Isabelle de Mozenette
Project Title: Sustainability in UW Dentistry: Introducing Bamboo Toothbrushes
Abstract
Every year in the United States, 50 million pounds of plastic toothbrushes are sent to landfills. This project aims to change that by convincing the American public to switch to compostable bamboo toothbrushes. To do this, I created a pilot program for the University of Washington School of Dentistry faculty and students to receive informed feedback. Funded by the UW Campus Sustainability Fund and the Community Support Grant through the Community, Environment and Planning major, the project produced 150 complete “green” goodie bags with compostable floss, biodegradable toothpaste, and a compostable bamboo toothbrush packaged in a compostable bag with a survey. The survey’s purpose is to assess the user experience of UW Dentistry faculty and students. The initial results of the study show barriers to adapting to “green” dental products, specifically bamboo toothbrushes. This was particularly acute among respondents, who expressed hesitation towards the green dental products. This study demonstrates that attempts to make dental care more sustainable will face challenges, including technological, regulatory, economic, and cultural barriers to change.
Literature Review
Since the 1950s, businesses have been adopting Corporate Social Responsibility practices into their corporate business models (Carroll). Corporate Social Responsibility is defined as “business firms contributing in a positive way to society by going beyond a narrow focus on profit maximization. This may include charitable giving, investing in green solutions, employing progressive human resource practices, and engaging in community development” (McWilliams). Through examining different business models and the value for businesses to care about ethics and sustainability, Carroll, the author of Corporate Social Responsibility: Evolution of a Definitional Construct, has done research that shows that in the long run it is worth the money and effort to make these changes (Carroll). This literature review will provide the framework, theories and reasoning for why corporate social responsibility, intentionally and ethical practices are always worth the cost, time and effort. I have divided my literature review into 3 topics: the environmental benefits of bamboo products, corporate social responsibility and green dentistry. My senior project is the communication, inspiration and implementation of getting UW Dentistry to incorporate bamboo toothbrushes as an option to handout to their patients. These topics can be utilised to measure and provide the foundation for the success of this project.
Why Bamboo is Better than Plastic
In order to communicate the importance of this issue from an environmental perspective, I need to be able to explain the environmental benefits of using bamboo over plastic to UW Dentistry. In terms of environmental sustainability, one of the leading bamboo toothbrush companies, “Brush with Bamboo”, explains that “Bamboo is the fastest growing plant on earth. Because it contains naturally-occurring antimicrobial agents, there is no need for using fertilizers or pesticides during its cultivation. Our bamboo is totally organic and wild. After we harvest a bamboo stalk to use it for toothbrushes, another stalk takes its place and grows to full size within just 2 years — a remarkable growth rate!” (Brush with Bamboo). This is important because if UW dentistry makes the switch, they will not be responsible for any of the detrimental effects that plastic toothbrushes have on the environment, and they will be able to be proud that they are supporting one of the most sustainable plants on earth! I am working to get more information from the specific bamboo toothbrush company that I am working with for my project, SenzaBamboo. I have plans to interview the founder about the sustainable farming practices he uses.
In terms of plastic, “Over 4.7 billion plastic toothbrushes that will never biodegrade are dumped in landfills and oceans every year worldwide.” (Ecoplanetbamboo) Plastic toothbrushes have plastic and rubber in the handle, nylon in the bristles, and plastic in the packaging. Since none of these materials can biodegrade safely in the environment, they are sent to landfills, and remain there for an undetermined amount of time. Often, if they don’t make it to the landfill, much plastic ends up in our oceans, and therefore consumed by wildlife. If the plastic is burnt, this process releases a combination of toxic and greenhouse gases (Ecoplanetbamboo). Essentially, there is no safe way to dispose of plastic, which is why businesses should be leading the way to support environmentally friendly alternatives. I will address more later on why businesses are responsible for making these changes, rather than citizens or the government.
According to the associate Dean of Clinics of UW School of Dentistry, Dr. Schwedhelm, UW Dentistry hands out approximately 2800 toothbrushes per year. At each toothbrush weighing 2 oz this adds up to be 525 pounds of plastic toothbrushes that UW Dentistry is responsible for every year. It is estimated that 50 million pounds of toothbrushes are sent to landfills each year, just in the USA! (West). It’s easy to see how we can take this number further and multiply it by cities and countries. We then can see how much of a negative impact handing out plastic toothbrushes is creating, and how easily it can be replaced with creating a positive impact by handing out bamboo ones.
In addition to the fact that plastic does not break down in the environment, the process of manufacturing plastics is detrimental as well. “Production of plastics is a major user of fossil fuels. Eight percent of world oil production goes to manufacturing plastics.” While toothbrushes would end up being a very small percentage of the plastic produced, it should still be the responsibility of the dentists to not support the production of unnecessary plastic, especially when there are already environmentally friendly alternatives. Making plastic causes many chemicals to be leached into the air, soil and water. “The Oakland Recycling Association commissioned an analysis of the toxic chemical burden that relied heavily on information from EPA data, especially the Toxics Release Inventory...the information available showed that most toxic releases went into the air, and the plastics industry contributed 14% of the national total” (Ecology Center). Toothbrushes that are made out of plastic containing phthalates. A study done by Sadeghi et al, aimed
to determine the Dioctyl phthalate (DEHP) concentration of PVC plastic parts of toothbrushes. The result showed that the phthalate concentration of a Reach adult’s toothbrush and a Equate kid’s toothbrush were 1.97 ppm and 0.56 ppm respectively. Therefore, this study found that considerable concentrations of phthalates were also present in toothbrushes, which, due to consumers’ daily exposure, would certainly have negative effects on users’ health in the long term (Sadeghi et al).
Since toothbrushes are made of plastic that is strong and durable, they are considered to be made of PBT plastic. The EPA explains that “Persistent, bioaccumulative and toxic (PBTs) chemicals or substances pose a risk to the marine environment because they resist degradation, persisting for years or even decades. PBTs are toxic to humans and marine organisms and have been shown to accumulate at various trophic levels through the food chain.”
Based on this information, plastic is not the right choice of material for most toothbrushes. The American Dental Association (ADA) recommends that consumers “replace toothbrushes approximately every 3–4 months or sooner if the bristles become frayed with use” (ADA). Since the ADA recommends that toothbrushes are disposed of so often, plastic is too strong and durable for an item that cannot be broken down naturally in our environment. While a non-disposable toothbrush might be the best choice resource wise and environmentally, it is not a financially viable option for dentists to handout to patients for free.
Corporate Social Responsibility
Businesses with a socially responsible mission have just recently been on the public's radar (Carroll). For example, companies such as TOMS and Warby Parker have implemented a 1 for 1 business model, where for every purchase made, one is donated to someone in need. Patagonia, an outdoor clothing company, has a mission statement that claims to: “Build the best product, cause no unnecessary harm, use business to inspire and implement solutions to the environmental crisis” (Patagonia). However, it hasn’t been easy to get businesses on board with the idea of being socially responsible. According to Bocken, the author of A Literature and Practice Review to Develop Sustainable Business Model Archetypes, a fundamental shift is required for holistic changes in the social corporate responsibility world (Bocken et al). Businesses and people must start to value long term use of products as well as quality and innovation in the realm of materials that are earth friendly. “A sustainable economy strives to encourage minimising consumption” (Bocken et al). We should be striving for systems that emphasize positive environmental impact and minimize unnecessary waste. Systems such as these save and protect our wildlife, our environment and our children. By making the effort to minimize our negative impact on the environment, as we go about our daily lives, we create an easier life for future generations as we will have saved them the despair and detriment if we avoid harmful practices. A closed loop economy or system is one that recycles, reuses, repairs or repurposes every item or material, letting nothing go to waste or landfills. Helping businesses to enter this closed loop economy will inspire them to be innovative in the products they produce and choose to supply (Bocken, N. M. P., et al).
In order to approach consumers in a way that will have them be excited about sustainable business and products, it will be beneficial to assess and acknowledge consumers’ values and attitudes. According to Triandis (1993), the contributing author of article, Individualism and Collectivism, individualism and collectivism are the two main values that influence consumer behavior. He says that the more someone values individualism the less likely they are to value eco-friendliness as they have more of a need to be unique, which would inspire more unnecessary purchases. In contrast, he claims that the more they value collectivism, the more likely they are to view their purchases as a holistic process that affects more than just themselves.
In terms of values, convenience and importance are the two most common studied, according to Laroche, a contributing author of “Targeting Consumers Who Are Willing To Pay More For Environmentally Friendly Products". He claims that “Importance is simply whether consumers view environmentally compatible behaviors as important to themselves or society as a whole.” (Laroche et. al). This plays a role in everyone’s daily lives as they make the decision (if they even have one) to purchase the “better” product. “Inconvenience refers to how inconvenient it is perceived for the individual to behave in an ecologically favorable fashion.” (Laroche et. al) This plays a major role in people's actions towards the environment. Even if people decide that choosing the more environmentally friendly option is important, it’s not fair to expect everyone to dedicate their lives and passions towards environmental issues. Therefore, it is the job of environmentalists in business to make acting sustainably easy and convenient. Convenience plays a major role into the bamboo toothbrush project as well. Bamboo toothbrushes are toothbrushes with a completely biodegradable/compostable handle made out of bamboo. Most people in the USA are familiar with the concept of leaving their dentist appointment with a goodie bag containing a plastic toothbrush, a plastic container of floss and a plastic container of toothpaste. It is responsible for the dentist to provide patients with these items, as they are then expected to use them to keep good dental health until the next visit to the dentist. However, these items are only responsible for the health of the dentist patients, and are not responsible in the environmental realm. While the bristles of bamboo toothbrushes are still nylon (plastic), replacing the plastic handle toothbrushes with bamboo toothbrushes will divert at least the waste of the handle. Therefore, having a more sustainable option come to you for free, through the dentist, takes the pressure off the consumer to make the “right” choice at the drugstore.
In order to implement a more sustainable option for the long run, companies must value sustainability, even if that means it’s a little more expensive. Lüdeke-Freund (2010) describes a sustainable business model as “a business model that creates competitive advantage through superior customer value and contributes to a sustainable development of the company and society”. The ideal sustainable business model preserves the environment while also improving the quality of people's lives.
Eco-Friendly Dentistry
“Green dentistry" is a practice of dentistry using technologies and materials that promote and protect the planet. It is a thought process, an attitude, and a guide for making earth friendly choices in dental practice” (Rupa 2015). There are many progressive and innovative choices that dentists can make to promote sustainable alternatives to what they are already using. Some dentist related companies are already proving that they value sustainability. SmartPractice is an online wholesale distributor that supplies items for companies that take care of people and pets. In January of 2016 they decided to start offering bamboo toothbrushes that can be ordered for dentist offices. “According to SmartPractice’s dental marketing specialist, Stacey Gowdy, “SmartPractice is devoted to bringing our dental customers products like WooBamboo Toothbrushes because they’re highly effective: for patients, for the environment, and for dental offices’ bottom [lines].” This is an important step toward sustainability in dentistry because it promotes dentist offices that order from this website to order bamboo toothbrushes. It does this by giving access to bamboo toothbrushes easily. So far, they are a bit hard to find. It is important for distribution sites such as these to normalize access to bamboo toothbrushes so that dentists will be aware and consider buying them. In the supply chain, the supplier offering them to dentist offices is one step above dentist offices offering them to patients. This is impressive for the sake of consistent values and normalizing sustainability on all ends of the spectrum.
At Ivy Dental in Charlottesville, VA, “Dr. Harding has made the commitment to be as environmentally friendly as possible in office selecting her equipment and practices for day-to-day patient care. Medical and Dental facilities can produce a large amount of waste and use a lot of energy and water in one day. Our goal at Ivy Dental is to recycle the waste we produce, reduce the energy and water spent running the dental equipment, and reuse as many products as possible through careful steam sterilization techniques” (Ivy Dental). Dr. Harding offers bamboo toothbrushes for purchase on the way out, as well as to collect the old plastic ones to recycle them for patients. “At Ivy Dental we are collecting your used plastic toothbrushes and will deliver them to the #5 collection at our local Whole Foods. At your next dentist appointment forego the plastic and pick up a bamboo toothbrush knowing you’re making a small choice that leads to a bigger impact” (Ivy Dental).
Dentistryiq.com, a website that provides resources for dental professionals, has a section dedicated to Eco-Friendly Dentistry. They define it as:
Eco-Friendly Dentistry is a newly evolving practice of dentistry, which encompasses a simultaneous devotion to sustainability, prevention, precaution, and a minimally invasive patient-centric as well as global-centric treatment philosophy.
Eco-Friendly Dentistry, through green design and operations, protects the immediate health of patients and team members, the health of the surrounding community, and the health of the global community and natural resources.
This definition fully supports the idea of the switch from handing out plastic toothbrushes to bamboo ones.
Another website, ecodentistry.org, which is dedicated to Green & Sustainable Dentistry Practices for Dental Professionals, Patients & Industry, addresses this issue as well. Under the section “Why Reduce Waste?” they remind us that “If we don’t create trash, it doesn’t have to be sent away somewhere. Packaging accounts for 33% of garbage. Many manufacturers are cutting down on the amount of packaging for their products, or making more of the packaging reusable or recyclable. Many high-tech innovations in dentistry help reduce waste, like oral cancer diagnostics that create less waste than oral cancer rinse screenings” (EcoDentistry.org). They also have an extensive list of resources for where and how to buy eco friendly products, however bamboo toothbrushes are not yet on that list nor do they offer a sustainable toothbrush alternative! Damle from the “Contemporary Clinical Dentistry” sums up the importance of this issue by saying “The key concepts of a green dental practice include conservation of water and energy, use of nontoxic products, reduction of waste, and elimination of hazardous toxins that negatively affect patients and the environment and promote ‘Green’ products.” Again, bamboo toothbrushes that are sustainable to make, and biodegrade fall perfectly under this description!
Other than these mentions from websites, I can not find any written proof that any dentist offices are explicitly handing out bamboo toothbrushes to their patients for free in their take home goodie bags. I have also asked many individuals if their dentists hand out toothbrushes, as well as searched extensively for dentist offices that hand them out. I did recently come across a dentist office in Vancouver BC that recently made the switch and have reached out to them for more information about what inspired the switch.
In conclusion, businesses should be held accountable for prioritizing an environmentally sustainable business model. According to a survey where I asked “When supporting a business does sustainability matter to you?” 89% of respondents said “yes.” This survey result suggests that people are moving towards a trend that prefers sustainable businesses. Another important aspect of corporate social responsibility is giving back to the community. Senzabamboo, the toothbrush company I am working with for my project donates 3% of their profits to a local women's shelter, Mary’s Place. Companies that take care of more than just themselves tend to attract more people that are starting to value businesses with a social mission. A study done by Mohr and Webb, the authors of “The effects of corporate social responsibility and price on consumer responses” concluded that “Results from a national sample of adults indicate that corporate social responsibility in both domains had a positive impact on evaluation of the company and purchase intent. Furthermore, in the environmental domain corporate social responsibility affected purchase intent more strongly than price did” (Mohr et al). Changes such as these can lead to customer loyalty and long-run success in the future. Green dentistry, while a relatively new trend, is picking up speed as more and more technology is released that support sustainable practices. Dentists will also be keen to follow the trend of corporate social responsibility since essentially they are a business as well. The more research that is released about natural products and practices, the more families will want to find healthcare that is better for their bodies, and the environment. It’s also clear now that supporting bamboo eliminates the toxins, waste and pollution that plastic creates. Bamboo is all natural to produce and will biodegrade. Effectively combining corporate social responsibility, with green dental practices that support getting bamboo toothbrushes into patients hands will create a better world for our bodies and the environment. Based on the current information that researchers have done already about the positive factors of socially responsible businesses, green dentistry and the benefits of bamboo over plastic, this literature review shows the benefits for UW Dentistry to switch from plastic to bamboo toothbrushes.
Sources:
Carroll, Archie B. “Corporate Social Responsibility: Evolution of a Definitional Construct.” Www.academia.edu, BUSINESS & SOCIETY, Vol. 38 No. 3, Sept. 1999, www.academia.edu/419517/Corporate_Social_Responsibility_Evolution_of_a_Definitional_Construct.
McWilliams, A. 2015. Corporate Social Responsibility. Wiley Encyclopedia of Management. 12:1–4.
http://www.patagonia.com/company-info.html
Triandis, H. (1995). Individualism & collectivism (New directions in social psychology). Boulder: Westview Press.
Quora, and Ayesha Barenblat. “Fast Fashion Is A Disaster For Women And The Environment.” Www.forbes.com, www.forbes.com/sites/quora/2017/07/26/fast-fashion-is-a-disaster-for-women-and-the-environment/#15c11cd61fa4.
West, Larry. “Can You Recycle Your Toothbrush?” Www.thoughtco.com, www.thoughtco.com/can-you-recycle-your-toothbrush-1203671.
Rupa K R, Laxmikanth Chatra, Prashanth Shenai, Veena K M, Prasanna Kumar Rao, & Rachana Prabhu. (2015). Taking a step towards greener future: A practical guideline for eco-friendly dentistry. Arsiv Kaynak Tarama Dergisi,24(1), 135-148.
“ Eco-Friendly WooBamboo Toothbrushes available through SmartPractice.” Edited by DentistryIQ Editors, Http://Www.dentistryiq.com, 8 Jan. 2016, www.dentistryiq.com/articles/2016/01/eco-friendly-woobamboo-toothbrushes-available-through-smartpractice.html.
Bocken, N. M. P., et al. "A literature and practice review to develop sustainable business model archetypes." Journal of cleaner production 65 (2014): 42-56.
Michel Laroche, Jasmin Bergeron, Guido Barbaro‐Forleo, (2001) "Targeting consumers who are willing to pay more for environmentally friendly products", Journal of Consumer Marketing, Vol. 18 Issue: 6, pp.503-520, https://doi.org/10.1108/EUM0000000006155
“Our Story.” Brush with bamboo, www.brushwithbamboo.com.
“The Environmental Impact of Toothbrushes.” Http://www.ecoplanetbamboo.com, 3 Aug. 2015, www.ecoplanetbamboo.com/news/the-environmental-impact-of-toothbrushes.
“Eco Friendly Dentistry.” Charlottesvilleivydentist.com, charlottesvilleivydentist.com/eco-friendly-dentistry/.
Practitioner Steven Koos, DDS, MD. “Eco-Friendly Dentistry.” Http://Www.dentistryiq.com/, Chicagohealers.com, www.dentistryiq.com/articles/2010/01/eco-friendly-dentistry.html.
“Why Reduce Waste.” Ecodentistry.org, Eco Dentistry Association, ecodentistry.org/green-dentistry/what-is-green-dentistry/reduce-waste/.
Damle, S. G. “Eco-Friendly Green Dentistry: The Future of Dentistry?” Contemporary Clinical Dentistry 7.4 (2016): 423–425. PMC. Web. 31 Jan. 2018.
Carol Tekavec RDH. “How Many Patients Should The Hygienist See?” Www.mckenziemgmt.com, www.mckenziemgmt.com/managementtips/print/carol/PrintCarolArticle462.html.
“PTF: ENVIRONMENTAL IMPACTS.” Ecologycenter.org, ecologycenter.org/plastics/ptf/report3/.
Esmaeili A, Pourbabaee AA, Alikhani HA, Shabani F, Esmaeili E (2013) Biodegradation of Low-Density Polyethylene (LDPE) by Mixed Culture of Lysinibacillus xylanilyticus and Aspergillus niger in Soil. PLoS ONE 8(9): e71720. https://doi.org/10.1371/journal.pone.0071720
Sadeghi, Ghazal; Ghaderian, Elham; and O'Connor, Anne. "Determination of Dioctyl phthalate (DEHP) concentration in polyvinyl chloride (PVC) plastic parts of toothbrushes." The Downtown Review. Vol. 1. Iss. 2 (2015).
Mohr, L. and Webb, D. (2005), The effects of corporate social responsibility and price on consumer responses. Journal of Consumer Affairs, 39: 121–147. doi:10.1111/j.1745-6606.2005.00006.x
Methods - how did you do what you did//why you did it that way?
My methodology for the success of this project includes: surveys to gauge interest in bamboo toothbrushes from the general public; technical toothbrush research, coalition, collaboration, communication, negotiation, identifying proper and appropriate criteria for choosing the right bamboo toothbrush company; Case Studies with UW Dentistry and bamboo toothbrush company, Senzabamboo; and Creating a pilot study/program to test the usability and create proof of concept. In order to test usability, I handed out green goodie bags, containing a bamboo toothbrush to UW Dentistry Faculty and Students, to gain informed feedback. This was funded by the Campus Sustainability Fund as well as the Community Support Grant through CEP. I created a user feedback survey and used this feedback to change the design of the bamboo toothbrush to meet the standards of the UW Dentists. After getting the “ultra soft” bristle toothbrush approved, I proposed that UW Dentistry includes bamboo toothbrushes as an option to handout to their patients. I used the rest of the grant money to pay for the first batch of toothbrushes.
My initial survey for this project asked three questions:
I considered this question to be defective because I sent this survey to many people that do not live in Seattle, therefore the answers are skewed.
I started my project winter quarter, late, because I was studying abroad fall quarter and I let that be a excuse for not doing anything for my senior project. The first thing I did when I got back was apply to the Campus Sustainability Fund, knowing that this project was doomed if it wasn’t initially “free”. I was awarded $900 in grant money to buy bamboo toothbrushes to give to UW Dentistry for them to hand out to patients. I was awarded this money based on the stipulation from the CSF people that there would be a permanent change funded by UW Dentistry once the supplies from the grant money ran out. This worried me because I was not entirely sure I would be able to convince UW Dentistry to pay for the toothbrushes themselves. At this time, UW Dentistry/UW Medicine is receiving a lot of backlash in the newspapers because they are in a lot of debt. I also decided to apply to the CSG grant from CEP, thinking that the more money I could receive for the project, the better. I was eventually also awarded $500 from the CSG grant too.
During this time, I also started my research on the best toothbrush companies. I chose the company "SenzaBamboo" because they are local to Seattle, and they donate 3% of their profits to Mary's Place, a women's shelter in downtown Seattle.
The beginning of winter quarter, I also joined the campus club “Eco-Reps”. I joined this club because their sole mission is for students to run sustainability projects on campus. Therefore, they were the perfect club to give me legitimacy and support. With the help of them, I planned my first meeting with UW Dentistry.
I had no idea how to meet with someone from UW Dentistry about my project. I started by going to the UW Dentistry bio page. There, I found staff with any relevant words in their bio to my project. I emailed 3-4 people saying that I had an idea for a sustainability project and could they please connect me with the right person to talk to. Eventually I was directed to the Associate Dean of Clinics, Dr. Schwedhelm. He agreed to meet with me about my project.
When I met with him I brought a project proposal that also included my survey results. (Appendix A). I felt that I was very lucky because during my attempts to explain to him the importance of compostability, he began to tell me about all of the efforts he makes at home to live sustainably. He understood my environmental mission! He was also very efficient with trying to answer my questions. For example, when I asked him how much they currently pay for their the toothbrushes they hand out to patients, in the middle of our meeting he called and emailed multiple people to try to find out the answer. Here lies my first mistake, I truly believed this man was invested in my project! Because of his personal interest in sustainability and his efforts to answer my questions efficiently, I felt confident that I had (with luck) been connected with the perfect person that would make my project a success.
At this point, my projects plan was to hand out bamboo toothbrushes to patients. Dr. S and I agreed that this could be a 10 week pilot program paired with Profi Clinic. Profi Clinic is where 2nd year dentistry students give cleanings to the public. The plan was that these patients would receive the bamboo toothbrushes.
After this meeting, I decided to move forward with the bamboo toothbrush company called “Senzacare”. I chose them out of all the others on the market because they are the cheapest, are local, and donate 3% of their profits to Mary’s Place, a women’s shelter in Seattle.
Once I realized that I had enough grant money, I had the idea to introduce the bamboo toothbrushes in the form of completely green goodie bags. This is when I decided to pursue getting floss samples, toothpaste and compostable goodie bags as well.
I found the company called “Uncle Harry’s” that donated 250 free samples to my goodie bag project. Their toothpaste is all natural and comes in a glass jar.
I also found a company called “Clear bags” who make commercially compostable bags.
Once all of the items arrived, I hosted a community volunteer event to assemble 250 goodie bags. About 10 people showed up which ended up being the perfect amount of people for the time slot I had allowed. All 250 were assembled! This event was a really key and crucial part of my project. It was a chance to engage and interact with my peers about a topic that is so important to me.
During this time I was also working on having an article written about my project in the UW Daily.
The week before my goodie bag assembly party was when my project took a major turn. Dr. S who has originally approved everything, including that these goodie bags would go to patients of UW Dentistry, told me that I should be in contact with Dr. Daubert.
I met with Dr. Daubert 4 days before the goodie bag assembly party, and 5 days before the goodie bags were planned on being handed out. It was during that meeting that I realized she was supposed to be the person I should have been in contact with this whole time. I had no idea. It was clear that she did not know much about my project at all, even though it was supposed to launch in 5 days. I tried to update her as kindly and sensitively as possible, so that she did not feel attacked or taken advantage of.
I left her office feeling very confused and discouraged. She had told me that since she knows this is my capstone project and I need to graduate, that she would be willing to work with me. That left me feeling at her mercy and her having all the power.
I continued on planning my volunteer event. It was stressful to get everything for it organized in time but it turned out great in the end! The day after the event was the day the UW Daily article was published. That was also the day that Dr. Daubert said I could not hand the goodie bags out to UW Dentistry patients. I was devastated. She told me instead that I could hand them out to UW Faculty and Students to get their feedback instead. I quickly rewrote my survey to tailor it to the educational aspect of sustainability in the UW Dentistry.
I was sure that she has absolutely ruined my project. However, I think it turned out to be a blessing in disguise.
I reframed my project as introducing bamboo toothbrushes to UW Dentistry from an educational standpoint, and as a change from the inside out. I realized that it was better to get legitimate feedback from professionals and future professionals in the field.
In order to introduce the goodie bags to UW Dentistry. I did 2 class presentations and 1 presentation to a faculty meetings. At those presentations I told them about my project, mission and the minimal environmental impact of each of the items in the goodie bag. After that, I told them to please fill out the survey.
When it came to survey results time, I had assumed that everyone would give me really positive feedback, and that I could use that feedback to vouch for toothbrushes for UW Dentistry patients, I was wrong again! The feedback was not in my favor. The concerns of UW Dentistry were about cost and bristle quality. In every one of the presentations I did, there was at least one person who was really eager and excited about my project and sustainability. However, in general I was getting a lot of resistance.
I used the feedback results to again frame my project in a way that shows that there is a lot of resistance to new products in the dentistry field and that bamboo toothbrushes are a really great and concrete way to introduce this idea.
Eventually Dr. Daubert and I decided that we can order a large batch of the bamboo toothbrushes with the “ultra soft” bristles that can be handed out to patients!
Results - description of what happened or the data you have collected and the analysis Implications
I have many versions of results for this project. Each phase of the project has its own results! However, to synthesize the main results, I would categorize them into the two main phases. The first phase was the educational component of the introduction of the bamboo toothbrushes through green goodie bags. The second being the decision to spend the rest of the grant money on ultra soft toothbrushes for UW Dentistry patients.
The findings of my survey that was sent out to UW Dentistry faculty and students imply that there is a lot of resistance to change at UW Dentistry. They take patient safety into consideration much more than I could have ever predicted.
The resistance of this project from the UW Dentistry side was to be expected. Any big level or corporate level change will be met with resistance. Therefore, the fact that they gave it a chance at all is considered a commendable result!
The resistance is also coming from a financial standpoint. UW Dentistry has an incredibly good deal with their current toothbrush price. They spend 0.18 for a toothbrush and a toothpaste. This number is incredibly and almost impossible to beat.
However, thanks to CEP and the CSF all of the reasons for resistance could be overcome because UW Dentistry could not say no to this project being free for them because of the grant money. That was a key factor in determining this pilot project to get the green light.
Next steps
My next steps for this project are to actually make the order for the toothbrushes. It is complicated because the CSF requires UW Dentistry to order them with a budget number.
Also, I will have to determine the measures for success. UW Dentistry has a wide array of products that they can choose from to give to a patient after their appointment. The next step will be to determine what factors and qualities a patient will have in order for the dentist to choose to give them the bamboo toothbrush.
Lastly, I will have to write a comprehensive plan for this project to have follow up in the future. This will be given to the UW Club “Eco-Reps”. Eco-Reps is a club on campus dedicated to implementing sustainability projects. Therefore, I can write a plan for them to continue this project forward and do an update on how it is going from the UW Dentistry side.
Also, it would be great to somehow expand this project to other dental offices! But that would have to be on my own free time.
Analysis -
This project was such a roller coaster! However, I think it did work! At the very least the impact of my project creates “awareness” of a new product that replaces a wasteful yet necessary one. At the most, it will inspire UW Dentists to handout bamboo toothbrushes at their own practices once they graduate! I do not think that UW Dentistry will choose to pay for more bamboo toothbrushes once these ones run out, as the price is not in their favor. However, even just saying yes to my pilot program will get roughly 2,000 toothbrushes into the hands of Seattle citizens!
Reflection Learning
I learned so much through this project! I learned about the science behind what I am advocating for. I also learned about about the challenges of communicating my ideas to people that are not already sustainability oriented. I learned the ups and downs and the barriers to corporate level bureaucratic change. I learned that there are power plays in the hierarchy of institutions.
Project Title: Sustainability in UW Dentistry: Introducing Bamboo Toothbrushes
Abstract
Every year in the United States, 50 million pounds of plastic toothbrushes are sent to landfills. This project aims to change that by convincing the American public to switch to compostable bamboo toothbrushes. To do this, I created a pilot program for the University of Washington School of Dentistry faculty and students to receive informed feedback. Funded by the UW Campus Sustainability Fund and the Community Support Grant through the Community, Environment and Planning major, the project produced 150 complete “green” goodie bags with compostable floss, biodegradable toothpaste, and a compostable bamboo toothbrush packaged in a compostable bag with a survey. The survey’s purpose is to assess the user experience of UW Dentistry faculty and students. The initial results of the study show barriers to adapting to “green” dental products, specifically bamboo toothbrushes. This was particularly acute among respondents, who expressed hesitation towards the green dental products. This study demonstrates that attempts to make dental care more sustainable will face challenges, including technological, regulatory, economic, and cultural barriers to change.
Literature Review
Since the 1950s, businesses have been adopting Corporate Social Responsibility practices into their corporate business models (Carroll). Corporate Social Responsibility is defined as “business firms contributing in a positive way to society by going beyond a narrow focus on profit maximization. This may include charitable giving, investing in green solutions, employing progressive human resource practices, and engaging in community development” (McWilliams). Through examining different business models and the value for businesses to care about ethics and sustainability, Carroll, the author of Corporate Social Responsibility: Evolution of a Definitional Construct, has done research that shows that in the long run it is worth the money and effort to make these changes (Carroll). This literature review will provide the framework, theories and reasoning for why corporate social responsibility, intentionally and ethical practices are always worth the cost, time and effort. I have divided my literature review into 3 topics: the environmental benefits of bamboo products, corporate social responsibility and green dentistry. My senior project is the communication, inspiration and implementation of getting UW Dentistry to incorporate bamboo toothbrushes as an option to handout to their patients. These topics can be utilised to measure and provide the foundation for the success of this project.
Why Bamboo is Better than Plastic
In order to communicate the importance of this issue from an environmental perspective, I need to be able to explain the environmental benefits of using bamboo over plastic to UW Dentistry. In terms of environmental sustainability, one of the leading bamboo toothbrush companies, “Brush with Bamboo”, explains that “Bamboo is the fastest growing plant on earth. Because it contains naturally-occurring antimicrobial agents, there is no need for using fertilizers or pesticides during its cultivation. Our bamboo is totally organic and wild. After we harvest a bamboo stalk to use it for toothbrushes, another stalk takes its place and grows to full size within just 2 years — a remarkable growth rate!” (Brush with Bamboo). This is important because if UW dentistry makes the switch, they will not be responsible for any of the detrimental effects that plastic toothbrushes have on the environment, and they will be able to be proud that they are supporting one of the most sustainable plants on earth! I am working to get more information from the specific bamboo toothbrush company that I am working with for my project, SenzaBamboo. I have plans to interview the founder about the sustainable farming practices he uses.
In terms of plastic, “Over 4.7 billion plastic toothbrushes that will never biodegrade are dumped in landfills and oceans every year worldwide.” (Ecoplanetbamboo) Plastic toothbrushes have plastic and rubber in the handle, nylon in the bristles, and plastic in the packaging. Since none of these materials can biodegrade safely in the environment, they are sent to landfills, and remain there for an undetermined amount of time. Often, if they don’t make it to the landfill, much plastic ends up in our oceans, and therefore consumed by wildlife. If the plastic is burnt, this process releases a combination of toxic and greenhouse gases (Ecoplanetbamboo). Essentially, there is no safe way to dispose of plastic, which is why businesses should be leading the way to support environmentally friendly alternatives. I will address more later on why businesses are responsible for making these changes, rather than citizens or the government.
According to the associate Dean of Clinics of UW School of Dentistry, Dr. Schwedhelm, UW Dentistry hands out approximately 2800 toothbrushes per year. At each toothbrush weighing 2 oz this adds up to be 525 pounds of plastic toothbrushes that UW Dentistry is responsible for every year. It is estimated that 50 million pounds of toothbrushes are sent to landfills each year, just in the USA! (West). It’s easy to see how we can take this number further and multiply it by cities and countries. We then can see how much of a negative impact handing out plastic toothbrushes is creating, and how easily it can be replaced with creating a positive impact by handing out bamboo ones.
In addition to the fact that plastic does not break down in the environment, the process of manufacturing plastics is detrimental as well. “Production of plastics is a major user of fossil fuels. Eight percent of world oil production goes to manufacturing plastics.” While toothbrushes would end up being a very small percentage of the plastic produced, it should still be the responsibility of the dentists to not support the production of unnecessary plastic, especially when there are already environmentally friendly alternatives. Making plastic causes many chemicals to be leached into the air, soil and water. “The Oakland Recycling Association commissioned an analysis of the toxic chemical burden that relied heavily on information from EPA data, especially the Toxics Release Inventory...the information available showed that most toxic releases went into the air, and the plastics industry contributed 14% of the national total” (Ecology Center). Toothbrushes that are made out of plastic containing phthalates. A study done by Sadeghi et al, aimed
to determine the Dioctyl phthalate (DEHP) concentration of PVC plastic parts of toothbrushes. The result showed that the phthalate concentration of a Reach adult’s toothbrush and a Equate kid’s toothbrush were 1.97 ppm and 0.56 ppm respectively. Therefore, this study found that considerable concentrations of phthalates were also present in toothbrushes, which, due to consumers’ daily exposure, would certainly have negative effects on users’ health in the long term (Sadeghi et al).
Since toothbrushes are made of plastic that is strong and durable, they are considered to be made of PBT plastic. The EPA explains that “Persistent, bioaccumulative and toxic (PBTs) chemicals or substances pose a risk to the marine environment because they resist degradation, persisting for years or even decades. PBTs are toxic to humans and marine organisms and have been shown to accumulate at various trophic levels through the food chain.”
Based on this information, plastic is not the right choice of material for most toothbrushes. The American Dental Association (ADA) recommends that consumers “replace toothbrushes approximately every 3–4 months or sooner if the bristles become frayed with use” (ADA). Since the ADA recommends that toothbrushes are disposed of so often, plastic is too strong and durable for an item that cannot be broken down naturally in our environment. While a non-disposable toothbrush might be the best choice resource wise and environmentally, it is not a financially viable option for dentists to handout to patients for free.
Corporate Social Responsibility
Businesses with a socially responsible mission have just recently been on the public's radar (Carroll). For example, companies such as TOMS and Warby Parker have implemented a 1 for 1 business model, where for every purchase made, one is donated to someone in need. Patagonia, an outdoor clothing company, has a mission statement that claims to: “Build the best product, cause no unnecessary harm, use business to inspire and implement solutions to the environmental crisis” (Patagonia). However, it hasn’t been easy to get businesses on board with the idea of being socially responsible. According to Bocken, the author of A Literature and Practice Review to Develop Sustainable Business Model Archetypes, a fundamental shift is required for holistic changes in the social corporate responsibility world (Bocken et al). Businesses and people must start to value long term use of products as well as quality and innovation in the realm of materials that are earth friendly. “A sustainable economy strives to encourage minimising consumption” (Bocken et al). We should be striving for systems that emphasize positive environmental impact and minimize unnecessary waste. Systems such as these save and protect our wildlife, our environment and our children. By making the effort to minimize our negative impact on the environment, as we go about our daily lives, we create an easier life for future generations as we will have saved them the despair and detriment if we avoid harmful practices. A closed loop economy or system is one that recycles, reuses, repairs or repurposes every item or material, letting nothing go to waste or landfills. Helping businesses to enter this closed loop economy will inspire them to be innovative in the products they produce and choose to supply (Bocken, N. M. P., et al).
In order to approach consumers in a way that will have them be excited about sustainable business and products, it will be beneficial to assess and acknowledge consumers’ values and attitudes. According to Triandis (1993), the contributing author of article, Individualism and Collectivism, individualism and collectivism are the two main values that influence consumer behavior. He says that the more someone values individualism the less likely they are to value eco-friendliness as they have more of a need to be unique, which would inspire more unnecessary purchases. In contrast, he claims that the more they value collectivism, the more likely they are to view their purchases as a holistic process that affects more than just themselves.
In terms of values, convenience and importance are the two most common studied, according to Laroche, a contributing author of “Targeting Consumers Who Are Willing To Pay More For Environmentally Friendly Products". He claims that “Importance is simply whether consumers view environmentally compatible behaviors as important to themselves or society as a whole.” (Laroche et. al). This plays a role in everyone’s daily lives as they make the decision (if they even have one) to purchase the “better” product. “Inconvenience refers to how inconvenient it is perceived for the individual to behave in an ecologically favorable fashion.” (Laroche et. al) This plays a major role in people's actions towards the environment. Even if people decide that choosing the more environmentally friendly option is important, it’s not fair to expect everyone to dedicate their lives and passions towards environmental issues. Therefore, it is the job of environmentalists in business to make acting sustainably easy and convenient. Convenience plays a major role into the bamboo toothbrush project as well. Bamboo toothbrushes are toothbrushes with a completely biodegradable/compostable handle made out of bamboo. Most people in the USA are familiar with the concept of leaving their dentist appointment with a goodie bag containing a plastic toothbrush, a plastic container of floss and a plastic container of toothpaste. It is responsible for the dentist to provide patients with these items, as they are then expected to use them to keep good dental health until the next visit to the dentist. However, these items are only responsible for the health of the dentist patients, and are not responsible in the environmental realm. While the bristles of bamboo toothbrushes are still nylon (plastic), replacing the plastic handle toothbrushes with bamboo toothbrushes will divert at least the waste of the handle. Therefore, having a more sustainable option come to you for free, through the dentist, takes the pressure off the consumer to make the “right” choice at the drugstore.
In order to implement a more sustainable option for the long run, companies must value sustainability, even if that means it’s a little more expensive. Lüdeke-Freund (2010) describes a sustainable business model as “a business model that creates competitive advantage through superior customer value and contributes to a sustainable development of the company and society”. The ideal sustainable business model preserves the environment while also improving the quality of people's lives.
Eco-Friendly Dentistry
“Green dentistry" is a practice of dentistry using technologies and materials that promote and protect the planet. It is a thought process, an attitude, and a guide for making earth friendly choices in dental practice” (Rupa 2015). There are many progressive and innovative choices that dentists can make to promote sustainable alternatives to what they are already using. Some dentist related companies are already proving that they value sustainability. SmartPractice is an online wholesale distributor that supplies items for companies that take care of people and pets. In January of 2016 they decided to start offering bamboo toothbrushes that can be ordered for dentist offices. “According to SmartPractice’s dental marketing specialist, Stacey Gowdy, “SmartPractice is devoted to bringing our dental customers products like WooBamboo Toothbrushes because they’re highly effective: for patients, for the environment, and for dental offices’ bottom [lines].” This is an important step toward sustainability in dentistry because it promotes dentist offices that order from this website to order bamboo toothbrushes. It does this by giving access to bamboo toothbrushes easily. So far, they are a bit hard to find. It is important for distribution sites such as these to normalize access to bamboo toothbrushes so that dentists will be aware and consider buying them. In the supply chain, the supplier offering them to dentist offices is one step above dentist offices offering them to patients. This is impressive for the sake of consistent values and normalizing sustainability on all ends of the spectrum.
At Ivy Dental in Charlottesville, VA, “Dr. Harding has made the commitment to be as environmentally friendly as possible in office selecting her equipment and practices for day-to-day patient care. Medical and Dental facilities can produce a large amount of waste and use a lot of energy and water in one day. Our goal at Ivy Dental is to recycle the waste we produce, reduce the energy and water spent running the dental equipment, and reuse as many products as possible through careful steam sterilization techniques” (Ivy Dental). Dr. Harding offers bamboo toothbrushes for purchase on the way out, as well as to collect the old plastic ones to recycle them for patients. “At Ivy Dental we are collecting your used plastic toothbrushes and will deliver them to the #5 collection at our local Whole Foods. At your next dentist appointment forego the plastic and pick up a bamboo toothbrush knowing you’re making a small choice that leads to a bigger impact” (Ivy Dental).
Dentistryiq.com, a website that provides resources for dental professionals, has a section dedicated to Eco-Friendly Dentistry. They define it as:
Eco-Friendly Dentistry is a newly evolving practice of dentistry, which encompasses a simultaneous devotion to sustainability, prevention, precaution, and a minimally invasive patient-centric as well as global-centric treatment philosophy.
Eco-Friendly Dentistry, through green design and operations, protects the immediate health of patients and team members, the health of the surrounding community, and the health of the global community and natural resources.
This definition fully supports the idea of the switch from handing out plastic toothbrushes to bamboo ones.
Another website, ecodentistry.org, which is dedicated to Green & Sustainable Dentistry Practices for Dental Professionals, Patients & Industry, addresses this issue as well. Under the section “Why Reduce Waste?” they remind us that “If we don’t create trash, it doesn’t have to be sent away somewhere. Packaging accounts for 33% of garbage. Many manufacturers are cutting down on the amount of packaging for their products, or making more of the packaging reusable or recyclable. Many high-tech innovations in dentistry help reduce waste, like oral cancer diagnostics that create less waste than oral cancer rinse screenings” (EcoDentistry.org). They also have an extensive list of resources for where and how to buy eco friendly products, however bamboo toothbrushes are not yet on that list nor do they offer a sustainable toothbrush alternative! Damle from the “Contemporary Clinical Dentistry” sums up the importance of this issue by saying “The key concepts of a green dental practice include conservation of water and energy, use of nontoxic products, reduction of waste, and elimination of hazardous toxins that negatively affect patients and the environment and promote ‘Green’ products.” Again, bamboo toothbrushes that are sustainable to make, and biodegrade fall perfectly under this description!
Other than these mentions from websites, I can not find any written proof that any dentist offices are explicitly handing out bamboo toothbrushes to their patients for free in their take home goodie bags. I have also asked many individuals if their dentists hand out toothbrushes, as well as searched extensively for dentist offices that hand them out. I did recently come across a dentist office in Vancouver BC that recently made the switch and have reached out to them for more information about what inspired the switch.
In conclusion, businesses should be held accountable for prioritizing an environmentally sustainable business model. According to a survey where I asked “When supporting a business does sustainability matter to you?” 89% of respondents said “yes.” This survey result suggests that people are moving towards a trend that prefers sustainable businesses. Another important aspect of corporate social responsibility is giving back to the community. Senzabamboo, the toothbrush company I am working with for my project donates 3% of their profits to a local women's shelter, Mary’s Place. Companies that take care of more than just themselves tend to attract more people that are starting to value businesses with a social mission. A study done by Mohr and Webb, the authors of “The effects of corporate social responsibility and price on consumer responses” concluded that “Results from a national sample of adults indicate that corporate social responsibility in both domains had a positive impact on evaluation of the company and purchase intent. Furthermore, in the environmental domain corporate social responsibility affected purchase intent more strongly than price did” (Mohr et al). Changes such as these can lead to customer loyalty and long-run success in the future. Green dentistry, while a relatively new trend, is picking up speed as more and more technology is released that support sustainable practices. Dentists will also be keen to follow the trend of corporate social responsibility since essentially they are a business as well. The more research that is released about natural products and practices, the more families will want to find healthcare that is better for their bodies, and the environment. It’s also clear now that supporting bamboo eliminates the toxins, waste and pollution that plastic creates. Bamboo is all natural to produce and will biodegrade. Effectively combining corporate social responsibility, with green dental practices that support getting bamboo toothbrushes into patients hands will create a better world for our bodies and the environment. Based on the current information that researchers have done already about the positive factors of socially responsible businesses, green dentistry and the benefits of bamboo over plastic, this literature review shows the benefits for UW Dentistry to switch from plastic to bamboo toothbrushes.
Sources:
Carroll, Archie B. “Corporate Social Responsibility: Evolution of a Definitional Construct.” Www.academia.edu, BUSINESS & SOCIETY, Vol. 38 No. 3, Sept. 1999, www.academia.edu/419517/Corporate_Social_Responsibility_Evolution_of_a_Definitional_Construct.
McWilliams, A. 2015. Corporate Social Responsibility. Wiley Encyclopedia of Management. 12:1–4.
http://www.patagonia.com/company-info.html
Triandis, H. (1995). Individualism & collectivism (New directions in social psychology). Boulder: Westview Press.
Quora, and Ayesha Barenblat. “Fast Fashion Is A Disaster For Women And The Environment.” Www.forbes.com, www.forbes.com/sites/quora/2017/07/26/fast-fashion-is-a-disaster-for-women-and-the-environment/#15c11cd61fa4.
West, Larry. “Can You Recycle Your Toothbrush?” Www.thoughtco.com, www.thoughtco.com/can-you-recycle-your-toothbrush-1203671.
Rupa K R, Laxmikanth Chatra, Prashanth Shenai, Veena K M, Prasanna Kumar Rao, & Rachana Prabhu. (2015). Taking a step towards greener future: A practical guideline for eco-friendly dentistry. Arsiv Kaynak Tarama Dergisi,24(1), 135-148.
“ Eco-Friendly WooBamboo Toothbrushes available through SmartPractice.” Edited by DentistryIQ Editors, Http://Www.dentistryiq.com, 8 Jan. 2016, www.dentistryiq.com/articles/2016/01/eco-friendly-woobamboo-toothbrushes-available-through-smartpractice.html.
Bocken, N. M. P., et al. "A literature and practice review to develop sustainable business model archetypes." Journal of cleaner production 65 (2014): 42-56.
Michel Laroche, Jasmin Bergeron, Guido Barbaro‐Forleo, (2001) "Targeting consumers who are willing to pay more for environmentally friendly products", Journal of Consumer Marketing, Vol. 18 Issue: 6, pp.503-520, https://doi.org/10.1108/EUM0000000006155
“Our Story.” Brush with bamboo, www.brushwithbamboo.com.
“The Environmental Impact of Toothbrushes.” Http://www.ecoplanetbamboo.com, 3 Aug. 2015, www.ecoplanetbamboo.com/news/the-environmental-impact-of-toothbrushes.
“Eco Friendly Dentistry.” Charlottesvilleivydentist.com, charlottesvilleivydentist.com/eco-friendly-dentistry/.
Practitioner Steven Koos, DDS, MD. “Eco-Friendly Dentistry.” Http://Www.dentistryiq.com/, Chicagohealers.com, www.dentistryiq.com/articles/2010/01/eco-friendly-dentistry.html.
“Why Reduce Waste.” Ecodentistry.org, Eco Dentistry Association, ecodentistry.org/green-dentistry/what-is-green-dentistry/reduce-waste/.
Damle, S. G. “Eco-Friendly Green Dentistry: The Future of Dentistry?” Contemporary Clinical Dentistry 7.4 (2016): 423–425. PMC. Web. 31 Jan. 2018.
Carol Tekavec RDH. “How Many Patients Should The Hygienist See?” Www.mckenziemgmt.com, www.mckenziemgmt.com/managementtips/print/carol/PrintCarolArticle462.html.
“PTF: ENVIRONMENTAL IMPACTS.” Ecologycenter.org, ecologycenter.org/plastics/ptf/report3/.
Esmaeili A, Pourbabaee AA, Alikhani HA, Shabani F, Esmaeili E (2013) Biodegradation of Low-Density Polyethylene (LDPE) by Mixed Culture of Lysinibacillus xylanilyticus and Aspergillus niger in Soil. PLoS ONE 8(9): e71720. https://doi.org/10.1371/journal.pone.0071720
Sadeghi, Ghazal; Ghaderian, Elham; and O'Connor, Anne. "Determination of Dioctyl phthalate (DEHP) concentration in polyvinyl chloride (PVC) plastic parts of toothbrushes." The Downtown Review. Vol. 1. Iss. 2 (2015).
Mohr, L. and Webb, D. (2005), The effects of corporate social responsibility and price on consumer responses. Journal of Consumer Affairs, 39: 121–147. doi:10.1111/j.1745-6606.2005.00006.x
Methods - how did you do what you did//why you did it that way?
My methodology for the success of this project includes: surveys to gauge interest in bamboo toothbrushes from the general public; technical toothbrush research, coalition, collaboration, communication, negotiation, identifying proper and appropriate criteria for choosing the right bamboo toothbrush company; Case Studies with UW Dentistry and bamboo toothbrush company, Senzabamboo; and Creating a pilot study/program to test the usability and create proof of concept. In order to test usability, I handed out green goodie bags, containing a bamboo toothbrush to UW Dentistry Faculty and Students, to gain informed feedback. This was funded by the Campus Sustainability Fund as well as the Community Support Grant through CEP. I created a user feedback survey and used this feedback to change the design of the bamboo toothbrush to meet the standards of the UW Dentists. After getting the “ultra soft” bristle toothbrush approved, I proposed that UW Dentistry includes bamboo toothbrushes as an option to handout to their patients. I used the rest of the grant money to pay for the first batch of toothbrushes.
My initial survey for this project asked three questions:
- If you were given a free bamboo toothbrush from your dentist, would you use it?
- Out of 180 responses, 91.67% of them chose “Yes”
- 2.22% of people chose “No”
- 6.11% of people chose “other” and specified their responses.
- The “other” responses include: see Appendix
- The “other” responses include: see Appendix
- Out of 180 responses, 91.67% of them chose “Yes”
- When supporting a business does sustainability matter to you?
- Out of 180 responses 89.44% of people chose “Yes! - Keep up the great work!”
- 10% of people chose “I am indifferent”
- 0.56% of people chose “No”
- Out of 180 responses 89.44% of people chose “Yes! - Keep up the great work!”
I considered this question to be defective because I sent this survey to many people that do not live in Seattle, therefore the answers are skewed.
I started my project winter quarter, late, because I was studying abroad fall quarter and I let that be a excuse for not doing anything for my senior project. The first thing I did when I got back was apply to the Campus Sustainability Fund, knowing that this project was doomed if it wasn’t initially “free”. I was awarded $900 in grant money to buy bamboo toothbrushes to give to UW Dentistry for them to hand out to patients. I was awarded this money based on the stipulation from the CSF people that there would be a permanent change funded by UW Dentistry once the supplies from the grant money ran out. This worried me because I was not entirely sure I would be able to convince UW Dentistry to pay for the toothbrushes themselves. At this time, UW Dentistry/UW Medicine is receiving a lot of backlash in the newspapers because they are in a lot of debt. I also decided to apply to the CSG grant from CEP, thinking that the more money I could receive for the project, the better. I was eventually also awarded $500 from the CSG grant too.
During this time, I also started my research on the best toothbrush companies. I chose the company "SenzaBamboo" because they are local to Seattle, and they donate 3% of their profits to Mary's Place, a women's shelter in downtown Seattle.
The beginning of winter quarter, I also joined the campus club “Eco-Reps”. I joined this club because their sole mission is for students to run sustainability projects on campus. Therefore, they were the perfect club to give me legitimacy and support. With the help of them, I planned my first meeting with UW Dentistry.
I had no idea how to meet with someone from UW Dentistry about my project. I started by going to the UW Dentistry bio page. There, I found staff with any relevant words in their bio to my project. I emailed 3-4 people saying that I had an idea for a sustainability project and could they please connect me with the right person to talk to. Eventually I was directed to the Associate Dean of Clinics, Dr. Schwedhelm. He agreed to meet with me about my project.
When I met with him I brought a project proposal that also included my survey results. (Appendix A). I felt that I was very lucky because during my attempts to explain to him the importance of compostability, he began to tell me about all of the efforts he makes at home to live sustainably. He understood my environmental mission! He was also very efficient with trying to answer my questions. For example, when I asked him how much they currently pay for their the toothbrushes they hand out to patients, in the middle of our meeting he called and emailed multiple people to try to find out the answer. Here lies my first mistake, I truly believed this man was invested in my project! Because of his personal interest in sustainability and his efforts to answer my questions efficiently, I felt confident that I had (with luck) been connected with the perfect person that would make my project a success.
At this point, my projects plan was to hand out bamboo toothbrushes to patients. Dr. S and I agreed that this could be a 10 week pilot program paired with Profi Clinic. Profi Clinic is where 2nd year dentistry students give cleanings to the public. The plan was that these patients would receive the bamboo toothbrushes.
After this meeting, I decided to move forward with the bamboo toothbrush company called “Senzacare”. I chose them out of all the others on the market because they are the cheapest, are local, and donate 3% of their profits to Mary’s Place, a women’s shelter in Seattle.
Once I realized that I had enough grant money, I had the idea to introduce the bamboo toothbrushes in the form of completely green goodie bags. This is when I decided to pursue getting floss samples, toothpaste and compostable goodie bags as well.
I found the company called “Uncle Harry’s” that donated 250 free samples to my goodie bag project. Their toothpaste is all natural and comes in a glass jar.
I also found a company called “Clear bags” who make commercially compostable bags.
Once all of the items arrived, I hosted a community volunteer event to assemble 250 goodie bags. About 10 people showed up which ended up being the perfect amount of people for the time slot I had allowed. All 250 were assembled! This event was a really key and crucial part of my project. It was a chance to engage and interact with my peers about a topic that is so important to me.
During this time I was also working on having an article written about my project in the UW Daily.
The week before my goodie bag assembly party was when my project took a major turn. Dr. S who has originally approved everything, including that these goodie bags would go to patients of UW Dentistry, told me that I should be in contact with Dr. Daubert.
I met with Dr. Daubert 4 days before the goodie bag assembly party, and 5 days before the goodie bags were planned on being handed out. It was during that meeting that I realized she was supposed to be the person I should have been in contact with this whole time. I had no idea. It was clear that she did not know much about my project at all, even though it was supposed to launch in 5 days. I tried to update her as kindly and sensitively as possible, so that she did not feel attacked or taken advantage of.
I left her office feeling very confused and discouraged. She had told me that since she knows this is my capstone project and I need to graduate, that she would be willing to work with me. That left me feeling at her mercy and her having all the power.
I continued on planning my volunteer event. It was stressful to get everything for it organized in time but it turned out great in the end! The day after the event was the day the UW Daily article was published. That was also the day that Dr. Daubert said I could not hand the goodie bags out to UW Dentistry patients. I was devastated. She told me instead that I could hand them out to UW Faculty and Students to get their feedback instead. I quickly rewrote my survey to tailor it to the educational aspect of sustainability in the UW Dentistry.
I was sure that she has absolutely ruined my project. However, I think it turned out to be a blessing in disguise.
I reframed my project as introducing bamboo toothbrushes to UW Dentistry from an educational standpoint, and as a change from the inside out. I realized that it was better to get legitimate feedback from professionals and future professionals in the field.
In order to introduce the goodie bags to UW Dentistry. I did 2 class presentations and 1 presentation to a faculty meetings. At those presentations I told them about my project, mission and the minimal environmental impact of each of the items in the goodie bag. After that, I told them to please fill out the survey.
When it came to survey results time, I had assumed that everyone would give me really positive feedback, and that I could use that feedback to vouch for toothbrushes for UW Dentistry patients, I was wrong again! The feedback was not in my favor. The concerns of UW Dentistry were about cost and bristle quality. In every one of the presentations I did, there was at least one person who was really eager and excited about my project and sustainability. However, in general I was getting a lot of resistance.
I used the feedback results to again frame my project in a way that shows that there is a lot of resistance to new products in the dentistry field and that bamboo toothbrushes are a really great and concrete way to introduce this idea.
Eventually Dr. Daubert and I decided that we can order a large batch of the bamboo toothbrushes with the “ultra soft” bristles that can be handed out to patients!
Results - description of what happened or the data you have collected and the analysis Implications
I have many versions of results for this project. Each phase of the project has its own results! However, to synthesize the main results, I would categorize them into the two main phases. The first phase was the educational component of the introduction of the bamboo toothbrushes through green goodie bags. The second being the decision to spend the rest of the grant money on ultra soft toothbrushes for UW Dentistry patients.
The findings of my survey that was sent out to UW Dentistry faculty and students imply that there is a lot of resistance to change at UW Dentistry. They take patient safety into consideration much more than I could have ever predicted.
The resistance of this project from the UW Dentistry side was to be expected. Any big level or corporate level change will be met with resistance. Therefore, the fact that they gave it a chance at all is considered a commendable result!
The resistance is also coming from a financial standpoint. UW Dentistry has an incredibly good deal with their current toothbrush price. They spend 0.18 for a toothbrush and a toothpaste. This number is incredibly and almost impossible to beat.
However, thanks to CEP and the CSF all of the reasons for resistance could be overcome because UW Dentistry could not say no to this project being free for them because of the grant money. That was a key factor in determining this pilot project to get the green light.
Next steps
My next steps for this project are to actually make the order for the toothbrushes. It is complicated because the CSF requires UW Dentistry to order them with a budget number.
Also, I will have to determine the measures for success. UW Dentistry has a wide array of products that they can choose from to give to a patient after their appointment. The next step will be to determine what factors and qualities a patient will have in order for the dentist to choose to give them the bamboo toothbrush.
Lastly, I will have to write a comprehensive plan for this project to have follow up in the future. This will be given to the UW Club “Eco-Reps”. Eco-Reps is a club on campus dedicated to implementing sustainability projects. Therefore, I can write a plan for them to continue this project forward and do an update on how it is going from the UW Dentistry side.
Also, it would be great to somehow expand this project to other dental offices! But that would have to be on my own free time.
Analysis -
This project was such a roller coaster! However, I think it did work! At the very least the impact of my project creates “awareness” of a new product that replaces a wasteful yet necessary one. At the most, it will inspire UW Dentists to handout bamboo toothbrushes at their own practices once they graduate! I do not think that UW Dentistry will choose to pay for more bamboo toothbrushes once these ones run out, as the price is not in their favor. However, even just saying yes to my pilot program will get roughly 2,000 toothbrushes into the hands of Seattle citizens!
Reflection Learning
I learned so much through this project! I learned about the science behind what I am advocating for. I also learned about about the challenges of communicating my ideas to people that are not already sustainability oriented. I learned the ups and downs and the barriers to corporate level bureaucratic change. I learned that there are power plays in the hierarchy of institutions.