Taking a bite out of Scotland's dental carbon emissions in the transition to a low carbon future

Background: Climate change is a significant global health threat requiring concerted action to reduce greenhouse gas emissions. This study provides the first systematic attempt to quantify the carbon emissions of a national dental service. Methods: Carbon accounting combined a top-down approach using input-output analysis for indirect emissions (procurement) and a process analysis (bottom-up) approach for direct emissions (building energy, travel, waste and water). Energy and water consumption were based on meter readings, waste-related emissions from collection contracts and travel from staff and patient questionnaires. Dental companies were approached for carbon footprint data on their products. Results: The carbon footprint for the service was 1798.9 tonnes CO eq per annum. Travel was the greatest source (45.1%) followed by procurement (35.9%) and building energy (18.3%). Perhaps counter-intuitively older clinics had lower footprints than newer clinics as they are less energy intensive. Extrapolating the data suggests that Scotland's NHS dental service annually generates 0.16 mega tonne (Mt) CO eq (4%) of the total Scottish NHS carbon footprint. Conclusions: The lack of comprehensive data reduces the ability to effectively manage emissions. Consideration needs to be given to the impact of patient travel, staff travel and new clinic construction on the carbon footprint. Medical suppliers are encouraged to provide life cycle analysis (LCA) for dental products. Crown