To mark Earth Day this Thursday (22 April), Rachael Norton, head dental nurse at Bow Lane Dental in the City of London, she shares how to implement environmentally friendly ways in your practice

It was November 2018 when it really hit home with news of a sperm whale found washed up on an Indonesian coast with 115 plastic cups in its stomach – the kind we use in the dental surgery.

I was in shock and disbelief that humans caused such a thing to occur. What on earth are we doing to this planet?

I could not just sit back and wait for someone else do something. It was time for me to act. I have always been environmentally aware outside of work, making sure I recycle and reuse as much as possible. Inside of work, there did not seem to be an awful lot in place to protect our environment. A meeting was called, and I was appointed the practice's eco-friendly lead.

It’s my job to put new policies in place and ensure everyone adhered to them. Getting the team on board was easy, everyone felt the same as me, they just hadn’t spoken up.I guess they were waiting for someone else to take the lead.


The first step was to ensure we have a good recycling procedure in place. We placed recycling bins for paper, card and plastics in the sterilisation room, staff room and reception areas. This way there was no excuse not to recycle. This has reduced our general waste significantly and now most of our non-clinical waste happens to be recycling.

We also have a food waste bin in the staff room/kitchen that gets collected in biodegradable bags. In the reception area we have a Terracycle box where patients and members of staff can drop off their used toothbrushes and toothpastes. We have also recycled old filling cabinets and furniture from the waiting room for non-profit charity collections. Any old dental and electrical equipment we no longer use always gets sold on auction sites to be reused by someone else. Coffee pods used in the coffee machine are sent back to the supplier to recycle.


Such a big practice uses a lot of energy to power. It was obvious that we had to change our energy provider. We have now started using Bulb, which is the UK's biggest green energy supplier. They provide 100% renewable electricity. They produce this with solar, wind and hydro. Their gas is also 100% carbon neutral. Other ways we have reduced the amount of energy we use in the practice is by switching off lights and power in rooms we are not using. Sounds very simple but makes all the difference. Turning off the hot water and heating every evening is also a very easy way to conserve energy. We have also fitted a sensor light in the patient toilet, this is to avoid the light being switched on all day. When the autoclaves are between uses, we close the doors to keep in the heat so they do not need use as much power to heat up next time.


In surgery, we try to be as conservative as possible with our materials. It is always very difficult with single-use products that have to be used due to infection control standards. There are certainly ways to ensure that we are doing the best we can. As we have a lab on site, we decided to stop using single-use plastic lab bags. We now have reusable snap grip plastics boxes to transport the impressions up to the lab. When taking impressions, we use metal impression trays which we can sterilize with our instruments. This cuts down on single-use plastics considerably and these metal impression trays seem to be indestructible and last for years and years. We are no longer using single use plastic dappen dishes and now use reusable glass dishes that we are able to sterilise in the autoclave.

The high-speed suction tips we use are manufactured from renewable resources and produced from ethanol sugar cane and manufactured as a renewable raw material, saving about 80% CO2 compared to ordinary plastic. The patient rinse cups we use are made from bamboo. The microbrushes and three-in-one tips that we have are made from recycled plastics. Biodegradable wet wipes are given to patients after long treatments ensure no materials are left on their faces.In the patient and staff toilets we use a recycled toilet paper and recycled paper towels. We refill the soap container in the bathroom with an eco-friendly refill pack. Even our cleaner is on board with our green ways, she uses a natural product that is free from animal testing and has fully recyclable packaging. The sundries we have available and recommend to our patients are also eco-friendly. These include floss picks made of corn-starch, floss that is packaged in cardboard and toothbrushes made from bamboo. They love to have these options available to them.


Of course, we love a bit of tech at Bow Lane Dental Group. Our digital X-rays provide less chemical waste than the old school ones and no need to mount the films in plastic. We always make sure that we use our iTero scanner for Invisalign patients. This means no need to use any impression materials and cardboard boxing to send them off, leading to less trips for the courier to make in their van to collect them.

All correspondence is sent to patients via email or text, making us a paper-free practice. Medical history forms are completed digitally and emailed to us directly. Consent forms, estimates and invoices are emailed to patients. Recall reminders are no longer postal and are sent via text message and email. Patient records are all digital. Staff folders including CPD certificates are all saved digitally.

Water management

In our patient bathroom, we have just fitted a sensor tap to avoid the tap being left running while brushing teeth or soaping hands. The water purified water we use for the autoclave and dental chairs comes direct from the mains. This means there is no excess waste of water plus we don’t have to get big bottles of water delivered in plastic containers minimising plastic use.

Carbon neutral

Bow Lane Dental group is now verified carbon-neutral plus and we have planted 46 trees in the south east of the UK.


For our efforts in becoming green, our practice has been awarded platinum status from the City of London Clean City Awards two years in a row and, in 2019, e won the prestigious Chairman’s Cup Award. I feel great pride that our practice was recognised for our reduction of single-use plastics.

Helpful links to products we use in our practice