The plastic economy bubble of clear aligners

Sherif Kandil
Apr 27 · 6 min read

We are at conflict with the fundamental imperative at the heart of our economic model: grow or die!

Should we recycle clear aligners or cut down plastic usage??

Courtesy of Sherif Kandil

Many of us, when engaged in the discussion related to climate change and saving oceans, get bored in a split of a second and give a denial look, and sometimes we comfort ourselves that it will be just ok.
Climate change and wildlife endangerment are happening faster than you could even imagine. According to the Economic world forum, every minute a truck dumps plastic into the ocean. That is about five to seven trucks till you read my article till the end, that is if you don’t get in denial and close the browser tab before that:)

https://globalclimate.ucr.edu/resources.html

In the 1980s plastic bottle sales have started to boom since the advancing technology in manufacturing PET (Polyethylene Terephthalate). Since then plastic has been the hotspot of many industries to switch to, because of one simple fact; it’s cheap, easy to manufacture and transport.
Only 14% of plastic ever produced has been collected, and 5% has been recycled (rather than down-cycled).
Waste facilities vary worldwide and in spite in countries with very advanced infrastructure like the Netherlands, and Japan the plastic production waste has far exceeded the capabilities for recycling. China used to take over the plastic waste from other countries for recycling; now China has far more locally than what it could handle recycling. What do we do? Just throw it or burn it!

Did you know that less than 20% of plastic produced right now could be recycled? and only 9% is actually recycled?
Do you know where the rest 91% will go to?
Yes, you know it by now just throw it in landfills, oceans or burn it.

So marketing for recycling, in my opinion, is done out of good will but some ignorance lies underneath. The ignorance lies in contemplating and comprehending the actual situation.

The only solution is to stop the main reason for all the problems and cut down on plastic! cut the problem source and find alternatives.

However, it is counter-intuitive for many to start searching for alternatives when businesses just started catching up very fast lately, isn’t it?!

I work in the field of teeth straightening. We use in modern orthodontics what is so-called clear aligners to straighten teeth. These are clear plastic trays either made of PET, PETG or TPU as the main chemical component. The material is classified as Medical grade class I.
We also use in the process of manufacturing 3D printed teeth models made mostly out of thermoset plastics with high cross-linkage.

These are all petroleum-based polymers with various grades of unleashing nano plastics in temperature and moisture mediums.
Our patients get multiple plastic trays each worn for one or two weeks then the next one in a sequence is worn till the final retainer. All these used aligners are thrown in the bin afterward with no hope for recycling.

Now there are three main fragments influenced by the plastics used in this industry; climate change, oceans/wildlife, and our health.

https://climate.nasa.gov/effects/

Taken as a whole, the range of published evidence indicates that the net damage costs of climate change are likely to be significant and to increase over time.

- Intergovernmental Panel on Climate Change

I found it very daunting, so I tried to make a little research and reached out to two CEOs for plastic sellers/producers in the industry in Germany to ask them why the plastic aligners couldn’t be recycled.

Answers were honestly shocking to me as both seemed not to even care about the matter. (pretty reasonable, don’t sh** where you eat) One CEO said they don’t take any responsibility for recycling even the unused plastic that every lab never uses anymore nor has been used by any patient, they don’t take it back for recycling even if the lab wants to deliberately send the waste of unused plastic back to recycle.

What about the used aligners? Answer: We can’t recycle custom made medical devices and don’t take responsibility for this! The word responsibility was mentioned twice, what is with the attitude there?!

I recall a colleague of mine Amanda Wilson on Linkedin raised the topic days ago and asked help for answers on the plastic recycling dilemma if there are any solutions for it.

Align Tech Linkedin account took the initiative to reply back, below was the answer.

I believe it is good when you try and analyze, but when you are a giant then trying is not enough, your obligation as a market tractor is to change and drive the market to the same good! In spite, I have some comments on the statements mentioned in the comment, yet I will point to the fact that ALIGN Tech doesn’t seem to have the solution for either recycling used clear aligners nor decreasing the plastic waste. On the contrary, Align Tech gives five years guarantee of free plastic for every patient that means you could keep ordering refinements or more aligners if you are not satisfied with the treatment results up to 5 years and since every aligner is worn for 1 week, that might mean that the possibility exists that some patients may get 520 aligners if they didn’t get any midcourse corrections throughout the treatment!!

However, I give them credit for stating that they found a solution for almost 50% of the problem.

Since recycling of plastic is still far away from being adequately a quantitative solution and the time frame we have left before experiencing more drastic environmental consequences is very short, there is one solution left for us.

Cut down plastic and find alternatives if possible!

Courtesy of Sherif Kandil

So by now, I hope you are merely convinced that recycling plastic waste is not a very smart option anymore.
I have addressed the physical problem of the plastic itself till now. What about the health impact of plastics?
Many scientists have been testing the effect of plastic unleash in the ocean and also in our food. Results came like a blow to everyone.

There is truly a staggering amount of microplastics in our world’s oceans. Though there is debate over exactly how much microplastic is in the world’s oceans a 2015 study estimated that there were between 93 and 236 thousand metric tons of microplastics in the world’s oceans.

They found microplastic traces in most of the seafood we eat!

Also the food or drinks you place in a plastic container will include micro or nano plastic traces that will go directly to your gut. The Nanoplastics could even cross cell membranes making it more dangerous to changing cellular medium and causing cell death or mutation.

Let’s go one step before dumping plastic clear aligners in the ocean and landfills. The plastic clear aligners are worn almost 21 hours a day. The mouth has the harshest conditions for any material or plastic, there is fluctuating temperatures, salivation, bacteria, and biting forces.

Do you think there is a slight chance that the patients wearing clear aligners to straighten their teeth might have some nano plastic traces in their bodies? and do you think by any chance that could be dangerous? I will leave them as open questions for now...

Why were there no studies done in that direction to compare nano plastic concentration in blood or stool before treatment and within treatment?

Basically, it represents a conflict of interest for all service providers!

Summary:

Plastic waste represents a considerably big endangerment whether to our environment and also to us as humans.

If we don’t start now cutting down on plastic, the consequences will be too big and too late to fix.

    Sherif Kandil

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