The carbon footprint of dental practice: sources, measurement, and evidence for reduction

The carbon footprint of dental practice is usually presented either as a negligible per-visit emission or as the large aggregate burden of a high-volume service. This narrative review synthesizes the evidence published between 2018 and 2025 on the size, sources, and reduction strategies of the carbon footprint of dental care. Literature was searched in OpenAlex, Crossref, and PubMed and organized into four thematic axes: measurement of the footprint, materials and single-use consumables, clinical gases and waste, and interventions. Reported estimates range from 4.3 kg CO2e per patient visit and 4.9 kg CO2e per root canal treatment to 31.8 to 35.1 kg CO2e per implant-supported prosthesis, and from 285 to 2,170 kg CO2e per person over a lifetime of oral care. Patient and staff travel consistently dominate practice-level footprints, accounting for 65.2% of clinic emissions in one Egyptian study, while procurement, energy, and single-use plastics dominate the material side. Reusable instruments outperform disposable kits, and removing unnecessary plastics, harvesting rainwater, and teledentistry produce measurable reductions, whereas digital fabrication is not automatically lower-carbon. Nitrous oxide and amalgam remain high-priority targets. The apparent contradiction between a small per-unit footprint and a large aggregate footprint is reconciled by volume, travel, and procurement. Comparability across studies is limited by heterogeneous methods; standardized functional units and routine measurement are needed to move the field from awareness to verified emission reductions.