Green Dentistry Education in the Post-Minamata Era: Knowledge, Attitudes, and Practices in Türkiye

In the post-Minamata era, integrating environmental sustainability into dental practice is increasingly necessary, yet evidence linking policy awareness to clinical behavior remains limited. This study evaluated green dentistry-related knowledge and awareness, attitudes, and clinical behaviors among dentists and dental students in Türkiye, and examined key determinants, including Minamata-related knowledge.

A web-based cross-sectional survey was conducted in December 2025. The questionnaire comprised 68 items, including subscales for subjective knowledge and awareness (16 items), attitudes (16 items), and individual clinical behavior (6 items), and a Minamata knowledge subscore (7 items). Psychometric properties were assessed using Cronbach's α and exploratory factor analysis. Group comparisons used nonparametric tests; associations were examined with Spearman correlations. High behavior level was defined by median split and analyzed using multivariable logistic regression.

A total of 482 participants were included. Mean (±SD) subscale scores were 41.66 ± 9.6 (knowledge and awareness), 59.91 ± 6.4 (attitude), 23.50 ± 3.9 (individual clinical behavior), and 18.17 ± 4.6 (Minamata knowledge). Knowledge and awareness correlated with attitudes (ρ = 0.32) and behavior (ρ = 0.21), while attitudes correlated with behavior (ρ = 0.36) (all p < 0.05). Although Minamata knowledge correlated with all subscales, it was not an independent predictor of high behavior levels (OR = 0.94; p = 0.139). Higher knowledge and awareness (OR = 1.06; p = 0.006) and attitudes (OR = 1.08; p < 0.001) independently predicted high behavior.

Sustainable dental behaviors were more strongly associated with attitudes than with knowledge and awareness, and the Minamata knowledge score was not an independent determinant of clinical practice. These findings highlight the need for practice-oriented sustainability education in dental curricula and stronger educational and institutional support to promote environmentally responsible individual clinical behaviors in the post-Minamata era.