4.1 The dental industry's size and scope translate to a significant environmental and social footprint. Moreover, dental professionals and dental service organizations are calling for a consensus-based practical guidance document to support cost-efficient integration of sustainable development principles into their day-to-day management with the goal of achieving carbon neutrality, for example, by reducing CO₂ emissions. Formation of ASTM Subcommittee E60.80.7, and development of this practice recognizes and fulfills this demand.

4.2 To most dentists, it remains unclear what constitutes sustainable dentistry practice in principle. This presents a challenge to incorporating a systematic and pragmatic management framework that identifies, prioritizes, and supports relevant sustainable development issues. Most dental professionals are primarily limited to recognition of environmental impacts or so-called "green practices" or "green dentistry."

4.3 Given management commitment as the first step, this practice describes procedural feasibility of integrating measurable sustainability performance in daily dental service activities. Preferential treatment is not given to claims of "green" practices. Strategic decision-making needs to be a balanced approach that takes into consideration environmental, social, and economic issues. This practice provides a comprehensive guidance on managing sustainability issues and offers a systematic approach and a management framework that assists dental professionals and dental service organizations to improve overall performance and effectiveness in their products and deliveries.

4.4 This practice offers a concerted approach to managing social, economic, and environmental aspects of dental organizations; stipulates minimum sustainability considerations and requirements; and provides a framework to embed management of issues related to sustainable development into day-to-day decision-making and dental service activities. These management considerations include, but are not limited to, water, air quality, energy, waste management, transportation, responsible procurement, supply chain management, and green buildings. Additional considerations include social responsibility related to patient, staff, and the community; governance and leadership; and meetings.

4.5 This practice is intended to be adopted and used by dental professionals and dental service organizations of any size and specializations including those being a part of large healthcare service organizations. Further, in the scope of this practice, expectations are addressed that are relevant to dental service organizations' stakeholders with identification of possible benefits and desirable outcomes of managing for sustainability in dentistry. This approach is to provide a framework for embedding sustainability management in everyday decision-making and is necessarily challenging, provoking, and continually evolving. Effective and continuing stakeholder engagement is essential in sharpening understanding of real issues and broadening buy-in.

4.6 It is recognized that building confidence in processes and sustainable outcomes is an important part of this practice and certain dental service organizations may wish to use some forms of independent verification.

4.7 This practice shall not be viewed in isolation as there are many pertinent helpful texts, conventions, codes, and publications available; it acts as a guide to connect various existing "green" dental practices and services and offers a systemic approach to embedding sustainable development thinking that fits and is readily realizable for dental service organizations of any size or specialization.