Background There is increasing awareness of problems associated with global warming but a lack of a systematic approach on how to deliver more environmentally sustainable dental care. A sustainable world aims to ensure that basic needs and quality of life of everyone are met, now and for future generations. The carbon footprint is an indicator of environmental sustainability. Aim The aim is to suggest an environmental management change for the dental practice focusing on the objective of carbon footprint reduction. Environmental management change design The management change is based on the concept of “Plan-Do-Check-Act”, as recommended by the International Organisation for Standardisation (ISO) and described through the environmental aspects of the dental practice. The approach focuses on establishing and implementing environmental objectives, followed by monitoring results and taking actions to improve continually. The environmental aspects considered for the dental practice are activities causing an impact on the carbon footprint: energy use, travel, product purchasing, waste production, emission to air, water use, and contamination of land. Conclusions The “Plan-Do-Check-Act” ISO 14100-2015 model can be effectively integrated into the dental practice setting for its environmental management. A reduction of the carbon footprint of the dental practice is achieved by applying the environmental management change described for each activity.