Awareness of Students and Dentists on Sustainability Issues, Safety of Use and Disposal of Dental Amalgam

Abstract

Among the pillars of sustainability in health care units is environmental protection. Although an EU-wide dental amalgam phase-out legislation exists, quantities of this material are still to be found in the market, dental offices or in the mouths of patients. The purpose of this study is to record the views of dentists and dental students in Greece regarding the use and safety of dental amalgam for people and the environment as well as their attitudes towards its restriction and disposal. Materials and methods: Two different questionnaires, through Google forms, were filled by each group. Descriptive statistics were used to describe the variables. The chi-square test or the chi-square test with Yates correction was used to examine potential differences per group (p-value = 0.05). Overall, 564 people participated in this study; 462 (81.9%) dentists (N1) and 102 (18.1%) dental students (N2). Results: Both groups agreed that they no longer use dental amalgam often. Dentists (39.8%) and students (36.4%) consider amalgam to have a moderate burden on the environment. This answer differed significantly per year of profession and year of undergraduate studies, respectively, with dentists from 6–25 years in the profession and 4th-year students, being the least aware on the environmental footprint of dental amalgam. Further, professionals (70%) and students (60%) believe that dental amalgam has a hazardous impact on patient’s health, at all or to a small extent. For staff health, dentists reported at a moderate degree dangerous impact (32.9%) while students (36.4%), respectively. The impact on patients and staff health, were found to differ significantly per region of practicing dentistry for both groups. Finally, there were suggestions made from both groups about the necessity of information sharing on amalgam and mercury safety and the impact on the environment at the level of professional organizations. Conclusions: Students, younger dentists and those living in non-urban regions seem to be more sensitive to the environmental impact of amalgam use, disposal, and health of people. Environmental issues should be addressed thoroughly by professional organizations, enhancing relevant activities for all people involved.

Green Dental Environmentalism among Students and Dentists in Greece

“…As it is proposed, to design effective interventions to modify habitual environmental behaviour, it is important to consider how habits are formed, reinforced, and sustained [43][44][45][46][47]. Dental authorities and energy companies should play an important role in rewarding green practices and thus cultivate green motivation among professionals to change habits, improve motivations, perceptions, cognitions, and norms while structural state strategies, should aim at changing the circumstances under which behavioural choices are made [14,38,41,42,48].…”

“…There is a lack of experimental elements which could more rigorously assess the willingness and practice of the specific sample as reported elsewhere too [48][49][50]. Because of this limitation, behavioral results should be further assessed to link specific green building elements and technologies with the sensitive environmental behaviors of this study.…”

Aspects Regarding Sustainability among Private Dental Practitioners from Bucharest, Romania: A Pilot Study

“…Amalgam used for dental fillings is a well-known health hazard due to its high mercury content; it must be separated from dental waste by means of appropriate separators [41,45,46]. It is acknowledged that the use of dental amalgam is currently very limited; various studies worldwide indicate that dental professionals consider that amalgam has a negative effect on the environment to a small or moderate extent [47][48][49]. On the other hand, the choice to use amalgam as a dental filling depend on "shared decision-making between dental providers and patients in the clinic setting, and local directives and protocols" [50].…”

“…Our results also revealed that educating dental employees and patients about sustainable practices was not thought to be a successful method for integrating sustainability into dental offices (the lowest score reported for this strategy confirms the fact). There exists a lack of understanding and knowledge on how to become more environmentally sustainable in many fields of human activities [47,55,56]. Awareness through education is the essential key in all domains, and this should be the foundation of future strategies, as other authors have also mentioned [14,47].…”

“…There exists a lack of understanding and knowledge on how to become more environmentally sustainable in many fields of human activities [47,55,56]. Awareness through education is the essential key in all domains, and this should be the foundation of future strategies, as other authors have also mentioned [14,47]. On the other hand, a study conducted by Grose et al (2016) [18] in England, UK indicated that the participants exhibited a positive disposition towards the notion of sustainability in dentistry; nonetheless, the analysis revealed that the participants also expressed criticism concerning the absence of explicit guidelines for sustainable practices within the field of dentistry.…”