What is the best toothbrush from a social impact perspective?

Introduction: The healthcare sector faces increasing pressure to adopt sustainable practices. While traditional toothbrushes are affordable, their environmental and social impacts-plastic waste and unfair labour practices-are concerning. This study applies a Social Life Cycle Assessment (S-LCA) to evaluate toothbrush production across four scenarios: a bamboo toothbrush with non-biobased nylon bristles (produced outside Europe), a plastic toothbrush (produced outside Europe/ROW), a plastic toothbrush (produced in Europe with wind energy), and the Reswirl recycled toothbrush (globally produced, recycled in Europe using renewable energy). Methods: Using OpenLCA v1.10.3 and Soca V2 databases, the study assessed a five-year functional unit covering production, transport, and disposal. Data sources included supplier reports, academic research, and grey literature. Social impacts were measured in medium-risk hours, considering child labour, fair wages, and corruption. Results: The Reswirl toothbrush (now discontinued) had the lowest social impact due to its circular economy model and renewable energy use. The highest impact came from plastic toothbrushes produced outside Europe, linked to coal-dependent production, child labour risks, and inadequate wages. Bamboo toothbrushes had environmental benefits but elevated social risks due to global production. European-made brushes using wind energy had moderate impacts. Discussion: Toothbrush production exhibits significant social disparities. Coal mining in South Africa and low labour standards in India and ROW exacerbate inequities. European manufacturing and circular economies reduce impacts. Despite data limitations, S-LCA offers insights for ethical healthcare procurement, promoting equity and sustainability. Clinical significance: This study is clinically relevant as it highlights the overlooked social impacts of toothbrush production in dentistry. By integrating Social Life Cycle Assessment (SLCA), it informs dental professionals and policymakers on sustainable choices, ensuring oral health products align with labour practices and environmental responsibility