4.1 There have been growing interests from dental professionals and dental service organizations in the United States and elsewhere in the world calling for a consensus-based practical guidance document in support of the cost-efficient integration of generally recognized sustainable development principles into day-to-day management of dental practices both for individual dental professionals as well as dental service organizations. Formation of ASTM Subcommittee E60.80.7 and development of this practice recognizes and fulfills such demand. While it is recognized that current interests expressed by most dental professionals are primarily limited to environmental impacts attributable to existing dental practices, or so-called "green dentistry," it remains to be unclear as to what constitutes sustainable dentistry practice in principle and presents a challenge to incorporate a systematic and pragmatic management framework identifying, prioritizing, supporting, and addressing relevant sustainable development issues in a dental service provider's practice. Given the breadth and extent of management commitment, this practice embodies emerging comprehension and procedural feasibility of practical realization of measurable sustainability performance in daily dental service activities without given preferential considerations or uneven weight to one or more existing claim of "green" in dental practice nor does it give favor to any particular group of dental equipment or product. Aligned with generally recognized principles of sustainable development, this practice provides a comprehensive guidance on managing sustainability issues in dental practices and offers a system approach and management framework assists dental professionals and dental service organizations to improve overall performance and effectiveness in their products and deliveries. It offers a concerted approach to managing social, economic, and environmental aspects of dental practice; stipulates minimum sustainability considerations and requirements; and provides a framework for embedding sustainable development issue management into day-to-day decision making and dental service activities. 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, the scope of this practice addresses the expectations of, and is relevant to, dental service organizations' stakeholders starts with identification of possible benefits and desirable outcomes of managing for sustainability in dentistry. The approach stipulated in this practice 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. It is recognized that building confidence in processes and sustainable outcomes is an important part of this practice and that certain dental service organizations may wish to use some forms of independent verification. 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 system approach to embedding sustainable development thinking that fits and is readily realizable for dental service organization of any size or specialization.