Microplastics are all around us. In 2022, researchers found the first evidence of microplastics being in human blood – identified in 77 per cent of study participants.
Dental professionals need to review the impact of microplastics on general and oral health and identify ways in which they can reduce the presence of microplastics in the environment around us. Within all healthcare, the most fundamental principle is: “First, do no harm.” Once dental professionals understand the risks microplastics present, they should take action to minimise their presence at all costs.
Larger impacts
Defined as plastic particles that are <5mm in length – though this is not universally agreed upon – microplastics may be produced at this size or could be fragmented debris from larger plastic items. It’s estimated that an individual consumes, on average, 0.1-5g of microplastics every week, through inhalation, ingestion, and dermal contact. Considering the first case of microplastics in the bloodstream was discovered just under three years ago, research into the effect on general and oral health is somewhat limited – with time, this will grow, and current findings are still impactful.
It is known that microplastics may cause changes to the digestive, respiratory, endocrine, reproductive, and immune systems. In vitro testing has found that microplastics in the human colonic microbiota affected the microbial communities present, reducing the levels of several groups that are essential for compositional stability. An increase of pro-inflammatory and disease-related bacterial groups was observed, which could alter the intestinal homeostasis, and general health.
Microplastic particles in the cardiac structures have been linked with oxidative stress, inflammation, apoptosis, and pyroptosis. The current understanding is that microplastics can translocate to other organs and structures, inducing systemic toxicities.
Dental professionals are no doubt interested in the potential impact of microplastics on the oral cavity. Research is, again, limited, but a 2022 study is noteworthy. It took in vitro gingival fibroblasts and exposed them to sea water specimens which are understood to be heavily polluted by microplastics. These can infect marine wildlife, and make their way into the food chain, where the oral cavity is in direct contact with any contaminants present. The results found that microplastics affected metabolic activity rate, which is potentially related to an increase in cellular oxidative stress, reactive oxygen species accumulation and mitochondrial depolarisation. In all, this suggests that microplastics interfere with the viability of gingival cells. The study also displayed an increase in inflammatory factors, as reported elsewhere in the literature.
Microplastics have a known detrimental effect on the environment around us. They have an ecotoxicological impact on aquatic organisms and can carry other environmental contaminants into soil, which then affects the viability of plants and animals that eat them.
Make your move
Knowing the potential threat to human and environmental health, it is the responsibility of dental professionals to minimise microplastics produced within the field. This takes two steps: identifying and minimising the use of materials which create microplastics, and managing waste in an effective manner to reduce the spread of microplastics to the surrounding world.
It’s no surprise that plastics are almost inevitable in the modern dental workflow. They make up key parts of PPE, toothbrushes and disposable aspirator suction tips, just to name a few sources. Clinicians could choose to invest in autoclavable items that replace single-use, disposable plastic equipment, or encourage patients to switch to bamboo toothbrushes to reduce their creation of plastic waste. Overall this reduces the volume of plastic in circulation, minimising the risk of items reaching water systems and polluting them with microplastic fragments.
Recyclable solutions are also favoured, as laid out in Health Technical Memorandum 07-01, as they minimise the need to create new plastics, in turn reducing the production of microplastics in the future.
Where plastic waste is unavoidable in dentistry, it is essential that clinicians ensure environmentally conscious waste management processes are in place. This can be achieved by working with a specialist waste management service that handles clinical waste safely.
Initial Medical presents a leading specialist team trusted by clinicians to ensure regulatory-complaint and environmentally-friendly disposal of their waste. Clinicians can discover a variety of recyclable waste solutions, including colour-coded clinical waste bags which are made from 30 per cent recycled plastic to actively reduce your potential for plastic pollution. Initial Medical collects your clinical waste and ensures it is treated, incinerated, used in energy-from-waste processes or recycled in line with HTM 07-01 and its principles for best practice management.
Microplastics are a modern inevitability. The dental team should understand what this means for the health of all patients and recognise that with effective action, the impact of the field can be reduced. This takes time, but effective steps can work towards the principle of “First, do no harm.”
References available on request.
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