In every profession, inherent risks exist, and dentistry is no exception. Despite its association with bright smiles and pristine clinics, dentistry entails a spectrum of occupational hazards for dental healthcare personnel (DHCP). From intricate procedures to daily tasks, every aspect of dentistry carries its own set of risks. Recognizing these hazards is crucial for creating a healthy and safe work environment.
Musculoskeletal Disorders (MSDs) encompass various conditions, such as back, shoulder, limb pain, and carpal tunnel syndrome. Studies from different countries indicate a high prevalence of MSDs among dentists, leading to pain, discomfort, and restricted work ability. These disorders are positively correlated with factors like age, duration of work, average number of patients treated per day, gender (with females being more affected), and type of practice (e.g., standing dentistry).
Ergonomic challenges in dentistry are improper posture of the dentist and patient on the dental chair, poor lighting, and extended duration of sitting. These can lead to musculoskeletal disorders. I overcome these challenges by maintaining a proper erect working posture, using a chair with sufficient arm support, ensuring proper lighting conditions, and adjusting the chair position to a comfortable level, so that I may not have to strain much. I try to take frequent breaks while working.Dr. G.Sneha, BDS, General Dentist, Chennai
Dentistry presents a substantial risk of microbial transmission, including bacteria such as Mycobacterium tuberculosis, and viruses like herpes, hepatitis, and HIV. Pathogens can spread through various means, including inhalation of airborne droplets or aerosols from saliva and respiratory fluids, direct contact with infected blood and saliva, and indirect transmission via contaminated instruments (particularly needle sticks) and surfaces. Additionally, dental unit water systems are recognized as significant sources of microorganism spread due to biofilm formation, water stagnation, and inadequate disinfection.
After the COVID-19 pandemic, the importance of ventilation in indoor spaces, particularly in dental facilities, has become even more emphasized. This includes ventilation systems ensuring a clean-to-less-clean airflow direction, where supply-air vents deliver clean air into corridors and reception areas, while return-air vents remove air from patient operatories and waiting rooms. The use of portable HEPA air filtration units is recommended. Dentists should use personal protective equipment (PPE) such as N95 respirators or a combination of a surgical mask and full-face shield, during procedures involving potential exposure to aerosols. Additionally, they should regularly inspect their facemasks, promptly replacing them if they become soiled, damp, or difficult to breathe through.Dr. Ming-Yeng Lin, Ph.D., Associate Professor, Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan.
Noise-producing devices in dental settings including handpieces, ultrasonic instruments, suction devices, vibrators, amalgamators and dental lathes pose significant threats to DCHPs' hearing. Using earplugs and earmuffs can help mitigate noise-induced damage. Traumatic eye injuries during dental procedures, such as filling removal, bone removal, orthodontic treatments, prosthetic preparations, and use of curing lights, range from minor issues like conjunctivitis to severe conditions like corneal abrasions or blindness. Eye-protective shields like goggles and visors are recommended to prevent injuries.
Mercury in dental amalgam poses one of the most common chemical hazards in dentistry, with elevated vapor levels potentially causing neurological and biological harm. Other hazardous chemical substances include hydrogen peroxide used for teeth bleaching, formocresol used in pediatric endodontics, and organic resins found in composite fillings and denture materials.
I try to minimize the usage of hazardous chemicals like mercury. Biomedical waste management should be practiced diligently. Since latex gloves are known to cause allergies, I prefer using latex-free gloves.Dr. G. Sneha, BDS, General Dentist, Chennai, Tamil Nadu, India
Allergic skin reactions from latex-containing gloves, X-ray chemicals, dental materials, solvents, and lubricating oils are also documented. Dental technicians handle metals like chromium and nickel, and the resulting dust can cause pneumoconiosis.
Radiation hazards are a significant concern in dental practice due to frequent diagnostic X-ray usage. Accumulative exposure to low-dose radiation poses risks of brain, thyroid, and head and neck cancers, particularly for radiology technicians and dentists. However, advancements in digital radiography techniques have reduced radiation doses. Protective measures such as lead aprons, radiation-resistant gloves, and thyroid collars help safeguard against ionizing radiation.
In conclusion, fostering a safety-oriented workplace culture involves adhering to health guidelines, regularly maintaining and inspecting dental equipment, conducting risk assessments, using PPE, promoting open communication, and promptly reporting hazards. Continuous dental education programs and workshops are essential for raising awareness and providing education. By prioritizing safety, dental practices can enhance worker productivity and ensure high-quality patient care, creating a working environment free from harm and preventing occupational health injuries.
References
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https://www.cdc.gov/infectioncontrol/index.html
(By Dr. Nirainila Joseph)