Sensitive Dentistry
Dr. Donna L. Smolinski
Go Green
Green dentistry involves the use of restorative and prosthetic materials which are most compatible with oral tissues, as well as the health of the entire body. Green dentistry takes into consideration that the supplies required, and the waste generated, from each patient visit has impact on the world which we all share.
But the equipment, materials and methods we use in dental care are merely a small portion of environmental improvements taking place everywhere in society. We hope that you will explore our Green Road Map and find out how we dramatically reduced the impact your dental care has on your environment. Here you'll find extensive coverage of the alterations we've made to our facilities and operations, as well as links and suggestions for reducing your own environmental footprint. The eco alternative ordinarily saves money in the long run, often saves time in an ongoing basis and always provides the reward of knowing that your are part of solution, instead of the problem.
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LED Patient Care Lamps. The first green thing you are likely to notice with Eco Sensitive Dentistry (actually not notice) is that you are no longer blinded and cooked while you have your dental work done. Notice the photograph of the seated patient. The only area illuminated is directly over the mouth. LED (for light emitting diode) technology enables light to be efficiently directed where needed, with little heat being produced in the process. Traditional patient care lamps are indeed so hot that staff can be burned by accidentally touching the fixture. Additionally, many patients experience extreme discomfort from having an overheated face, concurrent with chilled extremities.
If you have noticed that holiday LED lighting can trend either toward cooler blue or warmer yellow colors, you will understand that the dentist can now work more efficiently by altering this colors temperature. Some light temperature adjustments aim to imitate sunlight to improve color matching for your restorations, while other color adjustments enable dental materials to cure under more optimum conditions.
Traditional lights are so heat intensive that they give off as much heat as a person's body. This means our air conditioning has to work that much harder to remove this waste heat. All lighting (not just for patient care) in our office is either LED or CFL. Not only do these lighting options consume less electricity and create less heat, these bulbs last many times longer than traditional bulbs.
Photovoltaic Solar Panels. Our office has 57 panels on the roof, totaling a production capacity of 13 Kilowatts. With the sun at its peak, this means that we can produce all the electricity we need to power the dental office and still have some left over to put back on the grid and help to power your home with zero emissions. And when our office is closed (3 days per week), virtually all of our electricity is going back to the grid. While not every day is sunny, we have removed over 90% of our energy footprint and during some months, the utility indeed receives a net surplus of electricity from Eco Sensitive Dentistry.
Each panel has its own microinverter. This converts the DC electricity produced by the panel into AC electricity used by electrical appliances. Previously, solar electric power production utilized one, large inverter for the entire array. However, by downsizing the inverter, you encounter several advantages. This enables you to build an array in stages, a panel at a time if you desire. You no longer have to put all panels on the same roof plane or worry so much about shadowing. Any loss of degradation of individual panels does not influence other panels in the array.
Fafco Solar assisted Eco Sensitive Dentistry in achieving many of its green goals.
Solar Hybrid Air Conditioning (Heat Pump). To the right of the solar array shown in the accompanying photo, on the adjoining roof surface (and directly above the conventional looking air conditioning units) is a solar collector used to heat air conditioning refrigerant. The largest energy draw in conventional air conditioning is the compressor. However, our solar collector provides the unit with enough energy to bypass the compressor most of the time. Our current system uses approximately one third of the energy of the system it replaced. This means that the air conditioner uses just a bit more electricity than a microwave oven!
And lack of sun is not normally an issue, because the refrigerant will retain enough solar energy to last approximately 96 hours. This solar hybrid air conditioning system, combined wiht other improvements to be discussed shortly, has enabled us to reduce the energy consumed in cooling the office by over 75%.
We need to emphasize 'Heat Pump' versus plain air conditioning, because some mornings in Southwest Florida can be quite chilly. However it doesn't last long. Conventional heating coils are terribly inefficient and cost a great deal to operate. The unit we use acts as a heat pump when needed, and no heating coils are ever used in our office.
Efficient Water Heating. While Eco Sensitive Dentistry doesn't utilize much hot water, how that water is heated has an enormous effect on the electric bill. For most residential users, solar host water heating is the way to go and is what we would recommend. However, businesses are billed differently and the rate of electricity consumption is of paramount importance. Even if you don't flip the electric switch very often, the hit can be huge if you draw a lot of current when the switch is flipped. This is the problem for solar water heating in business. On cloudy days, the back up to solar heating is standard electrical coils which easily draw five thousand or more watts. The solution is to utilize a heat pump water heater which moves heat energy instead of creating it. This is four times more efficient and yields a maximum power consumption of just 550 watts. Our water heater still has standard electric coils for back up, but we leave them turned off. Heat pump water heaters do not heat the water as fast, but for our business needs, this is not an issue. 'On Demand' water heaters offer advantages over conventional water heating, but they either require excessive current draw (for electric models) or burn fossil fuels. Since we are committed to removing fossil fuels from use, we encourage water heating by solar or heat pump as better alternatives.
Reduced Consumables. How would we feel, and how much would it cost, if every set of bed linens, table clothes and napkins, flatware, etc was required to be brand new every time we used them? No, we expect that we are reusing such items when we visit hotels and restaurants (expecting proper sanitation). The medical industry has become a notorious waster of resources by creating a tremendous amount of consumable items used up during every patient visit. Every year, dental practices generate over 2 billion throw away items from patient visits, including chair barriers, patient bibs and sterilization pouches. We have been replacing such items with reusable counterparts that can be properly sterilized and not end up in a land fill.
Washer & Dryer, Laundering with an Ion Advantage. In reducing consumables, we opted to upgrade our laundry equipment. Most are now aware of water and energy savings available from front loading washing machines. Beyond this, our Samsung Washing Machine utilizes silver ions to sterilize fabrics. These ions are retained in the material, so that the items continue to actively fight germs while in use in our operatories. We not only avoid throw away items, we do so in an energy efficient and more sanitary fashion.
Washer & Dryer, We would love to avoid using the clothes dryer, but it is impractical here at the dental office. When available, drying items in the sun is not only (obviously) more energy efficient, but it often saves time as well. If you have never tried it here in our Florida sun, we encourage you to do so. You will most likely find, as we have, that (especially with darker items) the sun and breeze dry clothes faster than an appliance. Additionally, you avoid adding heat and humidity to an environment which would require air conditioning to remove.
Solar Hybrid Air Conditioning (Heat Pump). To the right of the solar array shown in the accompanying photo, on the adjoining roof surface (and directly above the conventional looking air conditioning units) is a solar collector used to heat air conditioning refrigerant. The largest energy draw in conventional air conditioning is the compressor. However, our solar collector provides the unit with enough energy to bypass the compressor most of the time. Our current system uses approximately one third of the energy of the system it replaced. This means that the air conditioner uses just a bit more electricity than a microwave oven!
And lack of sun is not normally an issue, because the refrigerant will retain enough solar energy to last approximately 96 hours. This solar hybrid air conditioning system, combined with other improvements to be discussed shortly, has enabled us to reduce the energy consumed in cooling the office by over 75%.
Mercury Abatement. To our frustration, dentists continue to place mercury based, amalgam (‘silver’) fillings. The toxicity of mercury cannot be debated and we strongly believe that the industry needs to abandon this antiquated and dangerous method of tooth restoration. While no amalgam material is placed in Eco Sensitive Dentistry, we still must deal with the removal of this material from your old fillings- considered as toxic waste. While most practices properly collect the fragments of amalgam, dissolved mercury ends up being discharged down the drain and finding its way into our waterways and the sea life we consume. For this reason, we installed an Amalgam Separator to remove this, and other heavy metals, from our discharge lines. Our practice is the first in the county and one of very few in the state to install this toxin-cleansing apparatus. This is not a legal requirement, but we feel it should be. The EPA has determined that the dental industry is responsible for the annual discharge of 3.7 tons of mercury and half of all mercury pollution discharged via our sewer systems.
While you may not be aware of heavy metals you discharge to the environment, we would like to advise you to never throw away fluorescent bulbs, batteries or electronic waste (such as cell phones or computers) in your regular trash. Charlotte County accepts these hazardous wastes to ensure that they don’t find their way into landfills and useful metals can be processed for reuse.
Soy Foam Attic Insulation. Both of these statements must be put together. People have known for years that it is smart to insulate and keep the conditioned air in the ‘people space’. However, within the last few years, a blinding flash of the obvious dawned on builders- keep the attic insulated, too. Since our climate control ductwork is located in the attic, an uninsulated attic means conditioned air has already lost something before it makes it to the ‘people space’. Further, the many penetrations in the ceiling (for light fixtures, stereo speakers, fans, etc) caused nuisance losses. After you foam the attic, you not only stop worrying about losses from the people space, you encourage air flow to the attic. Heat and humidity are kept under control and the attic becomes a more appropriate environment for storage or occupation. The soy based foam we used not only does the insulation job well, but it displaces fossil fuel requirements and removes the VOC (volatile organic compound) off-gassing issue that causes respiratory issues for many people.
Solar Window Film. We actually had film applied to the windows to reduce solar energy transmission after we had performed other air conditioning alterations. We weren’t sure it would be necessary. It definitely was necessary. The soy insulation and other alterations highlighted the heat sources that windows had always been. And then we figured we’d only install the film on the windows seemingly to most need it. Well, after we did half the windows, it became clear that every window would benefit from the film- even if the window didn’t seem to receive direct sunlight. After the film was installed on all windows, the office became uniformly more comfortable. The film we used does not diminish the visible light available from the window. In fact, it is nearly impossible to detect at all.
Programmable, and Lockable, Thermostats. Once your ‘people space’ is well insulated, there is a definite advantage to setting, and forgetting, the thermostat. You see, modern air conditioning systems draw significantly more power when the difference between programmed and actual temperature is excessive. It is preferable to keep the air conditioner operating in its ‘Stage 1’ condition. The programmable thermostat enables you to set a schedule to gradually alter the temperature for when people will reoccupy the space. If the thermostat is locked, it can be relied upon to follow the program without unauthorized people whimsically causing the higher stage air conditioning to kick in.
Conditioned Air Flow Optimization. You may find, as we did, that your dwelling is uncomfortable partially because air supply and return locations are poorly located. When we decided to see if we could remove our need for a second air conditioning unit, an analysis of the original building plans showed that one corner of the premises had stagnating air. By relocating just one air return about twenty feet from where it had been, conditioned air was forced to cross places that had previously felt overheated. The effect was dramatic.
Motion Activated Light Switches. Some spaces which are infrequently occupied, but frequently visited, are good candidates for swapping out the light switch. Our supply room light was constantly being left on, even though actual occupation was quite limited. In just a few minutes, with a switch replacement available at most home supply retailers, we swapped out the old light switch with one that detects motion and provides a time delay for turning off the lights. The new switch also has a manual on/off for extended periods of occupation. However, most trips into this space are brief, making it a perfect candidate for this upgrade. [Obvious warning- shut off the breaker to kill power to the switch before you work on it.]
Solar Tube Lights. Our patient lavatory was the perfect application for solar tube lighting. It is a totally enclosed room, having no natural lighting at all. It is frequently occupied by folks who aren’t inclined to think about turning off the switch. Frankly, it is a tough call for any business to expect customers to enter a dark lavatory space and look for a light switch and then to remember to darken the room again upon exit. And of course, solar illumination uses no electricity and causes no heating of the space. The illumination is brilliant.
Recycling. Charlotte County does not make it as easy for businesses to recycle, but nonetheless, we collect up recyclables from the office (2 bins worth every week + cardboard shipping boxes) and submit them with the rest of our personal recyclables. For those who haven’t checked lately, Charlotte County has become very progressive with its recycling program. You no longer need to sort your recyclables and all numbered plastics are accepted.
Reduce, Reuse and … The phrase ‘Reduce, Reuse, Recycle’ is a phrase you are supposed to emphasize- in order. We just mentioned recycling, but it is the last choice of the three. You should reduce what you use in the first place. After that, repurposing, donation (for reuse), etc is the second best concept because it requires energy to recycle. We would like to use bottled water for an example here. First, we despise (for the most part) bottled drinking water. Tap water is normally just as good as bottled water and it has been shown that, in many cases, bottled water is just unprocessed tap water after all. When you consider all the packaging and transportation costs, using tap water instead is a good example of reducing. And as the commercials on TV point out, a water filter at your tap will be a much cheaper alternative, compared to bottled water, if you are looking out for the purity aspect.
In the case of a dental office, sometimes you can’t avoid bottled water, as distilled water is used in patient treatment, as well as sterilization. Our water supplier offers this water in 5 gallon reusable containers, as well as, 1 gallon recyclable containers. The frustrating thing is that the supplier is so geared towards the waste of single gallon containers, we actually pay more to buy the water in the larger, reusable containers. What makes this more confounding is that not only are single gallon jugs a throw away for the supplier, so are the sturdy cardboard containers which hold six of the jugs.
This is the epitome of what ails our society. In virtually every transaction, from power production to plastic bag utilization, the environment is a worthless consideration. If value were placed on environmental impacts, not only would people alter their behavior and the environment be protected, but jobs would be created in fields from pollution abatement to renewable energy.
And before we get too far off the concept of plastic, we should point out that the vast majority of plastic is not recycled. Additionally, so much plastic (which doesn’t biodegrade) ends up in waterways (and ultimately oceans) that hundreds of thousands of square miles of floating plastics have accumulated. Sea life, birds and animals mistakenly consume these plastics and die horrible deaths. Plastic is a measure of how unsustainable our lives have become. In our own lives, we have taken measures like reusable shopping bags and portable, insulated beverage containers.
Clothing made from Recycled Plastic…and Bamboo. Take a close look at our staff uniforms. Some were once plastic water bottles. Other uniform items are fabricated from bamboo- a highly renewable grass that grows naturally, without irrigation or pesticides. Human ingenuity is yielding significant progress in creating consumer products that will keep the planet healthy for our grandchildren. Now it is up to us to look for, and buy, the most responsible options available.
Digital Radiography. Years ago, we adopted xray technology that removed the smelly toxic processing chemicals from our office. Beside the obvious chemical handling and plastic film considerations, digital radiography sensors are also more sensitive to exposure. Therefore, patients are exposed to just a fraction of the radiation previously required.
Paperless Record Keeping. Since the birth of Sensitive Dentistry, we have utilized software which replaces virtually every paper oriented task. While it becomes obvious with respect to your patient records, businesses must deal with a multitude of details normally put to paper. From accounting, to maintenance, to interoffice communications, we have saved many trees over the years.
Beyond the business… Some of the green items in our personal lives have already been mentioned. To further your green ambitions, here are some more suggestions.
Solar Pool Pump. If you have a pool, you spend a bit less than $100 on monthly electricity to run the pump day in and day out. While you could install solar PV to power your conventional pump, there is a better solution. Your standard pump runs off AC power and your solar PV panels make DC power. You lose about 20% of your energy in converting DC to AC. The answer is a DC pool pump that runs from its own dedicated panels. It doesn’t move water as fast, but it moves it all the time the sun shines on it, which compensates. And since both algae growth and pump speed are directly dependent on solar intensity, the DC pump is the perfect application of high efficiency solar power usage.
Pool Water Ion Purification. While looking for a low maintenance way to take care of the pool, we discovered the Ecosmarte system. It eliminates toxic chlorine and other chemicals from your regimen by using a very small concentration (falls within drinking water specifications) of copper ions. We go weeks or months without doing anything to the pool. Between helping the environment and avoiding the game of mad chemist, this is a wonderful win-win.
One final word on pool maintenance (and if you have a choice)- get a fiberglass pool. A fiberglass pool is inert, compared to the alkalinity battle you fight with a concrete pool. A fiberglass pool has no coating which needs to be periodically replaced. The smooth surface enables many impurities to slide easily to the bottom, making cleaning much easier. And that smooth surface is kinder to your skin. If you bought a house with an existing concrete pool, we would recommend a fiberglass coating the next time you have to resurface.
Induction Cooking. Instead of heating a cooktop, why not heat the pan itself? Induction cooktops appear, at first glance, to be regular ceramic electric cooktops. However, there are no electric resistive heating elements. Instead, magnets inside the cooktop interact with your cookware (and therefore, not all cookware works). The pan gets hot and cooks the food with twice the efficiency of any other cooking method (and that includes gas). This also means that cooking response is faster than any other method. You can boil water faster than you can in a microwave. The cooktop is safer because the elements won’t work without a pan sitting on them and because the cooktop itself only heats up due to its contact with the pan, spilled food does not as readily burn, making cleaning a bit easier. And all that heat not going into your kitchen will make you more comfortable and cause your air conditioner to run less. Built-in induction cooktops, as well as Convection oven ranges with induction cooktops are available from many major manufacturers including GE, Samsung, Kenmore and LG.
Rainwater Harvesting. We’re not talking about simple rain barrels; we’re talking about tanks, holding thousands of gallons of water buried underground. Depending on the size of your roof (and yes, a metal or tile roof is best from a purity standpoint), an inch of rain represents a couple thousand gallons of clean, fresh water. We installed 7500 gallons worth of cisterns when our house was built in 1996 and have been very thankful we did. While you save money on your water bill every month, there are many other benefits.
Water Taste and Purity. Municipal water in FL is often extracted from, or stored in, underground caverns. This can result in water that tastes like sulfur or dirt. Chlorine is added and notably present. The chlorine can be enough to kill yeast in bread dough or bleach out hair dye. Take out your pool testing kit, and you may find as we did, that there could be more chlorine in your drinking water than in your pool!
No susceptibility to water supply interruptions- During the hurricane, we had plenty of water available to us. Additionally, every time water supply pressure is interrupted, a boil-water alert is generated, in case something nasty gets into the lines. Our rainwater means we can ignore all such issues.
Erosion and runoff. If your roof is surrounded by gutters, and all those gutters empty to buried tanks, you have no ‘drip line’ around the house and no possibility of soil erosion from blasts of rainwater at each downspout. There will be an overflow for the cisterns (for when they do fill up), but that overflow can be piped to a harmless dispersal point.
Peace of mind. Droughts in Florida can (and have) lasted years. We can use our rainwater guilt-free as others are being told to cut back and suffer through water quality degradation. Yes, droughts obviously affect the rainwater available to us, but it only takes one passing storm to give us enough water to last months, while officials tell your neighbors that the storm didn’t even make a dent in the drought.
Eco Technologies can assist you with catching the free water from the sky or rays from the sun.
Get rid of your grass. Whether it be the fertilizer and pesticide runoff destroying our waterways, the wasted water for irrigation, the countless man-hours of labor or the stinky gasoline powered tools used for its care, grass is the most un-green thing on your property. We have ripped out every blade of grass. In its place, we have installed xeriscape ground cover, shell and stone walkways and artificial turf. The turf we used is so natural looking that lawn care professionals have been fooled. While our neighbors fight the never ending battle which chinch bugs and weekly mowing, we swim in our chlorine free pool.
Rubber Mulch. In case you hadn’t noticed, green efforts at home go a long way toward enjoying your home instead of slaving over it. When you get rid of your grass, you gain a lot of space that requires mulch. Rubber mulch is made from recycled tires, but made to look like regular mulch. However, unlike regular mulch, it won’t disintegrate into the beds and require replacement. In addition to the pleasure of not having to re-mulch every year or two, we have noted that rubber mulch provides excellent moisture retention in the soil. When it comes time to water (which we do by hand to ensure water goes only where needed), a quick touch of the soil (through the mulch) tells us what needs watering. After we put in the rubber mulch, this moisture retention effect was very noticeable. So, not only don’t we have to re-mulch, we save water- and watering time.