A cross-sectional survey was conducted to determine the awareness of eco-friendly dentistry among 160 participants of King Khalid University, Saudi Arabia, consisting of 100 doctors, 50 students, and 10 dental auxiliaries. The sample size was determined based on the results of a previous study using proportion sampling technique [5]. Informed consent was obtained from all participants. Ethical clearance was obtained for Institutional Review Board. An 18 item closed-ended questionnaire (in English language) was designed and was checked for content and construct validity. The questionnaire was assessed for face and content validity. It was pilot tested on 20 participants and was evaluated for the uniformity of interpretation. Reliability for internal consistency of the questionnaire was checked with Cronbach’s alpha (0.80 - 1.00) during the pilot study. The survey consisted of two parts, the Pre-Education Survey, and the Post-Education Survey. The 2^nd set of survey was post-presentation in which the participants had to answer the same round of questions after going through a presentation on eco-friendly dentistry, which included practice of dentistry with minimal wastage, maximum recycle and more energy efficient resources. Statistical analysis was done using Wilcoxon’s matched paired test and one-way ANOVA. Data was analysed using Statistical Package for Social Sciences (SPSS) Inc. version 20 Chicago, USA (IBM Statistics Inc., Chicago, USA).

The survey was conducted among 160 participants of which 78.75% were males. The response rate was 100%. [Table/Fig-1] shows the distribution of male and female respondents by specialty and position. Comparison of knowledge before and after lectures in each question was analysed using Wilcoxon signed rank test. There was statistically significant increase found in the number of correct responses to all questions after the lecture [Table/Fig-2]. Comparison of gain in knowledge with respect to specialties after the lecture was determined using one-way ANOVA, and it was observed that there was a statistically significant increase in the knowledge regarding eco-friendly dentistry after the lecture. The gain was highest for Department of Preventive Dental Sciences (PDS) followed by Substitute Dental Sciences (SDS), No specialty, Maxillofacial Dental Sciences (MDS), and Restorative Dental Sciences (RDS) respectively [Table/Fig-3]. Comparison of gain in knowledge with respect to positions after lecture using one-way ANOVA shows that there was a statistically significant gain in knowledge among the participants. The gain was highest for General practitioners followed by Assistant Professor, Demonstrator and Lecturer, Associate Professor and Professor, student and auxiliary respectively [Table/Fig-4].

The response rate of the participants in this study was found to be good due to a direct contact with the respondents. The present study revealed several lacunae in the knowledge regarding eco-friendly dental practices among the study population which is in contrast to the findings of Al Shatrat et al., who found a high level of awareness among private practitioners in Jordan about eco-friendly dental practices for amalgam management, radiographs, waste paper management, infection control, energy and water conservation [5].

Continuing dental education is an important part of any dental health professional’s life. There was statistically significant difference seen in the change in knowledge of the respondents after the presentation thereby emphasizing the effect of continuing dental education for dental health professionals. Continuing dental education programs can improve professional practice and health care outcomes for the patients [6].

Eco-friendly/green dental practices are the need of the hour to reduce their effects on the environment. Implementation of new strategies to try and reduce the waste generated by the dental profession in a feasible and sustainable way is the rationale behind green dentistry. There are many rational, practical and easy substitutes which have the potential to reduce the environmental hazard of a dental office if it was to follow the ‘green’ commendations. It is the moral responsibility of dental professionals to take the lead in society and implement ‘green’ initiatives to lessen their impact on the environment [4,7,8].

The major barrier to the implementation of an eco-friendly dental practice is the economic consideration. A financial return from changes implemented may not be achieved for years. The initial cost and expenses are limiting factors of implementing an eco-friendly dental practice [5,9,10]. However, this should not deter us from adopting eco-friendly practices as every person holds the responsibility of working towards a safer and cleaner environment for the future generations.

Dental professionals share global responsibility for elimination or reduction of toxic wastes that could harm human health and the environment. Amalgam restoration materials, plastic covers, radiographic chemicals, lead foils and disinfectant solutions are waste materials from dental settings that eventually end-up in landfills and water supplies. Using eco-friendly strategies in dental offices can improve public health through minimizing waste and hence reducing pollution [4,9–12].

Dental health professionals can be on the forefront of change and help in saving our planet from the catastrophic effects of environmental changes adopting and advocating the four ‘R’s— Rethink, Reduce, Reuse, Recycle. It is common place to perceive recycling as the first step but the reduction in waste production and rethinking and reusing our things are much more effective. The key to reducing our waste is to extend the life of things we use. Moreover, by implementing these four easy steps, dentistry and dental hygienists can transform the dental health profession into a greener and cleaner one [4,9,13].

There are innumerable ways to introduce eco-friendly dental practices: 1) Introduce digital X-rays that will help in reduction of radiation and use of chemicals; 2) Low energy bulbs and motion sensors can be introduced to reduce electricity usage; 3) Reduce water wastage; 4) Using amalgam separators on chairs and sinks can reduce amalgam pollution; 5) Reduce paper usage and recycle wherever possible. Investing in energy efficient equipment can significantly help [10–13].

The sample size for the present study was determined based on a previous study which may have led to bias. The study examined the role of dentists but the role of dental hygienists and dental assistants in the implementation of eco-friendly dental strategies may also be important and the dental auxiliaries may have been inappropriately represented in the present study. The lack of literature on a similar topic limits our discussion to the viewpoint of the authors. Hence, further researches are recommended in this area among the dental fraternity all over the world. It is imperative that the dental fraternity contributes to the preservation of the environment through green practices. The practice of green dentistry has to be incorporated in the dental curriculum to make a difference.

Lack of knowledge of green dentistry amongst the dental frater-nity is highly prevailing. The same can be substantiated with effective training in the respective field, if channelized through the curriculum. The said proposal forms the need of an hour and can be designated as an essential para-dental platform that needs further exploration for evident dental literature. The present study shows the importance of eco-friendly dentistry among the dental profession. It should be highly emphasized in the dentistry program throughout the dental schools.