels - Specifications, Grades and Properties. 2005. Available at,actual%20composition%20is%20vastly%20different (accessed February 2021).

  28. The Welding Institute. What is Physical Vapour Deposition (PVD)? Available at,the%20range%201%20to%2010%C2%B5m (accessed February 2021).

  29. Kurt J Lesker Company. PRO Line PVD 75 - Versatile Sputtering, Electron Beam, & Thermal Evaporation Deposition Platform. Available at (accessed February 2021).

  30. Schrader G S, Elshennawy A K. Manufacturing Processes and Materials. Michigan: Society of Manufacturing Engineers, 2000.

  31. Miller. Guidelines for Resistance Spot Welding. 2018. Available at (accessed October 2020).

  32. iContainers. UK's Top 5 Major Ports. 2020. Available at (accessed February 2021).

  33. McGill University. How are mirrors made? 2018. Available at (accessed October 2021).

  34. Panjiva. Medicom Asia Pacific Holdings. Available at (Accessed March 2021).

  35. Lloyd's List Intelligence. One Hundred Ports 2019. Available at,from%206%25%20to%204.8%25 (accessed March 2021).

  36. Paper Index. Kraft Paper Manufacturing, Types of Kraft Paper, and Recycling of Kraft Paper. Available at (accessed February 2021).

  37. W&H Dentalwerk. User Manual: Water Steam Steriliser. Available at (accessed February 2021).

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The data compiled and examined during the study are not available to the general public due to the fact that datasets were extracted from Ecoinvent database (v.3.7.1).

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Authors and Affiliations



Brett Duane devised the concept of and supervised the research and critically appraised and revised manuscripts, as did Alexandra Lyne and Sophie Saget. David Byrne, Alexandra Davidson, Hassaan Haneef, Aisha Almudahkah, Toka Abdeldaim, Ann Marie Bergin, Niamh Basquille and John Prida performed background literature review, collected data for LCA input and contributed to overall study design. Hassaan Haneef ran openLCA software to generate raw research results, while Alexandra Davidson and David Byrne performed numerical and contribution analyses of all results. David Byrne is the primary manuscript author.

Corresponding author

Correspondence to David Byrne.

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The authors declare that there are no conflicts of interest in this study, financial or otherwise. This study did not involve the use of human participants, personal data or human tissue samples, and so ethical approval was not required. The manuscript does not contain any material or information reproduced from an individual's personal data.

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Byrne, D., Saget, S., Davidson, A. et al. Comparing the environmental impact of reusable and disposable dental examination kits: a life cycle assessment approach. Br Dent J 233, 317–325 (2022).

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