OCCUPATIONAL HAZARDS IN DENTISTRY

OCCUPATIONAL HAZARDS IN DENTISTRY includes those experienced in the workplace which has potential to affect the worker’s/ dentist’s physical, mental and social well-being.

Occupation health includes its maintenance to the highest degree of physical, mental and social well-being of all the workers in an occupation. Occupational health represents a dynamic equilibrium between the worker and his occupational environment.

TYPES OF OCCUPATIONAL HAZARDS IN DENTISTRY 

• Physical hazards
• Chemical hazards
• Biological hazards
• Mechanical hazards
• Psychosocial hazards

PHYSICAL HAZARDS

• Heat
• Light
• Noise
• Ultraviolet radiations, computers and lasers
• Sharps.

HEAT

Electrical hazards

Lack of maintenance of electrical equipment ,understanding of equipment and control of equipment.

Example

Painful shocks and burns

LIGHT

Poor illumination:

Eye strain , eye pain , headaches , eye fatigue.

Excessive illumination:

Discomfort , annoyance , visual fatigue.

Prevention is done by suitable light

NOISE

• Auditory effects

–Temporary or permanent hearing loss

• Non-auditory effects

–Fatigue

–Interference with communication by speech and annoyance.

Noise hazards are due to high speed turbines, suction or ultrasonic dental scaler.

ULTRAVIOLET RADIATION

• Radiations (x-ray):

–Effects are on both the body and offspring.

–Damage is painless but life threatening.

–International Commission of Radiology Protection has set the maximum permissible level of occupational exposure at 5 rem per year to the whole body.

Effects

– Dermatitis

–Skin cancer

Genetic:

–Congenital defect in employee’s offspring.

Goal

–Minimize the radiation exposure of office personnel and patient during x-Ray.

The instrument used to measure radiation dose is known as Dosimeter.

Radiation safety procedures

• Operator should leave the room or stay behind the barrier during exposure.
• Walls must be of sufficient density.
• Operator should use film holding instruments.
• During the exposure the radiographic tube should never be sterilized by the operator.

SHARPS

• Hazardous Material:

–Glassware and sharp needles

–Lancets

–B.P Test tubes

• Effects are:

–Cuts

–Scratches

• Preventions

– ONLY TO Handle with care

CHEMICAL HAZARDS

• Dentists are exposed to various types of chemicals which are hazardous,such as

–Mercury

–Metha Acrylates

–Silica

–Beryllium

–Formaldehyde

–Xylene

–Latex Gloves

CHEMICAL HAZARDS

• Dentists are exposed to various types of chemicals which are hazardous,such as

–Mercury

–Methaacrylates

–Silica

–Beryllium

–Formaldehyde

–Xylene

–Latex Gloves

MERCURY

• It is an element of mystery.
• Average daily take is 1.2 to 1.3 µg from amalgam filling in subjects with 7-8 restorations.
• Maximum level of safe exposure is 50µg/cc of air.
• Excess of mercury is hazardous to the dental personnel

PREVENTION

• Encapsulated alloys
• Ventilation
• Excess and spilled mercury should be collected in fixer containing break resistant bottles

METHAACRYLATE

• Skin, eye or mucous membrane irritation
• Allergic dermatitis
• Asthma
• Paresthesia in fingers

SILICA

Inhalation of free silica or silicon dioxide in ceramic laboratories lead to silicosis

Beryllium

Susceptible group are dental technicians

• Chronic beryllium disease may occour when working on items such as dental crowns,bridges and partial dentures.

FORMALDEHYDE

It is used in clinical setup for Disinfection

Effects

Acute:

eye and respiratory irritation

Severe abdominal pain

Nausea / vomiting, abdominal pain

Chronic :

Laryngitis

Bronchitis

XYLENE

Routinely used in clinical set-up for sterilization,

They are in the form of vapors

Prevention:

Acute: eye and mucous membrane irritation

Chronic: may cause leukemia

LATEX GLOVES

• Latex gloves with cornstarch powder are most often used.
• It is effective barrier against most pathogens
• Most of the professionals are allergic to this product

Effects

Urticaria

Prevention

Identification of non latex gloves example Vinyl or nitril gloves

BIOLOGICAL HAZARDS

• Infectious agents of human origin like Viruses, bacteria and fungi.
• Dentists are Infected directly or indirectly.
• Cut or wound, needle stick injuries, aerosols of saliva, gingival fluid, natural organic dust particles.

MAIN ENTRY POINTS OF INFECTION ARE

Epidermis of hands

Oral epithelium

Nasal epithelium

Epithelium of upper airways

Bronchial Tubes

Alveoli

Conjunctival Epithelium

Disease currently transmitted are of greatest concern to the dental professionals are 

• HBV
• HIV
• HCV
• HSV
• Mycobacterium tuberculosis

MECHANICAL HAZARDS

Not alarming but care should be taken while operating e.g Traumatic injuries due to projectiles, carelessness.

PSYCHOSOCIAL HAZARDS

• Stress situation of the dentist may lead to

High BP , sleeplessness , depression ,tension . Dentists with their busy schedules will be deprived of social interactions and this will lead to “burn out” syndrome

Prevention:

1.space out professional work

2. rest

3.social interaction

4.overcome stress

MUSCULOSKELETAL DISORDER

• Strained posture while standing or sitting close to the patient while providing care, causes overstress of the spine and limbs and peripheral nervous system(PNS).
• A good posture should be maintained, keeping the spine aligned in its natural state after any procedure is done
• Regular stretching and weight bearing exercises should also be undertaken to cope with the flexion of the spine and the stress associated with it
• This results in backache, neck discopathy, cervicoacromial pain, carpal tunnel syndrome.

RECOMMENDATIONS

• Dental education.
• Universal precautions.
• Follow the science of ergonomics.
• Alert while providing care.
• There should be suitable and sufficient lighting.
• Good administration
• Training good house keeping procedures.