The study, conducted between November 2025 and April 2026, used a proportionate stratified multistage, clinic-based sampling approach to recruit dentists working in private clinics in Sana’a City. Participants completed a structured questionnaire covering demographic information, six awareness items and 18 practice items, with scores classified as low, moderate or high according to predefined cutoffs. The researchers reported a mean awareness score of 2.93, with a standard deviation of 1.43, and a mean practice score of 9.45, with a standard deviation of 2.65, both indicating moderate levels.

Implementation varied sharply across specific measures. Adoption was strongest for alternative restorative materials, reported by 91.0 percent of respondents, and digital radiography, reported by 88.4 percent. By contrast, only 24.8 percent used amalgam separators, 19.7 percent practised sealed amalgam disposal and 33.9 percent used waterless vacuum systems, revealing pronounced weaknesses in the management of mercury-containing waste and in water-saving technology.

The statistical analysis relied on Mann–Whitney U and Kruskal–Wallis tests for group comparisons and multiple linear regression to estimate adjusted associations, with a significance threshold of P < 0.05. In multivariable models, the practice score rose with the awareness score, with a coefficient of 0.18 and P < 0.001, while the awareness score in turn rose with the practice score, with a coefficient of 0.67 and P < 0.001. The authors note that this mutual association cannot establish which direction drives the other, and the cross-sectional design means no causal effects can be inferred.

Demographic patterns also emerged. Female gender and 6 to 10 years of professional experience were associated with lower awareness scores, whereas a PhD qualification was associated with a higher practice score. The study addresses a notable evidence gap, since research on sustainable oral healthcare has largely come from well-resourced settings, while data from low-resource and conflict-affected environments such as Yemen have remained scarce.

The authors conclude that dental professionals in Sana’a City demonstrate moderate awareness and implementation of eco-friendly dentistry, with important shortfalls in formal sustainability knowledge, hazardous waste management and water conservation. They argue the findings support integrating sustainability competencies into dental curricula, offering targeted continuing professional development, and pursuing feasible clinic-level policy and infrastructure interventions. They also call for longitudinal research before any causal conclusions can be drawn about the relationship between awareness and practice.

Subject of Research: Awareness and implementation of eco-friendly dentistry among dental professionals in Sana'a, Yemen

Article Title: Eco-friendly dentistry in clinical practice: awareness, implementation and factors associated with sustainable dental care

Article References: Al-Hamati, A. N., Al-baadani, E. M., Shubayr, M. A., Jafer, M., Meshni, A. A., Al Moaleem, M. M., & Sakran, M. A. (2026). Eco-friendly dentistry in clinical practice: awareness, implementation and factors associated with sustainable dental care. BMC Medical Education. https://doi.org/10.1186/s12909-026-10286-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10286-8

Keywords: eco-friendly dentistry, sustainable healthcare, dental practice, Yemen, cross-sectional survey, amalgam separators, digital radiography, water conservation, dental education, environmental sustainability, Eco-friendly, dentistry