A newly published life cycle assessment (LCA) study in the Journal of Dentistry has quantified the environmental impact associated with periodontal health, disease progression, and related care pathways. The peer-reviewed paper, “Quantifying the Environmental Impact Potential from Periodontal Health to Disease: Findings from a Life Cycle Assessment Study,” is reported to be the first to evaluate environmental burdens across the continuum from periodontal health to advanced periodontal disease using a whole-system assessment approach.
Developed by sustainability and oral health researchers in collaboration with Procter & Gamble (P&G), the study was conducted in accordance with ISO 14040/14044 standards for life cycle assessment and underwent third-party verification. The analysis examined both at-home preventive care and clinical interventions, including travel associated with dental visits.
Expanding Sustainability Discussions in Oral Healthcare
While sustainability initiatives in dentistry have often focused on product design, manufacturing processes, and waste reduction, this study evaluates the environmental impact of complete oral healthcare pathways. The authors assessed environmental outcomes associated with maintaining periodontal health, managing early disease, and treating advanced periodontal conditions.
According to the study, clinical interventions accounted for approximately 90% of the total environmental impact across the modeled periodontal care pathway. Within at-home oral hygiene routines, water consumption represented the largest environmental contributor. The authors reported no meaningful difference in total at-home environmental impact between manual and powered toothbrushing routines within the parameters of the study.
Prevention and Resource Utilization
The findings suggest that preventing disease progression may reduce the need for more resource-intensive clinical care. The authors note that effective daily oral hygiene practices can contribute to maintaining periodontal health and potentially lessen the demand for complex treatment interventions.
The study highlights established recommendations for twice-daily toothbrushing with fluoride toothpaste and interdental cleaning as key components of preventive care. It also references evidence indicating that powered toothbrushes can improve plaque control and support periodontal health outcomes.
Periodontal Disease Remains a Global Challenge
The publication notes that more than 1 billion people worldwide were living with severe periodontitis in 2021, based on analyses of Global Burden of Disease (GBD) 2021 data.
In England, findings from the Adult Oral Health Survey (AOHS) 2023 showed that 93% of adults with natural teeth exhibited at least one sign of periodontal disease. Approximately 28% demonstrated early signs of periodontal breakdown, characterized by periodontal pocket depths greater than 3.5 mm.
Expert Commentary
“What’s important about this LCA is that it places products in the real-world context of oral health, showing that prevention at home, and reducing high-impact clinical care, is where the biggest sustainability leverage sits,” said Prof. Brett Duane, Co-author, Honorary Professor at the University of Dundee and Associate Professor (Visiting) at Trinity College Dublin.
“As periodontal disease progresses, care becomes more intensive. Prevention reduces the lifetime need for treatment, which matters for patients, healthcare systems, and environmental sustainability,” commented Prof. Nicolas Martin, Co-Author, University of Sheffield; Chair, FDI Sustainability in Dentistry Task Team.
Dr. Steven Mulligan, Co-Author, University of Sheffield; Founding Member, FDI Sustainability in Dentistry Task Team, added, “Around 90% of the environmental impact comes from clinical treatment, and it is up to ten times higher for advanced periodontal disease. Prevention is one of the most powerful levers we have.”
“Periodontal health isn’t only about the mouth, it’s closely linked to overall health. We see strong clinical associations between gum diseases and systemic conditions such as diabetes and cardiovascular diseases. That’s why prevention at home matters: consistent, effective plaque removal, especially along the gumline and between teeth—helps keep inflammation under control and supports long-term health,” noted Prof. Andrea Pilloni, Professor of Periodontology, Sapienza University of Rome.
Study Reference
Duane B, Martin N, Mulligan S, Dewaele J, Wedel L. Quantifying the Environmental Impact Potential from Periodontal Health to Disease: Findings from a Life Cycle Assessment Study.Journal of Dentistry. 2026.
Methodology
The study followed ISO 14040/14044 life cycle assessment standards and was independently verified. Researchers evaluated activities and products associated with maintaining periodontal health through preventive care at home, as well as those involved in periodontal treatment delivered in dental clinics. The analysis included patient travel and focused on environmental indicators that collectively accounted for at least 80% of the total modeled environmental impact.
