Integrating planetary health into dentistry: an updated Montreal-Toulouse model

The Earth has entered a critical phase, with seven of nine planetary boundaries already transgressed. This ecological catastrophe profoundly affects human health, highlighting the links between people's wellbeing and the state of the planet. Accordingly, health professionals are increasingly called to embrace planetary health and adopt sustainable practices. This is particularly relevant for dental clinics, which have a high ecological footprint and a responsibility to provide quality care that is both environmentally and socially sustainable. By integrating planetary health into practice, dental teams can participate in controlling and limiting ecological harm while promoting the health of patients and communities. This article aims to guide dental teams in implementing planetary health in their practice and to support professional schools in training future and current healthcare providers accordingly. It presents an updated version of the Montreal-Toulouse Model, incorporating planetary health across three types of dental professionals' actions (understanding, decision-making, and intervening) at three interrelated levels (individual, community and society). The model emphasises the ethical responsibility for professionals to become fully informed about the state of the planet and relevant policies, adopt systems thinking rather than siloed thinking, and be active agents of environmental and social change without compromising quality of care.