A Room-by-Room Guide
By Dr. Jason and Rebecca McMillan
The good news: Going green is a smart
move for the environment and for your
bottom line! If you feel daunted by the
undertaking, start by implementing the
easiest strategies first and as time and
finances permit, commit your office to
doing more.
Not only will your practice benefit from
your environmental stewardship, but you will have the
personal gratification of knowing you are doing your part to
protect the planet for generations to come.
Materials & Furnishings
• Use products and materials that are durable. A product that
lasts longer usually requires less maintenance and saves energy.
• Select building materials that will require little maintenance
(painting, retreatment, waterproofing, etc.), or whose
maintenance will have minimal environmental impact.
• Choose construction materials that are salvaged, have a
high-recycled content, are certified wood products, and/or
are rapidly renewable resources such as bamboo.
• Give preference to materials manufactured locally to offset
the adverse impacts of transportation.
• Create a custom look and conserve resources by furnishing
your space with second-hand finds, such as tables and chairs
for your waiting room.
• When purchasing new office furniture and fixtures, look for
products that follow the "cradle to cradle" design philosophy.
These products use environmentally healthy materials and
production methods and are designed for the product to be
easily recycled at the end of the product's useful life.
• Look for carpet that has no polyvinyl chloride (PVC) in the
backing. Consider using carpet tiles that will allow soiled
areas to easily be removed and laundered or switched with
tiles from other low traffic areas if necessary.
If possible, select a product that has been certified as Green
Label Plus, which means it has been tested by an independent,
certified laboratory and meets stringent criteria for low
chemical emissions.
• Select materials for your space that do not emit harmful
chemicals so that there aren't any issues with "off-gassing."
Use low VOC (volatile organic compounds) paints,
laminates and adhesives.
Lighting
• Design your office to maximize natural light and minimize
energy use with carefully placed windows and/or skylights.
• Install occupancy sensors in rooms that are infrequently used.
These sensors will save energy by automatically turning
lights on when someone enters a room and turning lights off
when they leave.
• Save money and energy by swapping out your incandescent
bulbs for compact fluorescents that are four times more
efficient and last up to 10 times longer.
• Use daylight dimmers that turn off lights automatically
when there is sufficient natural light.
• Control direct sunlight through windows with screens or film.
• Install LED exit signs that last 20 times longer than
conventional signs.
Energy Use
• Use high-performance windows, high levels of insulation,
and tight construction to conserve energy.
• Design your space to utilize renewable energy such as passive
solar heating, daylighting, and natural cooling.
• Purchase renewable energy through your local utility company.
As we all become increasingly concerned about the
environment, the demand for sustainable products and services
has grown exponentially. From organic produce to hybrid
automobiles and green contractors-consumers are
demonstrating their commitment to lightening their ecological
footprint with their checkbooks.
This trend is beginning to surface in the dental office as well.
Many patients are seeking to align themselves with
practitioners who show a commitment to improving both their
patients' health and the health of the environment. Businesses
that have incorporated sustainable features cite numerous
benefits, including:
• Recognition by their patients and community as an
environmental leader
• Strengthened bottom line through operating efficiencies
• Improved employee health and morale
• Marketing edge over their competition
• More opportunities to further increase productivity and
reduce costs
Whether you are renovating, planning ground-up construction,
or simply considering ways to be greener in your day to day
operations, there are many approaches for creating an office
that is more efficient and healthier for you, your staff, your
patients and your community. Take a stroll with us through
the rooms that populate a typical dental practice and learn
both the big and the small steps you can take to reduce your
environmental impact and join the growing number of
practitioners who are seeing green!
Front Office
Save paper, space, and time by investing in practicemanagement
software to handle billing; treatment plan tracking;
process insurance claims, patient information and consent forms,
appointment reminders, and optimize scheduling.
Purchase Energy-Star-rated computers, monitors, copy/fax
machines, printers, and mailing machines for your office.
Equipment with this designation saves you money by using
less energy and will last longer because they run at a cooler
temperature. Many states also have incentive programs with
rebates for selecting these appliances.
• Set your computers to enter system standby or hibernate after
30 to 60 minutes of inactivity. Set monitors to enter sleep
mode after five to 20 minutes of inactivity.
• Utilize recycled or Forest Stewardship Council (FSC) certified
paper products for your office business cards, letterhead,
envelopes, brochures, bags, and copy/fax paper.
• Ask at your print shop about using healthier soy-based inks
for printing your business identity materials instead of the
standard petroleum-based ink.
• Designate and clearly label recycling containers in accessible
areas for both patients and staff to encourage resource reuse
and recycling.
Many patients are seeking to align
themselves with practitioners who
show a commitment to improving
both their patients' health and
the health of the environment.
• Buy recycled/remanufactured toner and ink-jet cartridges for
your office machines.
• Communicate with electronic files rather than paper ones.
Use e-mail to correspond with doctors and patients and to
send digital X-rays.
• Have notepads and message pads made from the unused side
of scratch paper, outdated forms, or old letterhead. Simply
staple stacks together for staff use or have larger quantities
padded by a copy center.
• Make a commitment to reduce your junk mail by writing to
or calling senders directly and requesting removal from their
mailing list. You can also:
• Reduce pre-approved credit card and insurance offers by
calling 888-567-8688 (888-5-OPT-OUT) or visit
optoutprescreen.com.
• Register for the "do not mail me list" at the Direct
Marketing Association's Mail Preference Service Site:
dmaconsumers.org/cgi/offmailing.
• Reduce the amount of paper used in your office by utilizing
your printer's duplex printing capabilities.
• Sending faxes electronically. If you are not already sending
faxes electronically, try to eliminate fax cover sheets
whenever possible.
Rest Rooms
• Install low-flow faucets and toilets, which provide the same
functionality as conventional fixtures while saving substantial
amounts of water.
• Purchase dual-flush toilets that save water by providing two
flush options.
• Conserve water by using sensored faucets that also stop the
spread of germs and bacteria, avoid water overflow, and
prevent scalding injury.
• Reduce paper waste and improve restroom upkeep with an
energy-efficient hand dryer.
• Stock recycled tissue and toilet paper that are whitened
without chlorine bleach and free of dyes, inks, and fragrances.
Buying products made from recycled paper helps reduce the
need for virgin wood pulp.
• Encourage your team to walk or bicycle to work by
providing a shower for staff use.
Operatories
• Invest in digital radiography and save space, eliminate the
need for film processing, and expose patients to up to 90%
less radiation than a standard X-ray system.
• Consider purchasing a CAD/CAM milling machine. This
technology reduces material use in the office and it reduces
transportation and fuel consumption by patients and
laboratories.
• Utilize comprehensive practice-management software to save
space and increase efficiency by electronically storing
charting, progress notes, treatment plans, and X-rays.
• Select cabinetry constructed with a 100% pre-consumer
recycled wood fiber particleboard, that has no urea
formaldehyde added during the manufacturing process. This
reduces "off-gassing" of harmful chemicals and improves air
quality in your dental practice.
• Reduce the discharge of mercury-containing products, such
as dental amalgam waste, into the environment by
purchasing or upgrading your amalgam separator.
• Revisit your local dental association chapter's best practice
guidelines to make sure your practice is meeting or
exceeding guidelines for managing hazardous and mercurycontaining
waste products.
• Minimize water use by installing medical-grade hand
sanitizer dispensers in your operatories. This alternative to
hand washing is more effective than soap and water in killing
bacteria and viruses, helps prevent dry skin, and saves your
office time and resources.
• Find an alternative to latex gloves. Latex sensitivity is a
growing problem for both patients and staff. Be mindful of
latex in other products such as rubber dams and prophy cups.
• Purchase barriers manufactured with recycled materials.
Supply Closet
• Use biodegradable, non-toxic cleaners that have limited
environmental and health impacts.
• Stock natural oral-care products for patients.
• Purchase recycled or corn-based trash bags for waste products.
• Order sealants, adhesives, and other restorative materials in
package sizes that will result in all the contents being used in
a timely manner. This will minimize waste from expired
inventory and save you money and product.
• Consolidate your supply orders to prevent unnecessary
shipping and packaging waste.
Laboratory/Sterilization Room
• Switch to instrument sterilization via a steam autoclave
or dry heat oven. If medically appropriate for your
practice, switch your cold sterilant from a solution
containing glutaraldehyde to something less toxic, such as
hydrogen peroxide.
• Utilize cassettes for instrument processing. This is safer for
staff members and reduces the use of sterilization bags.
• Install a good ventilation system to address chemical and
airborne particulates.
• Research laundering garments in-house to reduce fuel
consumption and overhead costs.
Staff Lounge
• Provide an Energy-Star-rated refrigerator and microwave or
toaster oven to encourage employees to bring healthy food
from home.
• Purchase reusable dishes, silverware, cups, and glasses
for staff and patients and equip your lounge with an Energy- Star-rated dishwasher to encourage employees to
wash and reuse tableware.
• Promote carpooling and provide special parking spaces for
those who carpool.
• Encourage alternative transportation with public transit
maps and discount passes.
• Install convenient, safe places for bike parking.
Mechanical Room
• Select an oil-free compressor. Oil-lubricated compressors
can add oil to the compressed air stream and compromise
the quality of air for patients as well as having a damaging
impact on handpieces.
• Choose a dry, oil-free vacuum system for your practice.
This newer technology uses no water compared to a
traditional system that consumes approximately a gallon
a minute.
HVAC System
• Purchase high-efficiency heating and cooling equipment.
This will save money, and produce less pollution during
operation.
• Integrate a heat recovery feature into your HVAC system,
which can be used to pre-heat or pre-cool outside air by
using the exhaust air as the source. This will reduce energy
consumption during wintertime and during extreme summer
conditions.
• Install programmable thermostats that automatically adjust
temperature settings based on the time of day and day of
the week.
• Regularly change your HVAC filters and tune up your units.
• Consider installing locking devices on thermostats to
maintain desired temperature settings.
Water Heater
• Install an energy-efficient water heater. Consult with your
project team or visit the U.S. Department of Energy's
Web site for their Consumer Guide to Energy Efficiency
and Renewable Energy (eere.energy.gov/consumer) to
determine what type of water heater is most appropriate
for your practice.
• Insulate your existing water heater tank for energy savings.
A tank that's warm to the touch needs additional insulation.
Outside Your Building
• Implement storm-water-management strategies to help
reduce the discharge of sediment, oil, and chemicals into
storm drains, surface water, and groundwater.
• Select a light color for your building and roofing material.
This will reflect light and reduce your energy use.
• Landscape with drought-resistant and native plants to
minimize irrigation needs.
• Look into the feasibility of using gray water, which is water
from sinks, showers, or clothes washers that is recycled for
irrigation and to water plants and land.
• Consider a rainwater collection system to provide an alternate
water source for garden irrigation while reducing runoff.
• Ask your landscape maintenance team to compost clippings
to reduce waste.
• Limit the amount of synthetic fertilizers and pesticides used
for landscaping.
Overall Office Strategies: Design & Construction
• Select an architect and builder that are LEED (Leadership in
Energy and Environmental Design) accredited or have
experience working on green projects. A good place to start
is by visiting usgbc.org for contact information for your local
U.S. Green Building Council chapter.
• Evaluate the feasibility of pursuing LEED certification for
new practice construction and tenant improvements.
• Ask your contractor to develop a waste management plan
to facilitate recycling and insure proper disposal of nonrecyclable
materials during construction and/or renovation
of your practice.
• Select a location that fully utilizes your region's existing
characteristics. Work with your design team to weigh the
benefits and drawbacks of a potential site's sun, soil, water,
and wind conditions.
• Consider a high-density location when constructing a new
practice. Density reduces automobile use and creates
healthier communities. Look for nearby access to public
transportation and other vital services.
• Renovate an existing building for your new practice to
preserve more resources than construction that is built from
the ground up.
Some of the services or references mentioned apply to U.S.
practitioners only.