An interesting WFO white paper on orthodontics and the environment!

We should all be concerned with the future environment. As a result, we must be aware of the ecological consequences of our actions. This paper presents the WFO’s perspective on the environmental aspects of orthodontic practice. It is uncommon for me to review a paper of this kind, but it is an important publication.

The WFO Task Force on “environmental footprints” authored this paper. The Journal of the World Federation of Orthodontists published the paper.

This task force consisted of clinicians and well-known dental materials scientists who are experts. This was “convened under the auspices of the WFO executive committee”.

What did they aim to do?

The authors felt that 

“The panel represents diverse perspectives and experiences worldwide, providing a holistic view of the challenges and opportunities in sustainable orthodontics”.

The primary purpose of the paper was

“To initiate a dialogue within the orthodontic community regarding the environmental aspects of our practice”.

What did they find?

The team covered a wide range of ground in great detail. Importantly, they supported most of their statements with references. Unfortunately, I do not have enough space in a single blog post to detail their findings and recommendations.  But I have done my best to highlight the most important points.

What are the problems?

These introduce contaminants into the environment. For example, 

• Resin-based composites form microparticles during polishing or removal of restorations.
• Aligners release microparticles.
• Stainless steel brackets, among other materials, release nickel and chromium into saliva and wastewater.
• Clear aligners are made from non-biodegradable materials, which can result in increased long-term waste.
• Materials used in 3D printing can emit volatile organic compounds that are a health risk.

Developing sustainable orthodontics

They put forward some great solutions. They suggested that we should:

• Use more biodegradable materials
• Replace plastics with biodegradable polymers
• Reduce water and energy use.
• Promote effective disposal and recycling.
• Promote digital workflows to reduce material waste and improve efficiency in orthodontic treatments (I am not so sure about this last one).
• Professional organisations should produce guidelines to promote eco-friendly practice.
• We should run sustainable offices.
• We should reduce greenhouse gases and our carbon footprints.

Conclusions

The panel emphasised that this was a serious issue, and their recommendations serve as a starting point for discussion. They acknowledge that this is a difficult situation and that this article can serve as a catalyst for essential change.

What did I think?

This was an interesting and essential initiative. I would like to congratulate the authors on producing a well-researched and balanced paper.

I viewed this from the perspective of someone who strives to protect the environment for those who will come after us. On a personal level, I follow a plant-based diet, own an electric car, and have planted half of my garden with wildflowers; I also try to minimise my use of plastics.

They covered a wide range of factors that we need to consider in terms of sustainability. This list was extensive, and they made sensible and achievable recommendations.

However, I could not find a section devoted to the effects of travel, particularly air travel, on our carbon footprints. This is important when we consider that most societies hold national conferences that involve delegates flying to venues. Furthermore, I thought that a discussion comparing the risk from the different contaminants would have been useful. But, you may think that I am being too critical.

But what can our organisations do? Firstly, the WFO can try to take the lead on this and develop a plan to discuss with other specialist societies. This, of course, will be a major challenge. But I hope they can manage it.

I also believe it is important that they take the lead on this issue. For example, they could take some simple, straightforward steps immediately. These could be:

• Make this paper open access, so anyone can read it without being a member of the WFO. This would spread the word.
• Enable remote access to the presentations at the forthcoming WFO congress at no or reduced charge. So that people do not need to fly to Rio and increase their carbon footprint.
• Challenge the orthodontic supply companies to be more sustainable by asking them to include sustainability information on their stands at trade exhibitions and in the advertisements in journals. If they cannot do this, they should not be included in the exhibition.
• Initiate discussions with the other orthodontic societies.

Let’s start making progress with this.

Keypoints

• Environmental Impact of Orthodontics: Orthodontic practices contribute to environmental pollution through materials like composites, aligners, and metals releasing microparticles, nickel, chromium, and other waste, which pose ecological risks.
• Objectives of the WFO’s White Paper: The primary goal was to foster a global dialogue within the orthodontic community on sustainable practices and environmental consciousness in their field.
• Main Findings and Challenges: The research highlighted various environmental problems caused by orthodontic materials and emphasized the need for sustainable solutions, supported by extensive references.
• Proposed Solutions for Sustainable Orthodontics: Recommendations include adopting biodegradable materials, reducing resource use, promoting recycling, implementing digital workflows, and establishing eco-friendly guidelines for practice.
• Concluding Remarks and Personal Reflection: The panel underscores the urgency of addressing environmental issues in orthodontics, calling for leadership and proactive steps from professional organizations, with personal and collective efforts to minimize ecological footprints.