Balancing Infection Control and Environmental Responsibility

You're listening to the Phil Klein Dental Podcast Thanks for joining us. I'm Dr. Phil Klein. With all the emphasis in the news about climate change and environmental challenges, are there things we could do in our practice to minimize negative impacts on the environment? But we also have to keep in mind that protocols for becoming a green practice should not come at the expense of proper infection prevention control. To tell us more about balancing safety and environmental responsibility is our guest, Mary Govoni. Mary is a speaker, author, and consultant on infection prevention control and regulatory compliance. With a long-term interest in environmental quality, Mary lectures and consults on how dental practices can be safe in terms of infection control and use of chemicals, and at the same time, reduce their impact on the environment. Before we get started, I would like to mention that Mary will be presenting a live webinar on VivaLearning.com titled Balancing Infection Prevention, Efficiency, and Environmental Responsibility. It is scheduled for Tuesday, August 1st at 7 p.m. Eastern Time, 4 p.m. Pacific. Simply visit VivaLearning.com to register. The webinar is free and you can earn live interactive CE credit. Mary, it's a pleasure to have you on the show. Oh, thank you, Phil. It's a pleasure to be here. So is it possible and realistic for dental practice to operate, you know, where things don't have to be completely turned upside down in order to reduce its environmental impact? It is possible, but it does take some... planning and assessment to figure out what makes sense for any particular practice and in the beginning it takes a little bit of extra work to figure out what to do like how to recycle certain items and what can be recycled but the biggest issue is that the doctor and the team have to all be committed to any type of environmental type activities and they really need to become a part of their culture, so to speak, that they need to make a very dedicated effort to continue it. Otherwise, it's kind of a flash in the pan. Oh, yeah, we tried it. It didn't work. And we stopped doing it. The team members have to buy into it. The doctor has to buy into it. And they have to believe it's worth doing as a good citizen of the earth, so to speak. Yeah, for sure. And, you know, we have a lot of disposable products in dentistry. I know we're going to talk about that later on in this podcast. You know, a lot of that is for infection control. And a lot of these companies that sell these products promote these products based on the fact that they're single use and, you know, there's no regard for the environment there. But the question is, it's a trade-off, obviously. So how would a dental practice go about setting up a plan or program to become more environmentally responsible, as we call it, green, you know, going forward? Well, as I said before, the team, first of all, has to be dedicated to making it happen because it does take some planning. So they need to make a commitment. And as they commit to that, I would let their patients know, their suppliers know, and their business partners know what they're undertaking. They can post activities on their website and in social media. They need to look at, as part of the planning process, what is it possible to accomplish that might mean they need a little bit of education on environmental issues and maybe some recycling find out what types of recycling are available if it's not available at the office then maybe some of the team members have to commit to taking things to a recycling center or take them home for curbside recycling if they have that but they can also do things like conserve energy in the office temperature settings are are a tough discussion because of all the ppe and everybody wants to keep it really cold but the colder you keep it and now everybody's dealing with all these really high temperatures it obviously takes more energy but looking at the possibility of things like motion activated light switches My big push right now with all the people I work with is using less paper. So moving to electronic documentation for health histories and records and all those kinds of things. And use reusable items when it makes sense. We have a lot of technology that uses batteries. You can use rechargeable batteries. Many of the plastic items that we might use during treatment that become an infection control issue actually are heat sterilizable. Or they could be immersed in a high-level disinfectant, what we used to call cold sterile, if you don't want to be throwing those items away after every patient. Use things that can be recycled as much as possible. Even things like adding plants to... the office decor because plants help to boost oxygen levels in the facility and according to some nasa studies they help reduce indoor air pollutants and we use a lot of chemicals so that could help and then something as simple as recycling old electronics but make sure that you do it in a hipaa compliant way if it's a computer or a printer or something like that Yeah. Have you found through your consulting work and your interaction with offices all around the country, did we have a green movement for a while and then it kind of lost its momentum? Yes, we did. Tell us about that real quick. What charged it up and what kind of ratcheted it down? Well, I think what charged it up was the work of a doctor in California who started an echo dental organization and was really very enthusiastic in doing that. And I don't know, I haven't touched bases with them recently to know what's actually happening. I know they had some reusable sterilization pouches and they were sold to another company that then discontinued them. So that would have been. I guess a little bit disheartening, but yeah, it sort of lost steam. And I don't know whether it was because practices just really weren't that dedicated or found it too difficult to do it. I do know that ADOM, the Association of Dental Office Managers, does give an award every year to the... greenest or the best green practice. So it hasn't totally lost steam. COVID probably overshadowed it for one thing. And we got all caught up in all of that craziness. But I'd like to see it gain some momentum again. Yeah. It's just that dentists have so many things to worry about and do, especially since the pandemic, just an inordinate amount of infection control protocol when you think about it. And then for you to add in the green movement, it's very important, but it's just... Sometimes there's just so much you can do and focus on. Let's talk about disposable products. Like I mentioned earlier, you know, that's a big part of dentistry. You know, there's so many, I mean, there's even disposable burrs now. Given that disposable products are so important in dentistry to help prevent cross-contamination, how can a practice reduce the number of these kinds of items that get sent to the landfill? That is such a great question. And what a practice really needs to do is look at how, They run their practice. What are the types of disposable items they use and why? Are they disposed of because they have to be like gloves and face masks? They're contaminated after use and they must be disposed of? Or could an item like a burr be cleaned and sterilized for reuse, make it safe for reuse? And the whole issue that's come about with disposable burrs has to do. with the inability to adequately clean those and remove all the debris, be sure that you've removed all the debris in order to sterilize them. And many of the burr manufacturers don't have FDA cleared or FDA approved guidelines for reprocessing. i buy an xyz brand burr and it doesn't come with fda guidance on how to from the manufacturer on how to reprocess it then technically it is disposable and that's a whole that's a whole other podcast um but you look at things like single use items do i buy temporary cement for example in the little pouches that i tear open and mix together and then i'm throwing the um packaging away or do i buy it in bulk well if i buy it in bulk and save the packaging then i've got to be very careful about making sure that the outside of those containers are disinfected after use because i touched them during treatment with my hands so my contaminated hands so a practice really needs to take the time to make a list of all the things and say okay what does it make sense to use in bulk and not have all the packaging look for manufacturers of products that used packaging that's made from recycled materials because then we are you know saving some resources there so it's not as simple as don't throw anything away reuse everything or throw everything away i think we need to again strike a balance there and what makes sense to dispose of what must be disposed of and what could we reuse or use in a bulk packaging Of course, the important part is the safety, the infection control consideration. The other important part is efficiency, too, that the dentist has to consider. If it's way more efficient to use something that's a single-use item and chuck it away, they have to weigh that efficiency component against being green. Absolutely. It's really a mindset, right? It's a mindset of a person. It never compromises safety. Right, for sure. Let's talk about biodegradable products that are on the market. Can you give us some examples of how to evaluate a biodegradable product that's useful, that works, and that when it goes in the landfill, it doesn't do anything but break down safely? Right. Well, the first thing is that many of the products that we worry the most about are things that are like plastics. don't necessarily degrade in the landfill, but some of those could be recyclable. For example, if I buy my disinfectant in wipes, the canisters can be rinsed and put into a recycling container. As long as they have the little recycle triangle on them, they can be recycled. And any kind of packaging material that you perhaps get that... come in whether it's a box for the product or the shipping materials i know many of the suppliers have made a concerted effort to use less shipping materials and stop using things like those annoying styrofoam peanuts and they use paper packaging and things that can all be recycled there may not be a lot of products that we see yet that are actually biodegradable although some companies say that they are. If you look at things like plastic barriers that we put on chairs and light handles and so forth, if you do the research and you look at, you know, they make a claim that it's biodegradable, what it might say is that it takes several decades for that to happen. But recently, a new product has come out on the market that I'm pretty excited about. it is gloves that are biodegradable these are from cranberry and they're called the bio nitrile exam gloves and these are nitrile gloves like we use for you know exams and procedures they're not surgical gloves they have chemical incorporated into them a compound incorporated into them that when they go to the landfill that attracts the microbes in the soil at the landfill to break them down and their studies show that after about a year and a half 90 percent of the glove is broken down and if you compare that to a latex glove which is completely biodegradable because it's made from natural rubber that happens in about five years and then the other types of nitro gloves that we typically use probably don't biodegrade at all or certainly not in our lifetime those are the ones that will take decades so i think this is a pretty cool exciting innovation for those that want to be more environmentally responsible and i would certainly encourage our listeners to go to cranberryusa.com and do some research about the gloves i have tried them They are very comfortable. They're flexible. You have good gripping texture on the gloves. So I think that that could just be a great development for us in terms of being more environmentally responsible. Yeah, no, that sounds like a really cool innovation from Cranberry. And they are one of the leading companies in the space of gloves and infection control and prevention. So do you think that developing a green office, so to speak, and marketing that? to your patients as a practice builder, because you could kind of showcase that in the waiting room where patients come in and they see the culture of the office operating under the concept of environmental responsibility. Is that a practice builder to some extent? Oh, I think it's absolutely a practice builder. It's, as I said earlier, it's being a good citizen of the earth. Many of those patients recycle. from home they may recycle at their offices and i think that shows good leadership in business on the part of the dental practice and it will probably be a great conversation starter but absolutely i would let patients know through again social media and other types of of communications with them and let them know all the things that you do in order to be more responsible Yeah, absolutely. Thank you very much, Mary. We really appreciate your time. We hope some of these offices consider this among all the many things they have to do in their practice to build it. And it's not an easy business to be in dentistry for sure. But if they could work this into the system that they're running in their office and do that balancing act that you talk about, it helps them. It helps build their practice. And it's, of course, better for our planet. Thank you so much, Mary. Thank you. 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