Walking down Michigan Avenue in the South Loop toward the office of Dr. Steven Koos, ORA^® Oral Surgery & Implant Studio®, it’s clear that this is an area in transition. From the outside, the office looks much like every other storefront on this urban stretch of both old and new, but step inside and the picture is quite different. The reception area has a distinct modern feel yet is warm and welcoming. The clinical area is truly gorgeous, but what sets this office apart isn’t simply its aesthetic splendor. This is the first dental practice in the country to be recognized with the Eco-Dentistry Association’s GreenDOC™ Certification award and at their highest “Gold Level”, which is the only green business certification designed specifically for dentistry.

In the reception area, subtle design elements create a sense calmness and nature in the space. One wall is entirely river rock, another looks like gentle waves on a sand dune. It is dimensional and appears as though it was sculpted specifically for the room as a piece of art rather than a structural component. A third wall is entirely windows. The leather upholstered chairs and ottoman are recycled. The countertops are quartz and the lighting is a mixture of natural window light and energy efficient soft ambient light. A new patient completes all of their registration information on a small tablet PC, as one of the priorities of this green office is to be completely paperless.

Dr. Koos, an MD and a DDS specializing in oral and Maxillofacial surgery, proudly displays his recently received EDA Gold Certification Award, which is made entirely from recycled glass and etched using non-toxic green technology. Spend a few minutes with him and it becomes abundantly clear that Dr. Koos is passionate about both his Oral surgery practice and his commitment to environmentally friendly healthcare.  He has even officially defined and registered trademarked the term eco-friendly dentistry®

 “We carefully planned the construction of a green building on a sustainable site, preserving 100% of the envelope of the structure along with quite a bit of its interior, that is accessible to public transportation, bicyclists, pedestrians, and within a densely populated area. We are members of the United States Green Building Council, and we built our practice in accordance with LEED,” explains Dr. Koos. LEED® stands for Leadership in Energy and Environmental Design, and it is the national benchmark for the design, construction, and operations of high-performance green buildings. “We utilized all green interior design, finishes and textiles that are free of PBTs, which are persistent bio-accumulated toxins and VOCs (volatile organic compounds). Many of the materials are made from post-industrial and post consumer waste. We also employ green business practices, which include paperless charting, environmentally conscious purchasing, online referral forms, electronic claims, electronic reminders, and electronic recall,” he adds.

Dr. Koos explains that the carpeting is from a company called Chilewich®, which is made from post-consumer waste and is both durable and aesthetic. It also meets the stringent requirements of the Carpet and Rug Institute’s Green Label Plus program, indicating that flooring meets or exceeds the industry’s standards for VOC emissions.  “It is mold and mildew proof and can be used in many applications, even locker rooms.  All the adhesives used to set the floor are non-VOC.” In addition, he explains that there is no urea-formaldehyde or chlorine used in the medium-density fiberboard used behind the sustainable veneered custom cabinets. “The wave sculptural wall from ModularArts® is cast entirely out of non-toxic mineral. It contains no plastics, no VOC’s, and no urea-formaldehyde. The sliding doors to the operatories are an eco-resin made by 3Form®, which is a company very committed to the environment.”

In addition, Dr. Koos notes that all the paints used in the office are Benjamin Moore Natura™ non-voc paints and the cushions on the furniture are filled with non-BFR foam (brominated flame retardants). BFRs consist of organic compounds containing bromine. According to Dr. Koos, studies show that people are holding BFRs in their systems at higher and higher levels. “We wanted to make sure that all of the textiles, finishes, paints, etc. aren’t subject to hazardous polymerization and off-gassing. It was very important to us that we create a space that is healthy for our patients and healthy for our team members. We are in the business of healing; we have an obligation to not only protect the immediate health of the patient but to consider their overall wellbeing and the wellbeing of the planet.”

Creating the ‘Green’ Office

When establishing a green office, dentists should consider a number of factors, beginning with location. Ideally, the office should be built in an existing space close to public transportation. There should be a long-term lease agreement allowing the doctor to stay in the location for a minimum of 10 years. There should be onsite recycling or enough stORA^®ge to hold materials until they can be collected for recycling. In addition, the practice should take steps to be paperless, inCorporate digital radiography systems, and purchase recycled furniture and cabinetry. 

Moreover, recycled and renewable products should be inCorporated into the building wherever possible, including the flooring and cabinetry. The practice should seek to use energy efficient and natural lighting throughout the office as well as energy efficient HVAC systems, Energy Star rated computers, and the restrooms should be equipped with low-flow fixtures.

Dr. Koos emphasizes also that his office is the first dental practice to produce zero bio-hazardous waste. “Typically, companies are hired to haul that waste off and then it is incinerated and all those products’ harmful chemicals and toxins are released to pollute the air. We process our bio-hazardous waste on site using a system called the Demolizer II. It renders the waste safe for disposal through the regular garbage, thereby avoiding the toxic incineration process.”

It is his efforts in eliminating typical single-use disposables and bio-hazardous waste that have also earned Dr. Koos’ office the Green Health Care Program Gold Star Award. That recognition has been designated by the Teleosis Institute™, which formulated the Green Health Care Program benchmarks.  A "Gold Star" rating level is the highest possible rating that a health care facility can achieve. ORA^® Oral Surgery & Implant Studio is the first dental surgical office to receive the award.

Controlling the amount of non-hazardous as well as hazardous waste generated is a significant aspect of creating a green practice, notes Susan Beck. Ms. Beck is director of the Eco-Dentistry Association™, an international association promoting environmentally sound practices in dentistry. “Each year dental practices generate 4.8 million lead foils, 28 million liters of toxic X-ray fixer, 3.4 tons of mercury waste, 1.7 billion sterilization pouches, and 680 million chair barriers, light handle covers and patient bibs. The green dentistry approach to practice reduces waste and pollution. Saves water, energy, and money, and inCorporates high tech equipment.”

The Cost of Going Green

According to Paula Feigum of Paula Feigum Design, LLC based in Chicago, who worked with Dr. Koos in designing his green dental office, in the past year, 100% of her clients have asked for green /eco-friendly design options. “Green design is at the top of every client’s list these days.” That demand is increasing availability and decreasing costs. “The cost of going green continues to come down. It is still more expensive than traditional design, and I tell clients to plan on about 10%-20% additional expense. But that is changing because the marketplace is demanding green products and technologies.” Ms. Feigum notes that there is considerable information online about green options available to consumers. “A lot of companies now see being ‘green’ as a huge advantage and they will put that information front and center on their websites.” 

“This isn’t a fad. It is a necessary movement. The medical community has embraced this and it only makes sense that the dental community follow suit,” emphasized Dr. Koos.

For further information on Dr. Koos and ORA^® Oral Surgery & Implant Studio visit www.orasurgery.com, LEED certification and going green with the U.S. Green Building Council at www.usgbc.org, the Eco-Dentistry Association at www.ecodentistry.org, or www.Buildinggreen.com.