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INTRODUCTION Sustainability in oral healthcare is becoming a growing priority as the healthcare sector strives to reduce its carbon footprint. Dentistry is particularly associated with high levels of waste generation and greenhouse gas emissions, partly attributed to the shift of using more single-use items, which increases the carbon emissions. The aim of this study was to quantify the environmental and financial impacts of wasted resources resulting from unattended appointments in the restorative department at the Royal London Dental Hospital. Additionally, we sought to develop strategies to minimise waste and improve sustainability practices in dental healthcare delivery. METHODS Prospective data collection was completed to record unattended dental appointments and equipment wasted over a three-month period. The carbon footprint of sterilising equipment and wasting single-use items was calculated to quantify the environmental impact. The financial impact of wasted resources was calculated by including cost per item, sterilisation fees and staff expenditure. This information was presented locally and changes were implemented. After three months, further data were collected to ascertain any meaningful changes. RESULTS Following implementation of the changes, there was a 78.3% decrease in carbon emissions, from 710.7kg CO 2 e to 153.9kg CO 2 e. There was also a 56.4% reduction in the financial cost across the two audit cycles of the quality improvement project, from £2,902.18 to £1,264.33. CONCLUSIONS It is essential to adapt and develop protocols to reduce wasted resources and the environmental impact of these unattended dental appointments to comply with both local and national sustainability strategies.