Toward sustainable orthodontics: Environmental implementation and strategies for eco-friendly treatment

Environmental degradation and climate change have intensified the need for sustainable approaches across all health care disciplines, including orthodontics. Orthodontic practice contributes to environmental burden through biomedical waste generation, plastic pollution, energy consumption, and water usage. This narrative review synthesizes current evidence from published literature and policy documents to evaluate the environmental impact of orthodontics and identify strategies to enhance sustainability. Orthodontic care generates considerable nonbiodegradable waste, particularly from clear aligners, thermoplastic materials, and impression products, with each patient producing more than 50 g of plastic waste over the course of treatment. Additional environmental impact arises from sterilization processes, computer-aided design/computer-aided manufacturing systems, three-dimensional printing, and digital workflows, all of which increase energy consumption and carbon emissions. Routine clinical procedures may consume up to 30 liters of water per visit. Emerging sustainable innovations include the development of biodegradable polymers, recyclable brackets and archwires, bio-based adhesives, eco-friendly 3D printing resins, reusable instruments, and more efficient sterilization protocols. Digitalization, such as intraoral scanning and teleorthodontics, reduces physical material waste and patient travel but introduces concerns related to electronic waste and the energy demands of data storage systems. Improved waste segregation, minimized packaging, environmentally responsible procurement, and green clinic design further contribute to reducing ecological impact. Sustainable orthodontics represents both an ethical responsibility and a professional opportunity, fostering environmental stewardship while strengthening patient trust. Integrating biodegradable materials, circular economy principles, teleorthodontic models, and sustainability education into dental curricula will help align orthodontic practice with broader global sustainability objectives.