Net-zero emissions in dentistry—achievable goal or greenwashing?

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Natural carbon sinks, such as oceans and forests, are struggling to remove even one-third of global carbon emissions from the atmosphere and experts say that healthcare profession must be an advocate for change. (Image: Ivan Marc/Shutterstock)

LEIPZIG, Germany: “Net zero” has become one of the buzzwords of the climate crisis, and experts consider the emissions reduction strategy to be the current gold standard in sustainable business practice. Dental manufacturers have touted net-zero commitments, and there is a push to decarbonise oral care services and individual clinics. Does a net-zero commitment represent a zero-sum game, or does it add up for dental companies and the dental professionals that they serve?

Net zero differs from carbon neutrality. It considers all emissions that are attributable to an entity, including those resulting from the supply chain and other processes that occur outside of direct operations. Carbon neutrality can pertain only to carbon dioxide emissions from specific business operations. On the one hand, becoming carbon neutral means striking a balance between emitting carbon and having it absorbed from the atmosphere via carbon sinks—natural systems, such as the ocean and forests, that absorb more carbon that they emit. Emissions made in one sector can be offset by reducing them in another, and certification and international standards exist to verify carbon neutral claims. Corporate net-zero targets, on the other hand, can be backed by the Business Ambition for 1.5°C scheme and its Corporate Net-Zero Standard, which requires companies to make long-term, holistic commitments that are in line with the latest climate science and the 2015 Paris Agreement. Crucially, polluters who commit to the scheme may not simply offset their emissions into the ether; rather, they are required to actively and substantially decarbonise their entire value chain and offset any emissions that remain. The Science Based Targets initiative (SBTi), which governs the scheme, does not permit companies to make net-zero claims until they have committed to and achieved a long-term net-zero target.

Henry Schein, the US healthcare giant whose dental business is one of the world’s largest, is the only major dental company that has committed to the Corporate Net-Zero Standard. Henry Schein signed up to the Business Ambition for 1.5°C scheme in late 2021, from which date the company has 24 months to set short- and long-term net-zero targets for review by the SBTi. Henry Schein’s targets must account for its Scope 3 emissions, which are those that the company does not produce but for which it is indirectly responsible, and must aim for substantial carbon dioxide reductions and net-zero emissions by 2050 or sooner.

“We recognise that with our global environmental footprint and unique position within an ecosystem of relationships with suppliers and business partners, we are uniquely positioned to be a driving force for sustainability in the healthcare supply chain,” Stanley M. Bergman, CEO and chairman of the board at Henry Schein, commented at the time in a press release.

Of the more than 4,800 companies that have joined the initiative, 2,538 have made science-based targets and 1,779 have made a net-zero commitment.

Align Technology, whose mainstay is the manufacture and global distribution of clear aligner trays, says on its website that it is investing in energy efficient buildings and employee transportation in order to reduce emissions. Align thus far provides no data about its emissions or concrete plans to reduce them.

In its 2021 Sustainability Report, Envista Holdings quantified its operational emissions (Scope 1 and Scope 2) and said that it intended to assess and review its Scope 3 emissions. Envista, which was spun off as a new dental company in 2019, said at the time that identifying an environmental target, such as net-zero standard, was an area of priority for the young company. Dentsply Sirona also announced in 2021 its ambition to reach net-zero carbon emissions (Scopes 1–3) by 2050. The company said that its target is “in line with globally recognised standards” but did not detail which standards or whether its commitment was binding.

A push for net zero in health clinics and services

The UK National Health Service’s goal of reaching net-zero emissions by 2040 will require it to slash 80% of non-clinical emissions. (Image: John Gomez/Shutterstock)

There is a drive to reach net-zero emissions in individual dental clinics and health services that provide oral care. The UK government, for example, passed legislation last year to deliver a net-zero National Health Service (NHS), including NHS dental care. The ambitious vision of achieving a net-zero NHS by 2040 includes an 80% reduction in Scope 1 and Scope 2 emissions by 2032 and slashing Scope 3 emissions by the same figure by 2039. “Our intention for these targets is to construct the most ambitious, credible declaration to reach net zero of any national healthcare system in the world,” the health service declared in a report.

A forthcoming article from the Australian Journal of General Practice, shared with Dental Tribune International (DTI), showed that non-clinical emissions account for around 40% of total emissions at general medical practices in the UK and that the remaining 60% is attributable to the clinical component. The largest sources of non-clinical emissions were staff travel, at 22.8%, business services, at 22.5%, and patient travel, at 18.4%.

Dr Richard Yin, co-author of the article and chair for Western Australia of the organisation Doctors for the Environment Australia (DEA), told DTI: “With energy and transport being a large component of the non-clinical emissions, at least in Australia, with our vast solar and wind resources and with our transitioning to electric vehicles powered by renewable energy, I think the non-clinical emissions can realistically be substantially reduced. The clinical component, however, is largely attributable to pharmaceuticals and procurement. As doctors, we can minimise unnecessary treatments and focus on low carbon treatment options but it will be necessary to put pressure on supply chains to decarbonise. That is something that we can advocate for but is also out of our control.”

“The most important reason for the profession to take steps and be part of the climate movement is to be advocates for change” – Dr Richard Yin, Doctors for the Environment Australia

DEA advocates for a net-zero target for Australia’s healthcare sector, and Dr Yin said that the industry has an urgent responsibility to decarbonise. “The most important reason for the profession to take steps and be part of the climate movement is to be advocates for change,” he emphasised. Speaking about net-zero targets for individual clinics, Dr Yin said: “The issue is to define the carbon footprint of a dental practice and then understand how to reduce it.” Here, practice owners can engage consultancy services, such as Glasgow-based Net Zero Dentistry, which market a service of decarbonisation and offsetting to practice owners.

Earnestly adopted and used, the strength of net zero as a tool to make dental care and manufacturing more sustainable lies in its focus on proactively reducing emissions rather than offsetting them and its being backed by climate science; however, the risks of greenwashing and ineffective carbon offsets remain. An investigation by news outlets the Guardian and Die Zeit, together with not-for-profit investigative journalism organisation SourceMaterial, revealed in January that the bulk of forest carbon offsets issued by leading certifier Verra were largely worthless. Rainforest protection accounts for 40% of the credits that Verra sells, and journalists found that Verra overstated threats to its forest projects and sold credits that had failed to reduce deforestation. Washington DC-based Verra, whose clients include Shell, easyJet and Pearl Jam, disputed the claims.

Dr Yin said that carbon offsets were problematic and could not be relied upon for decarbonisation. “There is no guarantee that a tree planted today will be around in 30 years’ time. The time frame required for us to decarbonise to avoid the worst of climate impacts requires urgent action this decade. Nonetheless, buying offsets places carbon on a balance sheet, and that helps keep it as a cost that has to be addressed,” Dr Yin said.

Currently, no artificial carbon sinks are capable of removing carbon dioxide from the atmosphere at the scale that would be necessary to achieve climate goals, and even natural sinks are struggling to keep pace with perpetual economic growth. According to the European Commission, global carbon sinks remove up to 11 Gt of carbon dioxide from the atmosphere every year, whereas global carbon emissions totalled 36 Gt even in 2020, when global emissions dipped owing to the SARS-CoV-2 pandemic.

Carbon footprint Dental business Environmental sustainability Sustainable dentistry

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