Transforming orthodontic care with intraoral scanning for a sustainable future

Greener Smiles with Digital Scanning: Transforming orthodontic care with intraoral scanning for a sustainable future.

Project completed as part of Wrightington, Wigan and Leigh (WWL) Green Team Competition 2025. 

Team members: 

• Naomi Prado (Consultant Orthodontist)
• Laura Ewbank (Consultant Orthodontist). 

Setting / Patient Group 

Orthodontic patients at Royal Albert Edward Infirmary, WWL NHS Trust, undergoing impression-taking for diagnosis and appliance fabrication 

Issue 

Traditional orthodontic impressions using alginate or silicone materials generate significant clinical waste and carbon emissions. Each impression requires disposable trays, tissue, wax, and lab transport, with many materials unrecyclable due to contamination. Patients often need multiple impressions per treatment course, leading to repeat appointments, increased travel, and discomfort—especially for children and those with sensory sensitivities. Inaccuracies can necessitate retakes, compounding waste and emissions. These practices are misaligned with NHS sustainability goals and modern digital capabilities. 

Intervention 

The team evaluated the impact of replacing traditional impressions with digital intra-oral scanning. This involved service evaluation, carbon footprint analysis, cost comparison, and process mapping. Digital scanning captures both dental arches in one procedure, eliminating the need for impression materials and enabling reuse of digital files for appliance fabrication. Scans are securely transferred to labs and MDTs, reducing physical transport and improving coordination. Staff were introduced to the scanner and engaged through governance forums, with positive feedback on usability and workflow benefits. 

Outcomes

Impacts are modelled on assumptions that the team complete 1,350 traditional impressions per year. 

Clinical: 

• Faster workflows and lab turnaround. 
• Higher accuracy and reproducibility in scans. 
• Reduced human error and better long-term tracking of tooth movement. 
• Particularly beneficial for growing children and patients with additional needs. 

Environmental: 

• Total saving: 3,413 kgCO₂e/year, equivalent to driving 10,041 miles. 

Financial: 

• Savings of £13,500 from reduced consumables and lab costs
• Scanner cost: £16.500–£24,000k. This would be recuperated in 2–3 years, potentially sooner with staff-time savings. 

Social: 

• 70% of patients preferred digital scanning; 40% experienced nausea/gagging with traditional impressions. 
• Fewer appointments reduce time off school/work and improve dignity and comfort. 
• Staff reported improved morale and workflow efficiency. 
• Enhanced MDT coordination and service equity for complex cases. 

Key Learning Point 

Transitioning to digital intra-oral scanning requires more than clinical justification alone, as implementation within a hospital setting involves high upfront costs, requires integration with existing electronic health record systems, and staff training to adapt to new workflows. The project highlighted the importance of aligning sustainability initiatives with operational feasibility and stakeholder buy-in from the outset.