How to go green and keep it clean

March 21, 2012
Stan Goff
Issue 4

The Cloth-Op line of infection control barriers of chair and head rest covers not only protects, but also improves patient comfort according to Transcendentist.

The Cloth-Op line of infection control barriers of chair and head rest covers not only protects, but also improves patient comfort according to Transcendentist.

After all the years of dental practices being told to cover as much up with barriers as possible, it might be difficult to convince some dentists that doing away with barriers is a good thing,  that it can help save time and money and at the same time provide all the infection protection you get with disposable plastic barriers.

But don’t try and tell Serena Herrmann, RDAEF2, that an eco-friendly infection control protocol doesn’t provide the best possible infection control in dental practices.

And don’t try to tell her that doing such will not help with pretty much everything. The 25-year dental assistant, who is a registered dental assistant extended function level 2, raves about working at Transcendentist, the country’s first green dental practice.

“The first thing I’d tell them is that eco-friendly infection control meets the highest standards of infection control,” she said. “It also eliminates the use of toxic chemicals and it reduces landfill and water pollution. It’s also good for us dental assistants and hygienists that we’re not around so many plastics.”

Herrmann works for Dr. Fred Pockrass, whose green practice in Berkeley, Calif., minimizes the use of plastics and does not use chemical sterilizers or toxic surface cleaners. She believes the office helps protect patients and staff, as well as reduce waste and air and water pollution.

“One of my concerns was working for an office that looked at those concerns andactually changed things around,” said Herrmann, who believes her breast cancer may have come about in part because of all the years of working with chemical sterilizers and film x-rays. “That’s why I’m so happy to work here and everyone in our office feels the same way. The doctor runs these oxygen ionizers while we’re working and the air smells better and patients come in and say it doesn’t smell like a dental office.

“We use steam sterilization so we’re not breathing in those chemicals. It’s awesome. I love it." 

Does green mean green?
Not only does doing away with chemicals and barrier waste help the environment, but according to Herrmann and Ina Pockrass, co-founder of the Eco- Dentistry Association, it can save practices time and money. They point out that hospitals have switched to cloth tray covers and instrument barriers, meaning much less waste and also a safe environment.

“Practices should market the fact that they’re going green,” Herrmann said. “It creates a healthier and stabler environment for you as patients and for us as employees and for the doctor. In the hospitals you don’t see a lot of plastics, you see cloth wraps. They sterilize their instruments pretty much the way we do and they do it in cloth.”

Ina Pockrass describes how some practices generate excessive waste by trying to follow perceived infection control guidelines. “Many practices will cover their instrument trays in plastic, then cover them again with a paper tray liner, and then open up paper and plastic instrument pouches,” she said, noting that using cloth wraps and non-toxic cleaners such as SciCan’s OPTIM 33 TB can improve efficiency and be economically sound.

“We’re actually saving time and money because we use the wraps as our barriers for the table tops for our tray set up,” Herrmann added. “There’s no extra set up. You just open it up and you’re done.”

Dr. John Molinari, the Director of Infection Control for THE DENTAL ADVISOR, said manufacturers have made it easier for practices to find the right products and techniques to make the switch.

“It’s a lot easier now than it was probably just about 2-3 years ago,” he said. “I think medicine really started this when they realized just how much waste they were accumulating with each patient that was sitting in the hospital. I’ve seen estimates of up to 50 pounds of waste a day per patient from paper, all the plastic, syringes, things like that.”

But Dr. Molinari, who lectures at dental meetings on infection control and who has long been involved with OSAP, sees a trend from practices going green, either with cloth wraps or at least researching and choosing products that are recyclable.

“We are making a shift away from all the barriers,” he said. “One of the questions you hear at dental meetings is, ‘Do you want us to use these barriers to cut down on chemical disinfectant?’ Well, what are we doing to the landfills?”

He has noticed more companies at dental meetings offering more recyclable plastics for the barriers.

“That’s something for your readers to consider when they’re out looking for a chair cover or bracket handle cover…look to see what the material is and question the people at the meetings,” Dr. Molinari said. “Ask them, ‘Is this recyclable? Is it biodegradable?’ The chemistry has really come along way in recent years because of this.”

He said a nice change he noticed outside the office is that the bags on the newspapers delivered to homes have become biodegradable.

“You put it in the regular trash but it’s not going to be staying intact for very long. That’s just a small example, but multiply that by hundreds of millions of newspapers that get delivered each week. That makes a difference,” he said. “Most dental practices were using a blend of barriers and cleansers, and they can still do that. It’s just being smarter consumers and asking the questions. You know what, the manufacturers and reps should have the answers. And if they don’t, trust me, there are other alternatives out there.”

Mary Yakas, BA, CMC at THE DENTAL ADVISOR, said dentists need to be aware of things like Hu-Friedy’s instrument recycling program, and also know which surface cleaners and water line cleaners are best for practices and the environment.

“We just did a column on greener infection control products and even things like digital x-ray play a big role,” she said, adding that the OPTIM 33 TC breaks down into water and that the right water line cleaners can help prevent chemical waste.

“It’s not just barriers,” Dr. Molinari said. “People are looking at the chemistries of these things. We’re entering into an era where I think we’ll see more and more attention paid to it.”

He said he’s noticing some lectures strictly focusing on green infection control and he has tried hard to spread the word on the negative aspects of things such as overspraying with chemicals.

“You can see the ongoing evolution and you see more people asking the right

EDA offers IC information

The Eco-Dentistry Association is a great source for information so if you’re looking for tips on how to go green, which products are best or how you can save money, visit ecodentistry.org.

Director Susan Beck said the group established a Best Practices for Sterilization and Infection Control to assist practices in their efforts to go green, and according to the guidleines, eco-friendly infection control methods must:

  • Meet the highest infection control standards

  • Eliminate the use of toxic chemicals, and

  • Reduce landfill waster and air and water pollution

questions,” he said.

Yakas adds, “Know how to disinfect. Know what surfaces need to be cleaned. What surfaces need to be cleaned and disinfected and sterilized. Because so many people don’t know that and they just throw everything in a sterilizer or they buy disposables things because they think it’s too much of a hassle. You need to look at the process.”

Dr. Molinari said some practices just need to fine tune their methods to bring in the greener, more friendly techniques and products.

“They‘re just so used to doing things the way they originally learned,” he said. “Instead of re-learning, I’d say it’s fine tuning. And getting the word out as you are is great and getting them to at least begin thinking about it. And I think they have already started to think about it but it’s tough to make the application in their practice because they already have a lot of products.”

Herrmann adds, “It’s basically exactly the same as normal infection control other than we don’t use disposables.

Instead of having plastic that you throw into the garbage, ours go into the washing machine. It was a very quick and easy adjustment. And the chemicals, I don’t want to be around it. I myself have stage 3, grade 3 breast cancer. I believe it was probably from working around a chemiclave, breathing those chemicals in, and from taking x-rays that aren’t digital.”

There’s another benefit to the cloth covers used by Herrmann’s practice, and that benefit is comfort.

“The patients actually love it,” she said. “Our chair cover and our head rest cover is made of an organic, comfortable material and patients tell us this feels so good.”
Those happy patients also happen to tell their friends, which helps out quite a bit.

“A lot of our patients are eco-friendly, yoga type people who are concerned about the environment and their health,” Herrmann said. “They keep referring patients. We’re just growing like leaps and bounds from being eco and green.”