Green Dental Environmentalism: Comparison
Please note this is a comparison between Version 2 by Alfred Zheng and Version 1 by Maria Antoniadou.

In every workplace, human sustainability is closely connected to the quality of establishments, the accessibility of green and blue spaces, and safety In dentistry, as in other fields, the physical setting is linked to an employee’s ability to physically engage with the workplace. A healthy dental workplace atmosphere positively influences individual employees’ behavior, enthusiasm, creativity, motivation, and efficiency, and, on the other hand, their desire to quit.

  • green dental environmentalism
  • theories of environmentalism
  • green dentistry
  • green dental office

1. Introduction

In every workplace, human sustainability is closely connected to the quality of establishments, the accessibility of green and blue spaces, and safety [1]. Incorporating natural environments into human work settings with innovative architectural designs and sustainable construction materials and energy resources plays a serious direct and indirect role in health and wellbeing [2,3][2][3]. Although it has long been understood that green work settings play an important role in both human [4,5,6][4][5][6] and ecosystem health [3], it is only recently that these relationships have been specifically investigated to adapt sustainable planning and land use [6,7,8][6][7][8] to several social and environmental challenges [9], such as urban deprivation, biodiversity loss, pollution, and climate change [10,11,12,13][10][11][12][13]. Furthermore, human-centric designs for building environments enhance their occupants’ satisfaction and health and emphasize sustainable lifestyles [3,14,15][3][14][15].
It is well-documented that energy and material resources are diminishing in all aspects of human activities, or that they are consumed at a faster rate than they can be replenished [3,11][3][11]. Actions have already been taken to address issues related to green establishments that connect a physical setting with the smart use of construction materials and esthetics to provide sustainable workplace environments that support human and natural resources [4,5][4][5]. Since the beginning of this century, stakeholders and governments worldwide have been discussing using a circular flow of energy instead of a linear one to sustain resources [7]. The UN environment program describes the “Environmental rule of law” that combines essential legislation with environmental needs. It provides the basis for improving environmental strategies at the governmental level. Under this initiative, environmental sustainability reflects universal moral values and ethical norms of behavior and relates to fundamental human rights and obligations [16]. Furthermore, the “Roadmap to a Resource-Efficient Europe” provides a critical approach to the use of resources for environmental reasons but also for resource efficiency and security, employment, competitiveness, and human development [8]. It was additionally highlighted that functional, safe, and high-quality products should be more efficient, affordable, and long-lasting. They should be further designed for reuse, repair, or high-quality recycling. The philosophy of the four Rs (reuse, repair, rethink, recycle), or the “waste hierarchy” as it is known, is incorporated in various ways in CE national legislations [8]. In March 2020, the European Commission adopted the new Circular Economy Action Plan (CEAP). This is part of the European Green Deal, Europe’s new agenda for sustainable growth [9]. This deal will assist the transition to a circular economy (CE). The consequences of this transition will reduce the pressure on natural resources and provide sustainability to all stakeholders [9].
In this context, the design and construction of green buildings is a new research focus motivated by the need for human wellbeing and sustainable resources in the health sector [2,3,10][2][3][10]. The circular philosophy of dentistry is currently emerging as a theme in the research literature, providing knowledge and tools for information sharing and enhancing environmental actions [10,17,18,19][10][17][18][19]. A significant aspect of this field-specific discussion concerns providing better quality and sustainable dental services by using new processes and slow dentistry workflows in an esthetic, naturally designed environment; it also aims to offer digital solutions, provide innovative resource analysis and building constructions that guarantee less waste [6], improve skills and current knowledge related to this theme, [18,19,20][18][19][20] and, ultimately, provide better quality of life for all, up to 2050 [13]. In dentistry, as in other fields, the physical setting is linked to an employee’s ability to physically engage with the workplace [12]. A healthy dental workplace atmosphere positively influences individual employees’ behavior, enthusiasm, creativity, motivation, and efficiency [15[15][20],20], and, on the other hand, their desire to quit [21].
The World Green Building Council defines a green building as a building that “in its design, construction or operation, reduces or eliminates negative impacts, and can create positive impacts, on our climate and natural environment” [10]. Stakeholders in the construction industry are focusing on making modern buildings and their internal systems more sustainable by saving energy [3,19,20,21,22[3][19][20][21][22][23],23], water [24], human working hours [25], costs [26,27[26][27][28][29],28,29], and resources [3,30][3][30]. This attitude has positive impacts for a building, such as reduced carbon emissions [23], water and energy efficiency, the use of natural sunlight, exposure to nature, clean air circulation [31], reduced noise impact [32[32][33],33], higher returns in operating costs over five years, and higher investment returns with an asset value that can reach approximately 7% [26,27,28,29,30][26][27][28][29][30]. As a consequence, these constructions can facilitate sustainable dental practices that focus on indoor air and water quality, employees’ ability to socialize in a relaxing environment made from recycled materials, employees’ ability to exercise in the building due to long hours of continuous work, lighting and acoustic quality, safe waste disposal, and security issues [2,3,11,33][2][3][11][33].

2. Pro-Environmental Behaviors

Environmental problems correlate with human choices and behavior. Therefore, changes in behavior are necessary to improve the current status of environmental ethics. Pro-environmental behavior is behavior that minimizes the negative impact of individuals’ behavior on the environment [35][34]. It plays an important role in controlling energy resources and carbon footprints and protecting environmental sustainability [36][35]. In the literature, there are many labels similar to the term “pro-environmental behavior”, such as “environmental behavior”, “ecological behavior”, “environmentally friendly behavior”, “eco-friendly behavior”, “sustainable behavior”, “green behavior”, “conservation behavior”, “environmental action”, “responsible environmental behavior”, “ecological responsible behavior”, “environmentally responsible behavior”, “pro-ecological behaviors”, and “environmentally conscious behavior” [37][36]. All of these different terms have some common ground. They all essentially involve reducing resource use [38][37], recycling [39][38], or environmental volunteering [36][35]. They are also affected by personal values and ethics. They are further explained by psychological theories [36][35]. Understanding pro-environmental behaviors in healthcare has recently become a hotspot in research. Since 2012, the number of relevant studies has increased significantly [36][35]. Interest in pro-environmental behavior has mainly focused on the following aspects: (a) the definition and explanation of the influencing factors or results of pro-environmental behavior [40[39][40],41], (b) the relationship between pro-environmental behaviors and social norms [42][41], (c) the connection between pro-environmental behaviors and employees’ wellbeing [43][42], and (d) the design of models of pro-environmental behavior to introduce voluntary pro-environmental behaviors to employees [44][43]. The research conducted so far is of great significance to our systematic understanding of the tools and methodologies used to study pro-environmental ideas. However, academic research on pro-environmental behaviors in healthcare settings and especially in dental practices is in an active development stage and needs further exploration.

3. Theories of Pro-Environmental Behavior

The following theories are those most commonly applied in the study of pro-environmental behavior: (A) Psychological theories. These involve the internal psychological processes undergone by individuals before they take action. The most representative ones are: (a) the theory of planned behavior [45,46][44][45], which investigates the impact of attitudes, subjective norms, and perceived behavior control on individuals’ intention to engage in pro-environmental behavior [47,48[46][47][48],49], and (b) the norm activation theory [48][47]. According to this theory, personal norms such as awareness of consequences and responsibility [49][48] may control behaviors [50,51,52][49][50][51]. As such, an individual who believes that he has a moral obligation to protect the environment will undertake the corresponding actions [49,53][48][52]. (B) Sociological theories. These theories suggest that social situational factors may influence individual behaviors [54][53]. Members of a social network, such as dentists, inevitably interact with other members of the same network, influencing one another when making decisions or taking actions [55][54]. Through various kinds of social interaction, individuals obtain useful information [56][55], improve their understanding of environmental protection issues, and promote environmental sustainability [36][35]. (C) Economic theories. In this case, more attention is paid to the influence of external factors such as prices, costs, and income when studying the pro-environmental behavior of individuals. These theories provide a more realistic perspective on behaviors and choices [57][56]. They further suggest that people are rational and pursue their best interests. Thus, economic incentives are an effective way to promote sustainable pro-environmental behaviors [58,59][57][58]. Despite the research that has so far considered pro-environmental behaviors in many scientific fields, none of the extant literature adequately explains human attitudes towards environmentalism and sustainability. Thus, interpreting pro-environmental behaviors using a single theoretical or ethical approach should be limited [36,48][35][47]. All theories should provide complementary explanations and be revised for specific fields and practical situations. People should also keep in mind that individuals are not always rational when taking decisions. They often deviate from the hypothesis of rational choice [59][58]. This brings us to the hypothesis that a combined theoretical approach should be used in relevant research methodologies to acquire the greatest amount of information without bias.


  1. WHO. Green and New Evidence and Perspectives for Action Blue Spaces and Mental Health. Available online: (accessed on 26 March 2023).
  2. Cvenkel, N. Well-Being in the Workplace: Governance and Sustainability Insights to Promote Workplace Health; On Approaches to Global Sustainability Markets and Governance; Springer: Singapore, 2020.
  3. Kotsopoulos, D. Organizational Energy Conservation Matters in the Anthropocene. Energies 2022, 15, 8214.
  4. Allen, J.G.; MacNaughton, P.; Laurent, J.G.C. Green Buildings and Health. Curr. Environ. Health Rep. 2015, 2, 250–258.
  5. Scrima, F.; Mura, A.L.; Nonnis, M.; Fornara, F. The relation between workplace attachment style, design satisfaction, privacy and exhaustion in office employees: A moderated mediation model. J. Environ. Psychol. 2021, 78, 101693.
  6. Antoniadou, M. Quality of Life and Satisfaction from Career and Work–Life Integration of Greek Dentists before and during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2022, 19, 9865.
  7. EC. A Resource-Efficient Europe—Flagship Initiative under the Europe 2020 Strategy; COM 21; European Commision: Brussels, Belgium, 2011.
  8. EC. Road Map to a More Resource Efficient Europe; SEC 1067; European Commision: Brussels, Belgium, 2011.
  9. EC. New Circular Economy Action Plan. 2020. Available online: (accessed on 20 March 2023).
  10. FDI Consensus Statement. Consensus on Environmentally Sustainable Oral Healthcare: A Joint Stakeholder Statement. Available online: (accessed on 26 March 2023).
  11. Antoniadou, M.; Varzakas, T.; Tzoutzas, I. Circular Economy in Conjunction with Treatment Methodologies in the Biomedical and Dental Waste Sectors. Circ. Econ. Sustain. 2020, 1, 563–592.
  12. Di Noto, J. Healthy Buildings vs Green Buildings: What’s the Difference? 16 December 2021. Available online: (accessed on 23 March 2023).
  13. Intergovernmental Panel on Climate Change (IPCC). IPCC 5th Assessment Report; IPCC: Geneva, Switzerland, 2014.
  14. Zhang, M.; The Cong, P.; Sanyal, S.; Suksatan, W.; Maneengam, A.; Murtaza, N. Insights into rising environmental concern: Prompt corporate social responsibility to mediate green marketing perspective. Econ. Res. 2022, 35, 5097–5113.
  15. Zhenjing, G.; Chupradit, S.; Yen Ku, K.; Nassani, A.; Haffar, M. Impact of Employees’ Workplace Environment on Employees’ Performance: A Multi-Mediation Model. Front. Public Health 2022, 10, 890400.
  16. UN Environment Program. Environmental Rule of Law. Available online: (accessed on 20 May 2023).
  17. Duane, B.; Harford, S.; Ramasubbu, D.; Stancliffe, R.; Pasdeki-Clewer, E.; Lomax, R. Environmentally sustainable dentistry: A brief introduction to sustainable concepts within the dental practice. Br. Dent. J. 2019, 226, 292–295.
  18. Duane, B.; Stancliffe, R.; Miller, F.A.; Sherman, J.; Pasdeki-Clewer, E. Sustainability in Dentistry: A Multifaceted Approach Needed. J. Dent. Res. 2020, 99, 998–1003.
  19. Veress, A.; Kerekes-Máthé, B.; Székely, M. Environmentally friendly behavior in dentistry. Med. Pharm. Rep. 2023, 96, 199–205.
  20. Martin, N.; Mulligan, S. Environmental Sustainability through Good-Quality Oral Healthcare. Int. Dent. J. 2022, 72, 26–30.
  21. Markey, R.; Ravenswood, K.; Webber, D. The Impact of the Quality of the Work Environment on Employees’ Intention to Quit. Economics Working Paper Series 1220, University of West England. Available online: (accessed on 26 March 2023).
  22. Van Schaack, C.; Ben Dor, T. A comparative study of green building in urban and transitioning rural North Carolina. J. Environ. Plan. Manag. 2011, 54, 1125–1147.
  23. Tsai, W.H.; Yang, C.H.; Huang, C.T.; Wu, Y.Y. The impact of the carbon tax policy on green building strategy. J. Environ. Plan. Manag. 2017, 60, 1412–1438.
  24. Akamani, K. Challenges in the transition toward adaptive water governance. In Water Conservation: Practices, Challenges and Future Implications; Nova Science Publishers, Inc.: Hauppauge, NY, USA, 2014; pp. 165–178.
  25. Antoniadou, M. Estimation of Factors Affecting Burnout in Greek Dentists before and during the COVID-19 Pandemic. Dent. J. 2022, 13, 108.
  26. Kats, G. Greening Our Built World: Costs, Benefits, and Strategies; Island Press: Washington, DC, USA, 2010.
  27. Langdon, D. The Cost & Benefit of Achieving Green Buildings; Davis Langdon Management Consulting: London, UK, 2007.
  28. Jin-Lee, K.; Martin, G.; Sunkuk, K. Cost Comparative Analysis of a New Green Building Code for Residential Project Development. J. Constr. Eng. Manag. 2014, 140, 05014002.
  29. Dwaikat, L.N.; Ali, K.N. Green buildings cost premium: A review of empirical evidence. Energy Build. 2016, 110, 396–403.
  30. Darko, A.; Zhang, C.; Chan, A.P.C. Drivers for green building: A review of empirical studies. Habitat Int. 2017, 60, 34–49.
  31. Tzoutzas, I.; Maltezou, H.C.; Barmparesos, N.; Tasios, P.; Efthymiou, C.; Assimakopoulos, M.N.; Tseroni, M.; Vorou, R.; Tzermpos, F.; Antoniadou, M.; et al. Indoor Air Quality Evaluation Using Mechanical Ventilation and Portable Air Purifiers in an Academic Dentistry Clinic during the COVID-19 Pandemic in Greece. Int. J. Environ. Res. Public Health 2021, 18, 8886.
  32. de Lima Andrade, E.; Da Cunha e Silva, D.C.; De Lima, E.A. Environmental noise in hospitals: A systematic review. Environ. Sci. Pollut. Res. 2021, 28, 19629–19642.
  33. Antoniadou, M.; Tziovara, P.; Antoniadou, C. The Effect of Sound in the Dental Office: Practices and Recommendations for Quality Assurance—A Narrative Review. Dent. J. 2022, 10, 228.
  34. Kollmuss, A.; Agyeman, J. Mind the Gap: Why do people act environmentally and what are the barriers to pro-environmental behavior? Environ. Educ. Res. 2002, 8, 239–260.
  35. Mesmer-Magnus, J.; Viswesvaran, C.; Wiernik, B.M. The Role of Commitment in Bridging the Gap between Organizational Sustainability and Environmental Sustainability. In Managing Human Resources for Environmental Sustainability; Jackson, S.E., Ones, D.S., Dilchert, S., Eds.; Jossey-Bass: San Francisco, CA, USA, 2012; pp. 245–283.
  36. Tian, H.; Liu, X. Pro-Environmental Behavior Research: Theoretical Progress and Future Directions. Int. J. Environ. Res. Public Health 2022, 31, 6721.
  37. Dilchert, S.; Ones, D.S. Measuring and Improving Environmental Sustainability. In Managing Human Resources for Environmental Sustainability; Jackson, S.E., Ones, D.S., Dilchert, S., Eds.; sJossey-Bass: San Francisco, CA, USA, 2012; pp. 284–327.
  38. Topf, S.; Speekenbrink, M. Follow my example, for better and for worse: The influence of behavioral traces on recycling decisions. J. Exp. Psychol. Appl. 2023, 5, 452.
  39. Nilsson, A.; Bergquist, M.; Schultz, W.P. Spillover effects in environmental behaviors, across time and context: A review and research agenda. Environ. Educ. Res. 2017, 23, 573–589.
  40. Li, D.; Zhao, L.M.; Ma, S.; Shao, S.; Zhang, L.X. What influences an individual’s pro-environmental behavior? A literature review. Resour. Conserv. Recycl. 2019, 146, 28–34.
  41. Farrow, K.; Grolleau, G.; Ibanez, L. Social Norms and Pro-environmental Behavior: A Review of the Evidence. Ecol. Econ. 2017, 140, 1–13.
  42. Zawadzki, S.J.; Steg, L.; Bouman, T. Meta-analytic evidence for a robust and positive association between individuals’ pro-environmental behaviors and their subjective wellbeing. Environ. Res. Lett. 2020, 15, 123007.
  43. Lulfs, R.; Hahn, R. Corporate Greening beyond Formal Programs, Initiatives, and Systems: A Conceptual Model for Voluntary Pro-environmental Behavior of Employees. Eur. Manag. Rev. 2013, 10, 83–98.
  44. Asch, J.; Shore, B.M. Conservation Behavior as Outcome of Environmental-Education. J. Environ. Educ. 1975, 6, 25–33.
  45. Arbuthnot, J. The Roles of Attitudinal and Personality Variables in the Prediction of Environmental Behavior and Knowledge. Environ. Behav. 1977, 9, 217–232.
  46. Whitley, C.T.; Takahashi, B.; Zwickle, A.; Besley, J.C.; Lertpratchya, A.P. Sustainability behaviors among college students: An application of the VBN theory. Environ. Educ. Res. 2018, 24, 245–262.
  47. Whitmarsh, L.; O’Neill, S. Green identity, green living? The role of pro-environmental self-identity in determining consistency across diverse pro-environmental behaviours. J. Environ. Psychol. 2010, 30, 305–314.
  48. Klockner, C.A. A comprehensive model of the psychology of environmental behaviour-A meta-analysis. Glob. Environ. Chang. 2013, 23, 1028–1038.
  49. Schwartz, S.H. Awareness of Consequences and Influence of Moral Norms on Interpersonal Behavior. Sociometry 1968, 31, 355–369.
  50. Harland, P.; Staats, H.; Wilke, H.A.M. Explaining proenvironmental intention and behavior by personal norms and the theory of planned behavior. J. Appl. Soc. Psychol. 1999, 29, 2505–2528.
  51. Greaves, M.; Zibarras, L.D.; Stride, C. Using the theory of planned behavior to explore environmental behavioral intentions in the workplace. J. Environ. Psychol. 2013, 34, 109–120.
  52. Yadav, R.; Pathak, G.S. Young consumers’ intention towards buying green products in a developing nation: Extending the theory of planned behavior. J. Clean. Prod. 2016, 135, 732–739.
  53. Patrick, R.; Henderson-Wilson, C.; Ebden, M. Exploring the co-benefits of environmental volunteering for human and planetary health promotion. Health Promot. J. Aust. 2022, 33, 57–67.
  54. Kim, J.; Bae, Y.K.; Chung, J.H. Modeling Social Distance and Activity-Travel Decision Similarity to Identify Influential Agents in Social Networks and Geographic Space and Its Application to Travel Mode Choice Analysis. Transp. Res. Rec. 2020, 2674, 466–479.
  55. Zhou, X.L.; Tang, C.C.; Lv, X.Y.; Xing, B. Visitor Engagement, Relationship Quality, and Environmentally Responsible Behavior. Int. J. Environ. Res. Public Health 2020, 17, 1151.
  56. Gsottbauer, E.; van den Bergh, J.C.J.M. Environmental Policy Theory Given Bounded Rationality and Other-regarding Preferences. Environ. Resour. Econ. 2011, 49, 63–304.
  57. Klockner, C.A.; Blobaum, A. A comprehensive action determination model toward a broader understanding of ecological behaviour using the example of travel mode choice. J. Environ. Psychol. 2010, 30, 574–586.
  58. Frederiks, E.R.; Stennerl, K.; Hobman, E.V. Household energy use: Applying behavioural economics to understand consumer decision-making and behaviour. Renew. Sustain. Energy Rev. 2015, 41, 1385–1394.
Video Production Service