ASTM E3014-21

Standard Practice for Managing Sustainability in Dentistry

SIGNIFICANCE AND USE
4.1 The dental industry’s size and scope translate to a significant environmental and social footprint. Moreover, dental professionals and dental service organizations are calling for a consensus-based practical guidance document to support cost-efficient integration of sustainable development principles into their day-to-day management with the goal of achieving carbon neutrality, for example, by reducing CO2 emissions. Formation of ASTM Subcommittee E60.80.7, and development of this practice recognizes and fulfills this demand.  
4.2 To most dentists, it remains unclear what constitutes sustainable dentistry practice in principle. This presents a challenge to incorporating a systematic and pragmatic management framework that identifies, prioritizes, and supports relevant sustainable development issues. Most dental professionals are primarily limited to recognition of environmental impacts or so-called “green practices” or “green dentistry.”  
4.3 Given management commitment as the first step, this practice describes procedural feasibility of integrating measurable sustainability performance in daily dental service activities. Preferential treatment is not given to claims of “green” practices. Strategic decision-making needs to be a balanced approach that takes into consideration environmental, social, and economic issues. This practice provides a comprehensive guidance on managing sustainability issues and offers a systematic approach and a management framework that assists dental professionals and dental service organizations to improve overall performance and effectiveness in their products and deliveries.  
4.4 This practice offers a concerted approach to managing social, economic, and environmental aspects of dental organizations; stipulates minimum sustainability considerations and requirements; and provides a framework to embed management of issues related to sustainable development into day-to-day decision-making and dental service activities. These mana...
SCOPE
1.1 This practice provides a set of generally recognized activities to govern management of sustainability in dentistry and related dental service practice. It is a management system framework that assists dentists and dental service organizations to enhance their organizational performance and effectiveness. It offers an integrated framework to manage social, economic and environmental aspects of an organization’s activities. While this practice is intended to be adopted and used by dental professionals and dental service organizations of any size and specialization, the scope of this practice is relevant to dental service provider organizations’ stakeholders as well.  
1.2 This practice is intended to be used with pertinent dental office management principles and guidance documents published by professional dental associations.  
1.3 This practice should be implemented in alignment with the United Nations 17 Sustainable Development Goals2 (SDGs to be achieved by 2030) and the World Dental Federation (FDI) Sustainability in Dentistry3 Policy of August 2017.  
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety, health, and environmental practices and determine the applicability of regulatory limitations prior to use.  
1.5 This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.

General Information

• Status: Published
• Publication Date: 31-Aug-2021
• ICS: 11.060.01 - Dentistry in general
• Technical Committee: E60 - Sustainability
• Drafting Committee: E60.42 - Sustainable Healthcare

Overview

ASTM E3014-21: Standard Practice for Managing Sustainability in Dentistry provides internationally recognized guidance for dental professionals and dental service organizations seeking to integrate sustainable development principles into everyday operations. Developed by ASTM Committee E60 on Sustainability, this standard addresses the significant environmental and social footprint of dental care and responds to the growing demand for structured, practical sustainability management within dentistry.

The practice establishes a management system framework to systematically identify, address, and improve sustainability performance, aligning organizational practices with broader social, environmental, and economic goals. It is designed for dental practices of any size and specialization, including those within larger healthcare organizations.

Key Topics

• Comprehensive Sustainability Management: Sets out a systematic structure for managing sustainability, covering environmental responsibility, social accountability, and economic viability within dental organizations.
• Leadership and Commitment: Stresses the critical role of top management in embedding sustainability into the organization’s vision, policy, and daily practices.
• Risk and Opportunity Assessment: Guides dental organizations in identifying relevant risks and opportunities related to sustainability, including internal and external stakeholder expectations.
• Strategic Planning: Outlines requirements for setting, measuring, and reviewing clear, actionable sustainability objectives.
• Operational Integration: Provides methods for embedding sustainability into procurement, supply chain management, waste management, and all operational processes.
• Performance Evaluation and Continual Improvement: Recommends regular monitoring, internal audits, and management reviews to ensure ongoing advancement in sustainability practices.
• Stakeholder Engagement: Encourages engagement and communication with patients, staff, suppliers, and community partners to shape sustainable outcomes.

Applications

The ASTM E3014-21 standard has practical applications across multiple aspects of dental practice management and service delivery, including:

• Daily Operations: Enables integration of sustainability considerations into routine clinical and administrative workflows, from waste reduction and resource efficiency to responsible procurement.
• Quality and Patient Care: Assists in aligning quality dental care with environmental and social responsibility, supporting evidence-based dentistry and positive patient and community outcomes.
• Regulatory Compliance: Facilitates compliance with international principles on sustainable development, including alignment with the United Nations 17 Sustainable Development Goals (SDGs) and World Dental Federation (FDI) policies.
• Organizational Development: Provides tools such as management maturity matrices and the PDCA (Plan-Do-Check-Act) model to assess sustainability progress and foster a culture of continual improvement.
• Supply Chain Management: Guides dental organizations to evaluate suppliers based on sustainability criteria, promoting responsible sourcing of equipment and materials.
• Reporting and Communication: Supports transparent documentation and reporting of sustainability initiatives to internal and external stakeholders.

Related Standards

• BS 8900-1:2013: Managing sustainable development of organizations - Guide, which contributes principles such as integrity, inclusivity, stewardship, and transparency.
• World Dental Federation (FDI) Sustainability in Dentistry Policy (2017): Provides policy context for sustainability in dental care.
• United Nations Sustainable Development Goals (SDGs): Offers an international framework for sustainable management in all sectors, including health and dentistry.
• ISO Management System Standards: Practices and terminology are aligned with other recognized management system frameworks, facilitating integration with broader organizational strategies.

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Keywords: sustainability in dentistry, sustainable development, dental practice management, environmental responsibility, social accountability, sustainable dental services, ASTM E3014-21, green dentistry, management system framework, stakeholder engagement, SDGs.

Standards Content (Sample)

This international standard was developed in accordance with internationally recognized principles on standardization established in the Decision on Principles for the
Development of International Standards, Guides and Recommendations issued by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
Designation: E3014 − 21
Standard Practice for
Managing Sustainability in Dentistry
This standard is issued under the fixed designation E3014; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope* 2. Referenced Documents
1.1 This practice provides a set of generally recognized 2.1 BSI Standard:
activities to govern management of sustainability in dentistry BS 8900-1:2013 Managing sustainable development of
organizations—Guide
and related dental service practice. It is a management system
framework that assists dentists and dental service organizations
3. Terminology
to enhance their organizational performance and effectiveness.
It offers an integrated framework to manage social, economic
3.1 Definitions:
and environmental aspects of an organization’s activities.
3.1.1 context of dental service organization, n—business
While this practice is intended to be adopted and used by dental
environment; combination of internal and external factors and
professionals and dental service organizations of any size and conditions that can have an effect on the dental service
specialization, the scope of this practice is relevant to dental organization’s approach to its dental service, investments, and
stakeholder.
service provider organizations’ stakeholders as well.
3.1.2 dental professional, n—individual person who pro-
1.2 This practice is intended to be used with pertinent dental
vides and performs dental services within a dental service
office management principles and guidance documents pub-
organization.
lished by professional dental associations.
3.1.2.1 Discussion—Within the context of this practice,
1.3 This practice should be implemented in alignment with
dental professional may include dentists, registered dental
the United Nations 17 Sustainable Development Goals (SDGs assistants, licensed oral hygienists, dental technicians, and
to be achieved by 2030) and the World Dental Federation (FDI) dental laboratory technicians.
Sustainability in Dentistry Policy of August 2017.
3.1.3 dental service, n—intangible output that is the result of
at least one activity or procedure necessarily performed at the
1.4 This standard does not purport to address all of the
interface between the dental professional and his/her patient.
safety concerns, if any, associated with its use. It is the
responsibility of the user of this standard to establish appro- 3.1.4 dental service organization, n—person or group of
people holding proper and recognized dental service
priate safety, health, and environmental practices and deter-
accreditation, license, or certification that has its own functions
mine the applicability of regulatory limitations prior to use.
with responsibilities, authorities, and relationships to achieve
1.5 This international standard was developed in accor-
its objectives.
dance with internationally recognized principles on standard-
3.1.5 evidence-based dentistry, n—approach to oral health
ization established in the Decision on Principles for the
care that integrates the most current scientifically relevant
Development of International Standards, Guides and Recom-
evidence, the dentist’s clinical experience, and the patient’s
mendations issued by the World Trade Organization Technical
oral health needs and preferences.
Barriers to Trade (TBT) Committee.
3.1.6 management system, n—a set of interrelated policies,
processes, and procedures used by an organization to ensure
that it can fulfill the tasks required to achieve its objectives.
This practice is under the jurisdiction of ASTM Committee E60 on Sustain-
ability and is the direct responsibility of Subcommittee E60.42 on Sustainable
3.1.7 policy, n—the formal expression of intentions and
Healthcare.
direction of a dental professional or a dental service organiza-
Current edition approved Sept. 1, 2021. Published October 2021. Originally
tion who directs and controls its dental service activities at the
approved in 2015. Last previous edition approved in 2015 as E3014-15. DOI:
10.1520/E3014-21.
highest level.
The United Nations 17 Sustainable Development Goals (https://sdgs.un.org/
goals, retrieved 17-Mar-2021).
World Dental Federation (FDI) Sustainability in Dentistry (adopted by FDI
General Assembly August 2017 in Madrid, Spain (https://www.fdiworlddental.org/ Available from American National Standards Institute (ANSI), 25 W. 43rd St.,
sustainability-dentistry, retrieved 17-Mar-2021). 4th Floor, New York, NY 10036, http://www.ansi.org.
*A Summary of Changes section appears at the end of this standard
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E3014 − 21
3.1.7.1 Discussion—Throughout this practice, “activity” is related to patient, staff, and the community; governance and
used to refer collectively to activities, products, and services leadership; and meetings.
rendered through or directly by a dental professional or an
4.5 This practice is intended to be adopted and used by
affiliated dental service provider organization.
dental professionals and dental service organizations of any
3.1.8 sustainability, n—degree of sustainable development
size and specializations including those being a part of large
in the context of a dental professional or dental service
healthcare service organizations. Further, in the scope of this
organization.
practice, expectations are addressed that are relevant to dental
service organizations’ stakeholders with identification of pos-
3.1.9 sustainable development, n—development that meets
sible benefits and desirable outcomes of managing for sustain-
the needs of the present without compromising the ability of
ability in dentistry. This approach is to provide a framework for
future generations to meet their own needs.
embedding sustainability management in everyday decision-
3.1.9.1 Discussion—Sustainable development is about inte-
making and is necessarily challenging, provoking, and continu-
grating the goals of a high quality of life, health, and prosperity
ally evolving. Effective and continuing stakeholder engage-
with social justice and maintaining the earth’s capacity to
ment is essential in sharpening understanding of real issues and
support life in all its diversity. These social, economic, and
broadening buy-in.
environmental goals are interdependent and mutually reinforc-
ing. Sustainable development can be treated as a way of
4.6 It is recognized that building confidence in processes
expressing the broader expectations of society as a whole.
and sustainable outcomes is an important part of this practice
and certain dental service organizations may wish to use some
4. Significance and Use
forms of independent verification.
4.1 The dental industry’s size and scope translate to a
4.7 This practice shall not be viewed in isolation as there are
significant environmental and social footprint. Moreover, den-
many pertinent helpful texts, conventions, codes, and publica-
tal professionals and dental service organizations are calling
tions available; it acts as a guide to connect various existing
for a consensus-based practical guidance document to support
“green” dental practices and services and offers a systemic
cost-efficient integration of sustainable development principles
approach to embedding sustainable development thinking that
into their day-to-day management with the goal of achieving
fits and is readily realizable for dental service organizations of
carbon neutrality, for example, by reducing CO emissions.
any size or specialization.
Formation of ASTM Subcommittee E60.80.7, and develop-
ment of this practice recognizes and fulfills this demand.
5. Dental Service Organization
4.2 To most dentists, it remains unclear what constitutes
5.1 Understanding the Context of a Dental Service Organi-
sustainable dentistry practice in principle. This presents a
zation:
challenge to incorporating a systematic and pragmatic manage-
5.1.1 The dental service organization shall determine exter-
ment framework that identifies, prioritizes, and supports rel-
nal and internal issues that are relevant to its purpose and affect
evant sustainable development issues. Most dental profession-
its ability to achieve the intended outcome(s) of its manage-
als are primarily limited to recognition of environmental
ment system for sustainability in dentistry.
impacts or so-called “green practices” or “green dentistry.”
5.1.2 Understanding the Needs and Expectations of
4.3 Given management commitment as the first step, this
Stakeholders—The dental service organization shall determine:
practice describes procedural feasibility of integrating measur-
5.1.2.1 Stakeholders who are relevant to the management
able sustainability performance in daily dental service activi-
system for sustainability in dentistry;
ties. Preferential treatment is not given to claims of “green”
5.1.2.2 Relevant requirements of these stakeholders; and
practices. Strategic decision-making needs to be a balanced
5.1.2.3 Applicable legal and other requirements to which
approach that takes into consideration environmental, social,
the dental service organization subscribes.
and economic issues. This practice provides a comprehensive
5.1.3 Determining the Scope of the Management System for
guidance on managing sustainability issues and offers a sys-
Sustainability in Dentistry:
tematic approach and a management framework that assists
5.1.3.1 The dental service organization shall determine the
dental professionals and dental service organizations to im-
boundaries and applicability of the management system for
prove overall performance and effectiveness in their products
sustainability in dentistry to establish its scope. When deter-
and deliveries.
mining this scope, the dental service organization shall con-
4.4 This practice offers a concerted approach to managing
sider:
social, economic, and environmental aspects of dental organi-
(1) The external and internal issues referred to in 5.1,
zations; stipulates minimum sustainability considerations and
(2) The requirements referred to in 5.2, and
requirements; and provides a framework to embed manage-
(3) The type and extent of dental services offered.
ment of issues related to sustainable development into day-to-
5.1.3.2 The scope shall be available as documented infor-
day decision-making and dental service activities. These man-
mation.
agement considerations include, but are not limited to, water,
air quality, energy, waste management, transportation, respon- 5.2 Management System for Sustainability in Dentistry—
sible procurement, supply chain management, and green build- The dental service organization shall establish, implement,
ings. Additional considerations include social responsibility maintain, and continually improve a management system for
E3014 − 21
sustainability in dentistry, including the processes needed and integrity, inclusivity, transparency, and stewardship as well as
their interactions, in accordance with the requirements of this opportunities related to the practice of evidence-based den-
practice. tistry.
5.5.2 The dental service organization shall plan:
5.3 Leadership and Commitment—The leadership shall en-
5.5.2.1 Actions to address these risks and opportunities;
sure that the defined principles of sustainable development are
5.5.2.2 How to integrate and implement the actions into its
reflected and communicated in its policy. They shall also
management system for sustainability in dentistry processes;
ensure that the vision’s delivery leads to long-term success of
and
the dental service organization. Top management shall demon-
5.5.2.3 How to evaluate the effectiveness of these actions
strate leadership and commitment with respect to the sustain-
and develop corresponding countermeasures.
able dentistry management system by:
5.5.3 Documented information shall be retained on the
5.3.1 Ensuring that the sustainability policy and objectives
outcomes of planning for the management system for sustain-
are established and are compatible with the strategic direction
ability in dentistry.
of the dental service organization;
5.3.2 Ensuring that the requirements of the management
5.6 Sustainability in Dentistry Objectives and Planning to
system for sustainability in dentistry are integrated into the
Achieve Them:
dental service organization’s business processes;
5.6.1 The dental service organization shall establish sustain-
5.3.3 Ensuring that the financial, human, and organizational
ability objectives at relevant functions and levels. The sustain-
resources needed for the management system for sustainability ability in dentistry objectives shall:
in dentistry are available;
5.6.1.1 Be consistent with the sustainability in dentistry
5.3.4 Communicating throughout the organization the im- policy,
portance of using the management system effectively and
5.6.1.2 Be measurable (if practicable),
conforming to its associated requirements;
5.6.1.3 Take into account applicable legal and other require-
5.3.5 Ensuring that the management system for sustainabil- ments as well as technical feasibility,
ity in dentistry achieves its intended outcome(s);
5.6.1.4 Be measurable and monitored,
5.3.6 Directing and supporting persons to contribute to the
5.6.1.5 Be communicated, and
effectiveness of the management system for sustainability in
5.6.1.6 Be updated as appropriate.
dentistry;
5.6.2 The dental service organization shall retain docu-
5.3.7 Promoting continual improvement; and
mented information on the sustainability in dentistry objec-
5.3.8 Supporting other relevant management roles to dem-
tives. When planning how to achieve its sustainability in
onstrate their leadership as it applies to their areas of respon- dentistry objectives, the dental service organization shall de-
sibility.
termine:
5.6.2.1 What will be done,
5.4 Organizational Roles, Responsibilities, Account-
5.6.2.2 What resources will be required,
abilities, and Authorities—Top management shall ensure that
5.6.2.3 Who will be responsible,
respective responsibilities, accountabilities, and authorities for
5.6.2.4 When it will be completed, and
relevant roles to realize its sustainability policy and achieve its
objectives are assigned and communicated within the dental 5.6.2.5 How the results will be evaluated.
service organization. Top management shall assign the respon-
5.7 Support:
sibility and authority for:
5.7.1 Resource—The dental service organization shall deter-
5.4.1 Requirements of this practice, and
mine and provide the resources needed for the establishment,
5.4.2 Reporting on the performance of the management
implementation, maintenance, and continual improvement of
system for sustainability in dentistry to top management.
the management system for sustainability in dentistry and to
demonstrate enhanced performance.
5.5 Planning:
5.7.2 Competence—The dental service organization shall:
5.5.1 Actions to Address Risks and Opportunities:
5.7.2.1 Determine the necessary competence of person(s)
5.5.1.1 When planning for the management system for
doing work under its control that affects its sustainability
sustainability in dentistry, the dental service organization shall
performance;
consider, assess, and prioritize the issues referred to in 5.1, the
5.7.2.2 Ensure that these persons are competent on the basis
requirements referred to in 5.2, and determine the risks and
of appropriate education, training, or experience;
opportunities that need to be addressed to:
5.7.2.3 Where applicable, take actions to acquire the neces-
(1) Give assurance that the management system for sus-
sary competence and evaluate the effectiveness of the actions
tainability in dentistry can achieve its intended outcome(s);
taken; and
(2) Prevent or reduce undesired effects;
5.7.2.4 Retain appropriate documented information as evi-
(3) Enhance desired business outcomes; and
(4) Achieve continual improvement. dence of competence.
5.7.3 Awareness—Persons doing work under the dental
5.5.1.2 When determining the risks and opportunities that
service organization’s control shall be aware of:
need to be addressed, the dental service organization shall also
include considerations for risks associated with organizational 5.7.3.1 The sustainability in dentistry policy;
E3014 − 21
5.7.3.2 Their contribution to the effectiveness of the man- (2) Implementing control of the processes in accordance
agement system for sustainability in dentistry, including the with the criteria; and
benefits of improved sustainability performance; and (3) Keeping documented information to the extent neces-
5.7.3.3 The implications of not conforming to the manage- sary to have confidence that the processes have been carried
out as planned.
ment system for sustainability in dentistry requirements.
5.7.4 Communication—The dental service organization
5.7.6.2 Change Management:
shall determine the need for internal and external communica- (1) The dental service organization shall plan for and
tions relevant to the management system for sustainability in
manage changes to its management system for sustainability in
dentistry, including: dentistry to ensure they do not cause or lead to undesired
business performance, including:
5.7.4.1 What it will communicate,
(a) Changes to work processes, procedures, equipment,
5.7.4.2 When to communicate,
organizational structure, staffing, as well as scale and extent of
5.7.4.3 With whom to communicate,
dental services offered;
5.7.4.4 How to communicate, and
(b) Changes in newly established knowledge, techniques,
5.7.4.5 Why the communication takes place.
or technology; and
5.7.5 Documented Information:
(c) Changes to legal or other requirements.
5.7.5.1 General—The dental service organization’s manage-
(2) The dental service organization shall control planned
ment system for sustainability in dentistry shall include:
changes and review the consequences of unintended changes,
(1) Documented information required by this practice;
taking action to mitigate any adverse effects as necessary
(2) Documented information required by pertinent
before implementation of changes. The dental service organi-
certification, accreditation, and regulation; and
zation shall ensure that outsourced p
...

This document is not an ASTM standard and is intended only to provide the user of an ASTM standard an indication of what changes have been made to the previous version. Because
it may not be technically possible to adequately depict all changes accurately, ASTM recommends that users consult prior editions as appropriate. In all cases only the current version
of the standard as published by ASTM is to be considered the official document.
Designation: E3014 − 15 E3014 − 21
Standard Practice for
Managing Sustainability in Dentistry
This standard is issued under the fixed designation E3014; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope Scope*
1.1 This practice provides a set of generally recognized activities governing to govern management of sustainability in dentistry
and related dental service practice and practice. It is a management system framework that assists dentists and dental service
organizations to enhance their respective organizational performance and effectiveness. It offers an integrated framework to
managingmanage social, economic and environmental aspects of an organization’s activities. While this practice is intended to be
adopted and used by dental professionals and dental service organizations of any size and specializations including those being a
part of large healthcare service organizations, specialization, the scope of this practice addresses the expectations of and is relevant
to dental service provider organizations’ stakeholders.stakeholders as well.
1.2 This practice is intended to be used with pertinent dental office management principles and guidance documents published by
professional dental association in which dental services are delivered.associations.
1.3 This practice should be implemented in alignment with the United Nations 17 Sustainable Development Goals (SDGs to be
achieved by 2030) and the World Dental Federation (FDI) Sustainability in Dentistry Policy of August 2017.
1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility
of the user of this standard to establish appropriate safety safety, health, and healthenvironmental practices and determine the
applicability of regulatory limitations prior to use.
1.5 This international standard was developed in accordance with internationally recognized principles on standardization
established in the Decision on Principles for the Development of International Standards, Guides and Recommendations issued
by the World Trade Organization Technical Barriers to Trade (TBT) Committee.
2. Referenced Documents
2.1 BSBSI Standard:
BS 8900-1:2013 Managing sustainable development of organizations—Part 1: Guideorganizations—Guide
3. Terminology
3.1 Definitions:
3.1.1 context of dental service organization, n—business environment; combination of internal and external factors and conditions
that can have an effect on the dental service organization’s approach to its dental service, investments, and stakeholder.
This test method practice is under the jurisdiction of ASTM Committee E60 on Sustainability and is the direct responsibility of Subcommittee E60.80 on General
Sustainability Standards.
Current edition approved May 1, 2015Sept. 1, 2021. Published June 2015October 2021. Originally approved in 2015. Last previous edition approved in 2015 as E3014-15.
DOI: 10.1520/E3014–1510.1520/E3014-21.
The United Nations 17 Sustainable Development Goals (https://sdgs.un.org/goals, retrieved 17-Mar-2021).
World Dental Federation (FDI) Sustainability in Dentistry (adopted by FDI General Assembly August 2017 in Madrid, Spain (https://www.fdiworlddental.org/
sustainability-dentistry, retrieved 17-Mar-2021).
Available from American National Standards Institute (ANSI), 25 W. 43rd St., 4th Floor, New York, NY 10036, http://www.ansi.org.
*A Summary of Changes section appears at the end of this standard
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E3014 − 21
3.1.2 dental professional, n—individual person who provides and performs dental services within a dental service organization.
3.1.2.1 Discussion—
Within the context of this practice, dental professional may include dentists, registered dental assistants, licensed oral hygienists,
dental technicians, and dental laboratory technicians.
3.1.3 dental service, n—intangible output that is the result of at least one activity or procedure necessarily performed at the
interface between the dental professional and his/her patient.
3.1.4 dental service organization, n—person or group of people holding proper and recognized dental service accreditation,
license, or certification that has its own functions with responsibilities, authorities, and relationships to achieve its objectives.
3.1.5 evidence-based dentistry, n—approach to oral health care that requires the judicious integration of systematic assessments
of clinically relevant scientific evidence relating to the patient’s oral and medical condition and history with the dentist’s clinical
expertise and the patient’s treatment integrates the most current scientifically relevant evidence, the dentist’s clinical experience,
and the patient’s oral health needs and preferences.
3.1.6 management system, n—a set of interrelated or interacting elements of a dental service organization to establish policies,
objectives, and processes to achieve thosepolicies, processes, and procedures used by an organization to ensure that it can fulfill
the tasks required to achieve its objectives.
3.1.7 policy, n—the formal expression of intentions and direction of a dental professional or a dental service organization as
formally expressed by the person or group of people who directs and controls its dental service activities at the highest level.
3.1.7.1 Discussion—
Throughout this practice, “activity” is used to refer collectively to activities, products, and services rendered through or directly
by a dental professional or an affiliated dental service provider organization.
3.1.8 sustainability, n—degree of sustainable development in the context of a dental professional or dental service organization.
3.1.9 sustainable development, n—development that meets the needs of the present without compromising the ability of future
generations to meet their own needs.
3.1.9.1 Discussion—
Sustainable development is about integrating the goals of a high quality of life, health, and prosperity with social justice and
maintaining the earth’s capacity to support life in all its diversity. These social, economic, and environmental goals are
interdependent and mutually reinforcing. Sustainable development can be treated as a way of expressing the broader expectations
of society as a whole.
4. Significance and Use
4.1 The dental industry’s size and scope translate to a significant environmental and social footprint. Moreover, dental
professionals and dental service organizations are calling for a consensus-based practical guidance document to support
cost-efficient integration of sustainable development principles into their day-to-day management with the goal of achieving carbon
neutrality, for example, by reducing CO emissions. Formation of ASTM Subcommittee E60.80.7, and development of this
practice recognizes and fulfills this demand.
4.2 To most dentists, it remains unclear what constitutes sustainable dentistry practice in principle. This presents a challenge to
incorporating a systematic and pragmatic management framework that identifies, prioritizes, and supports relevant sustainable
development issues. Most dental professionals are primarily limited to recognition of environmental impacts or so-called “green
practices” or “green dentistry.”
4.3 Given management commitment as the first step, this practice describes procedural feasibility of integrating measurable
sustainability performance in daily dental service activities. Preferential treatment is not given to claims of “green” practices.
Strategic decision-making needs to be a balanced approach that takes into consideration environmental, social, and economic
issues. This practice provides a comprehensive guidance on managing sustainability issues and offers a systematic approach and
a management framework that assists dental professionals and dental service organizations to improve overall performance and
effectiveness in their products and deliveries.
E3014 − 21
4.4 This practice offers a concerted approach to managing social, economic, and environmental aspects of dental organizations;
stipulates minimum sustainability considerations and requirements; and provides a framework to embed management of issues
related to sustainable development into day-to-day decision-making and dental service activities. These management consider-
ations include, but are not limited to, water, air quality, energy, waste management, transportation, responsible procurement, supply
chain management, and green buildings. Additional considerations include social responsibility related to patient, staff, and the
community; governance and leadership; and meetings.
4.5 There have been growing interests from dental professionals and dental service organizations in the United States and
elsewhere in the world calling for a consensus-based practical guidance document in support of the cost-efficient integration of
generally recognized sustainable development principles into day-to-day management of dental practices both for individual dental
professionals as well as dental service organizations. Formation of ASTM Subcommittee E60.80.7 and development of this
practice recognizes and fulfills such demand. While it is recognized that current interests expressed by most dental professionals
are primarily limited to environmental impacts attributable to existing dental practices, or so-called “green dentistry,” it remains
to be unclear as to what constitutes sustainable dentistry practice in principle and presents a challenge to incorporate a systematic
and pragmatic management framework identifying, prioritizing, supporting, and addressing relevant sustainable development
issues in a dental service provider’s practice. Given the breadth and extent of management commitment, this practice embodies
emerging comprehension and procedural feasibility of practical realization of measurable sustainability performance in daily dental
service activities without given preferential considerations or uneven weight to one or more existing claim of “green” in dental
practice nor does it give favor to any particular group of dental equipment or product. Aligned with generally recognized principles
of sustainable development, this practice provides a comprehensive guidance on managing sustainability issues in dental practices
and offers a system approach and management framework assists dental professionals and dental service organizations to improve
overall performance and effectiveness in their products and deliveries. It offers a concerted approach to managing social, economic,
and environmental aspects of dental practice; stipulates minimum sustainability considerations and requirements; and provides a
framework for embedding sustainable development issue management into day-to-day decision making and dental service
activities. This practice is intended to be adopted and used by dental professionals and dental service organizations of any size and
specializations including those being a part of large healthcare service organizations. Further, in the scope of this practice addresses
the expectations of, and is relevant to,practice, expectations are addressed that are relevant to dental service organizations’
stakeholders starts with identification of possible benefits and desirable outcomes of managing for sustainability in dentistry. The
approach stipulated in this practice This approach is to provide a framework for embedding sustainability management in everyday
decision making decision-making and is necessarily challenging, provoking, and continually evolving. Effective and continuing
stakeholder engagement is essential in sharpening understanding of real issues and broadening buy in. It is recognized that building
confidence in processes and sustainable outcomes is an important part of this practice and that certain dental service organizations
may wish to use some forms of independent verification. This practice shall not be viewed in isolation as there are many pertinent
helpful texts, conventions, codes, and publications available; it acts as a guide to connect various existing “green” dental practices
and services and offers a system approach to embedding sustainable development thinking that fits and is readily realizable for
dental service organization of any size or specialization.buy-in.
4.6 It is recognized that building confidence in processes and sustainable outcomes is an important part of this practice and certain
dental service organizations may wish to use some forms of independent verification.
4.7 This practice shall not be viewed in isolation as there are many pertinent helpful texts, conventions, codes, and publications
available; it acts as a guide to connect various existing “green” dental practices and services and offers a systemic approach to
embedding sustainable development thinking that fits and is readily realizable for dental service organizations of any size or
specialization.
5. Dental Service Organization
5.1 Understanding the Context of a Dental Service Organization:
5.1.1 The dental service organization shall determine external and internal issues that are relevant to its purpose and affect its
ability to achieve the intended outcome(s) of its management system for sustainability in dentistry.
5.1.2 Understanding the Needs and Expectations of Stakeholders—The dental service organization shall determine:
5.1.2.1 Stakeholders who are relevant to the management system for sustainability in dentistry;
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5.1.2.2 Relevant requirements of these stakeholders; and
5.1.2.3 Applicable legal and other requirements to which the dental service organization subscribes.
5.1.3 Determining the Scope of the Management System for Sustainability in Dentistry:
5.1.3.1 The dental service organization shall determine the boundaries and applicability of the management system for
sustainability in dentistry to establish its scope. When determining this scope, the dental service organization shall consider:
(1) The external and internal issues referred to in 5.1,
(2) The requirements referred to in 5.2, and
(3) The type and extent of dental services offered.
5.1.3.2 The scope shall be available as documented information.
5.2 Management System for Sustainability in Dentistry—The dental service organization shall establish, implement, maintain, and
continually improve a management system for sustainability in dentistry, including the processes needed and their interactions, in
accordance with the requirements of this practice.
5.3 Leadership and Commitment—The leadership shall ensure that the defined principles of sustainable development are reflected
and communicated in its policy. They shall also ensure that the vision’s delivery leads to long-term success of the dental service
organization. Top management shall demonstrate leadership and commitment with respect to the sustainable dentistry management
system by:
5.3.1 Ensuring that the sustainability policy and objectives are established and are compatible with the strategic direction of the
dental service organization;
5.3.2 Ensuring that the integrationrequirements of the management system for sustainability in dentistry requirements are
integrated into the dental service organization’s business processes;
5.3.3 Ensuring that the appropriate financial, human, and organizational resources needed for the management system for
sustainability in dentistry are available;
5.3.4 Communicating throughout the importance of effective management of sustainability in dentistry and conforming to
organization the importance of using the management system for sustainability in dentistry requirements thoughout the
organization;effectively and conforming to its associated requirements;
5.3.5 Ensuring that the management system for sustainability in dentistry achieves its intended outcome(s);
5.3.6 Directing and supporting persons to contribute to the effectiveness of the management system for sustainability in dentistry;
5.3.7 Promoting continual improvement; and
5.3.8 Supporting other relevant management roles to demonstrate their leadership as it applies to their areas of responsibility.
5.4 Organizational Roles, Responsibilities, Account-
abilities, and Authorities—Top management shall ensure that respective responsibilities, accountabilities, and authorities for
relevant roles to realize its sustainability policy and achieve its objectives are assigned and communicated within the dental service
organization. Top management shall assign the responsibility and authority for:
5.4.1 Requirements of this practice, and
5.4.2 Reporting on the performance of the management system for sustainability in dentistry to top management.
5.5 Planning:
5.5.1 Actions to Address Risks and Opportunities:
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5.5.1.1 When planning for the management system for sustainability in dentistry, the dental service organization shall consider,
assess, and prioritize the issues referred to in 5.1, the requirements referred to in 5.2, and determine the risks and opportunities
that need to be addressed to:
(1) Give assurance that the management system for sustainability in dentistry can achieve its intended outcome(s);
(2) Prevent or reduce undesired effects;
(3) Enhance desired business outcomes; and
(4) Achieve continual improvement.
5.5.1.2 When determining the risks and opportunities that need to be addressed, the dental service organization shall also include
considerations for risks associated with organizational integrity, inclusivity, transparency, and stewardship as well as opportunities
related to the practice of evidence-based dentistry.
5.5.2 The dental service organization shall plan:
5.5.2.1 Actions to address these risks and opportunities;
5.5.2.2 How to integrate and implement the actions into its management system for sustainability in dentistry processes; and
5.5.2.3 How to evaluate the effectiveness of these actions and develop corresponding countermeasures.
5.5.3 Documented information shall be retained on the outcomes of planning for the management system for sustainability in
dentistry.
5.6 Sustainability in Dentistry Objectives and Planning to Achieve Them:
5.6.1 The dental service organization shall establish sustainability objectives at relevant functions and levels. The sustainability
in dentistry objectives shall:
5.6.1.1 Be consistent with the sustainability in dentistry policy,
5.6.1.2 Be measurable (if practicable),
5.6.1.3 Take into account applicable legal and other requirements as well as technical feasibility,
5.6.1.4 Be measurable and monitored,
5.6.1.5 Be communicated, and
5.6.1.6 Be updated as appropriate.
5.6.2 The dental service organization shall retain documented information on the sustainability in dentistry objectives. When
planning how to achieve its sustainability in dentistry objectives, the dental service organization shall determine:
5.6.2.1 What will be done,
5.6.2.2 What resources will be required,
5.6.2.3 Who will be responsible,
5.6.2.4 When it will be completed, and
5.6.2.5 How the results will be evaluated.
5.7 Support:
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5.7.1 Resource—The dental service organization shall determine and provide the resources needed for the establishment,
implementation, maintenance, and continual improvement of the management system for sustainability in dentistry and to
demonstrate enhanced performance.
5.7.2 Competence—The dental service organization shall:
5.7.2.1 Determine the necessary competence of person(s) doing work under its control that affects its sustainability performance;
5.7.2.2 Ensure that these persons are competent on the basis of appropriate education, training, or experience;
5.7.2.3 Where applicable, take actions to acquire the necessary competence and evaluate the effectiveness of the actions taken; and
5.7.2.4 Retain appropriate documented information as evidence of competence.
5.7.3 Awareness—Persons doing work under the dental service organization’s control shall be aware of:
5.7.3.1 The sustainability in dentistry policy;
5.7.3.2 Their contribution to the effectiveness of the management system for sustainability in dentistry, including the benefits of
improved sustainability performance; and
5.7.3.3 The implications of not conforming withto the management system for sustainability in dentistry requirements.
5.7.4 Communication—The dental service organization shall determine the need for internal
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