Dr Vivek V. Nair
Editor, JPID
Eco-Responsibility in Prosthodontics:
Shaping a Sustainable Dental Future
With global society facing the mounting climate crisis,
health care systems long thought to be passive are
being challenged today for their ecological impacts.
Dentistry and, in this case, prosthodontics have long
been focused on outcomes based on patient care
without consideration of the ecological impacts of
clinical practice. Prosthodontics, however, today
must evolve into a profession that not only delivers
functional and aesthetic rehabilitation but also
environmental responsibility.
Prosthodontics is material1,2- and energy-thirsty by
design. Beginning with impression materials, casting
alloys, and resin polymers and continuing with digital
fabrication equipment and disposable consumables,
the environmental price of creating one prosthesis
can be high. A standard crown fabrication process
is typically a multi-step process with material usage,
water-expensive laboratory procedures, and energy
demanding furnace use—all with carbon emissions,
water waste, and landfill load. Data show that the healthcare sector contributes to producing some
4.4% of overall greenhouse gas emissions (Karliner
et al., 2019), and dentistry’s contribution is small
but not insignificant. Duane et al. (2017) found in a
study that up to 60% of emissions related to general
dental practice can be attributed to material usage
and travel—both factors that are predominant in
prosthodontic treatment.
The arrival of digital dentistry—CAD/CAM milling,
3D printing, and intraoral scanning—has offered
accuracy, minimized chairside time, and even cost
benefits. Is it, however, environmentally better?
Digital impressions, in a sense, minimize reliance
on alginate or silicone-based materials and gypsum
casts. Milled restorations can potentially bypass
conventional steps such as flasking, curing, and
investing. However, milling machines and sintering
ovens are energy-intensive. Moreover, milling blocks
made of polymers tend to generate much waste due
to subtractive manufacturing processes. Life cycle analyses (LCA) of conventional and digital workflows
are currently few, but evidence (Schnitzler et al., 2021)
exists that well-optimized digital workflows can have
total environmental gains — especially if deployed
in centralized laboratories with efficient power
infrastructure and recycling centers.
Roads to a Greener
Prosthodontics2,3
A shift towards sustainable prosthodontic practice
is a well-planned, systematic process, informed by
clinical evidence and ethics. The following are five
key components to inform the shift:
1. Material Sustainability
Recyclable, biodegradable, or low-energy
synthesized materials must be used. Development of
eco-friendly denture base resins, bio-derived waxes,
and remeltable metal alloys must be expedited.
Segregation and recycling of dental materials must
also be institutionalized in dental schools and dental
laboratory environments.
2. Green Clinics and Laboratories
Prosthodontic laboratory design and operatory can
be made more energy-efficient and less wasteful.
This can be achieved by employing LED lighting,
motion sensors, low-flow water systems, and digital
reports to minimize paper consumption. Prosthodontic
laboratories can be incentivized to use locally sourced
materials to minimize transportation emissions.
3. Digital Workflow Optimization
As they digitize, clinics should examine the material
and energy expense at each step. Cloud computing
can reduce the need for in-clinic hardware. Shared
scanning and milling facilities can eliminate
duplication of high-energy equipment in each clinic.
4. Ethical Treatment Planning
Conservative prosthodontics—preserving tooth
structure and avoiding overtreatment—adheres to
both biologic and ecological principles. Planning for
treatment should not only consider patient advantage
but also stewardship of resources.
5. Education and Advocacy
Prosthodontic education needs to incorporate
sustainability as a central competency. From the
undergraduate clinic to board training in a specialty,
future clinicians need to take their environmental
footprint into account and become educated about
green substitutes. Editorial boards, organizations,
and policy makers need to encourage eco-standards
in dental licensure and accreditation. We editors,
reviewers, and researchers have a scholarly duty
to facilitate sustainable innovation. Journals need
to disseminate eco-audits in clinical trials, open up
research avenues in green material science, and
provide space for critical discussion in climate
sensitive care. Academic conferences need to
provide a platform for promoting green technology,
energy audits, and environmental policy initiatives
in prosthodontics. A future worth smiling about
Prosthodontics has always been an art and a
calling—restoring not only teeth but dignity, speech,
nutrition, and quality of life. With the age of climate
emergency, this empathy has now to transcend the
patient to the planet. Sustainability in prosthodontics
is not a sacrifice on quality—it is an evolution of
conscience. In our pursuit of creating smiles, it is
imperative that we create a future where every
impression, every crown, and every denture not only
touches the patient but also contributes to a smaller
environmental footprint.
A fundamental shift from conventional restorative
paradigms to environmentally conscious clinical
approach is required for the transition to sustainable prosthodontics.
Life-cycle analysis,
material
innovations, and evidence-based procedures can
all be integrated to guarantee that prosthodontic
care meets environmental and functional standards.
Restoring oral health and minimising the ecological
burden of care are two responsibilities that we as
dental professionals have to shoulder. In doing
so, prosthodontics can lead the broader dental
profession toward a truly sustainable future.