Submitted by, Bipin Jose Guided by Dr.Mehamood muthedath Dr.Azeela Ahammad Dr. Aswathi Occupational...
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Transcript of Submitted by, Bipin Jose Guided by Dr.Mehamood muthedath Dr.Azeela Ahammad Dr. Aswathi Occupational...
Submitted by,Bipin JoseGuided by
Dr .Mehamood muthedathDr .Azeela Ahammad
Dr. Aswathi
Occupational Hazards in Dentistry
IntroductionOccupational hazardsTypesPrevention of disease transmissionInfection control and management of
hazardous materialsOSHA regulationsCenter for disease control and
preventionConclusionReference
Outline of Contents
Introduction
- As in any other working environment, dental practice can
be associated with harmful effects to dentists, referred to as
occupational hazards. These hazards vary from mild and easily or self curable, as
influenza and mental fatigue, to more serious and incurable as
AIDS .
Classification of hazards
• Physical• Chemical• Biological• Mechanical• Psychosocial• Mucoskeletal Disorders
Physical hazards
Light Heat Noise
Radiation Sharps
HEAT
Exposure may occur when there is lack of maintenance to any electrical equipment lack of understanding of the equipment and its controls
Effects
Painful shocks burns etc
LIGHT
• Poor Illumination or excessive brightness• Poor Illumination
EffectsEye pain, eye strain, headache, eye fatigue.
• Excessive BrightnessEffects
• Discomfort and visual fatigue
Prevention• Sufficient and suitable lighting-natural or artificial is
advised
NOISE
Use of high speed turbines, compressor, suction, ultrasonic dental scaler
Effects
Auditory- temporary or permanent hearing loss
Non-Auditory- fatigue, interference with communication by speech, decreased efficiency.
RADIATION
• Contact with X-ray
• X-ray is an ionizing radiation that is capable of initiating and producing damage to body cells, as well as carcinogenic and genetic changes. Careless dentists used to hold the dental X-ray films inside the patient’s mouth (for obtaining better quality of image) are at risk for developing radiation dermatitis on hands, or on a long run squamous cell carcinoma of the finger.
Prevention
• Buying of standard radiographic equipment• Well collimated and filtered beam of at least 1.5
mm of aluminum filtration• Use of lead barriers between the dental surgeon
and the x-ray machine• Dentist should not hold the film in patients mouth • Regular checking of leakage from x-ray machine
should always be performed
SHARPS
Glassware and sharp needles, lancets,B.P-blades, test tube are hazardous
• Cut, scratches, abrasions are potential locations for infections.
Prevention• Handle with care• Mange and dispose waste sharps.
Chemical hazardsDentist are exposed to various types of chemicals that
are hazardous while providing care. They include,
• Mercury• Methaacrylates• Silica• Beryllium• Formaldehyde• Xylene• Latex glove
Mercury
The greatest risk from mercury is from vapor in the air.
• The maximum level of exposure considered to be safe is 50 microgms/cc of air.
• Average daily take of mercury from amalgam restoration is estimated to be 1.2 to1.3 microgm
• Mercury is hazardous not only• to dental personnel but also• to the environment.
Effects• Mercury poisoning
Prevention
• Use of precapsulated alloys• Use of automatic triturators• Good ventilation• Spilled mercury should be collected with
gloved hands and stored under water.
METHAACRYLATES– Effects
• Irritation to skin,eye or mucous membrane,allergic dermatitis,asthma
• PNEUMOCONIOSIS can occur due to inhalation of methylmethacrylate
Silica• Inhalation of dust containing free silica or
silicon dioxide in ceramic laboratories leads to sillicosis
BERYLLIUM• Susceptible groups are dental laboratory
technicians.• They develop chronic beryllium diseases
(CBD)
Formaldehyde• Chemical used for disinfection
Effects• Acute- eye and respiratory irritation from
the liquid and vapour forms.• Chronic- laryngitis, bronchitis.
XYLENE• Chemical used for sterilization purpose.• Acute- eye and mucous membrane
irritation• Chronic- leukemia
Latex glove
• Latex gloves dusted with corn starch powder
• Efficient barrier against most pathogens• A very good barrier against viruses• Unfortunately most of the professionals
are allergic to this productEffects- urticaria
Prevention• Non latex gloves-eg vinyl or nitril gloves
Biological hazards
Dental surgeons run a risk to different infectious agents
• Bacterial,viral, and fungal• Tuberculosis and hepatitis B appears to be
very real danger and AIDS has begun to spread like wild fire.
HEPATITIS B
• Causative agent- hepatitis B virus• It is a serious disease
• May result in prolonged illness,destruction of liver cells, cirrhosis of the liver, and death
• It is a bloodborne disease that may also be transmitted by other body fluids,including saliva.
Prevention• HBV vaccine – 3 dose
Hepatitis C
• Transmitted via blood transfusion• Contaminated needles among injection
drug users• There is no vaccine against hepatitis C
TUBERCULOSIS• Causative agent ; mycobacterium
tuberculosis• Patient may easily spread the disease
through close contact
• When the individual coughs and the tubercle bacilli which are present in the sputum are expelled through the mouth
• These bacteria are inhaled by other persons and carried to the lungs
Prevention• No effective form of protective immunization against TB
• There are drugs but these are not effective against the newer drug-resistant strains of TB
• Patients instructed to cover their mouths and nose when coughing or sneezing
• If possible dental treatment is postponed until the patient no longer has the symptoms of active TB.
• If emergency care is required it should be rendered in a facility that can provide TB isolation
Legionella
• Aerosols generated in dental operations are a source of exposure to microorganisms proliferated within dental unit water lines.
• Causative agent –Legionella pneumophila• There is no person-to-person transmission• Causes severe pneumonia
HERPES SIMPLEX VIRUS• Causative agent- herpes virus
• Causes recurrent sores on lips• Dental personnel could infect their digits from
contact with infected patients.• Herpetic whitlow
• HIV AND AIDS
HIV is transmitted by blood/blood contaminated body fluids.
• Precaution are taken to minimise state of injuries with sharp instrument.
Tetanus
• Also known as lockjaw• Dangerous and often fatal • Enter the body through a wound or break
in the skin from a solid instrument.
Prevention• Administration of a TT vaccine
Mechanical hazards
• Though not alarming it can be reduced or avoided
• Being careful while operating• Eg –traumatic injuries due to projectiles,
carelessness while using sharp instruments, airotors
Psychosocial hazards• Mental fatigue: - This results from communication and
dealing with the patients, added to realization of professional abilities.
• Although this is not a disease, but unfortunately, it is sometimes unavoidable and it might adversely affect the quality of the dentist’s work.
• This leads to development of increased tension,high BP,tiredness,depression and sleeplessness.
• Dentists with their busy schedules will be deprived of social intraction,spend less time with family leading to “burn out syndrome”.
Prevention
• Space out professional work • Sufficient rest • Allot time for social interaction and family• To overcome stress –yoga,art of living etc..
Musculoskeletal Disorders• At work,the dentist assumes a strained posture. • Both while standing and sitting close to a patient while
providing care.• Causes and over stress of the spine and limbs and PNS.• This results in,
• Back pain syndrome.• Neck discopathy.• Cervicoacromial pains.• Carpal tunnel syndrome
Carpal tunnel syndrome• Is a defect of the median nerve and cubital nerve .• It is manifested as paraesthesia of the thumb and the
index finger.
• Low back area and legs are two points where dental practitioner strains himself
• In India dentists work hard for more than 8 hours without rest cause
» Cervical spondylosis» Low back pain » Varicose veins » Knee and ankle joint osteoarthritis.» Rarely scoliosis and other vertebral column
problems
Prevention of disease transmission
• Prevention of disease transmission is of utmost importance in the dental office.
• It is necessary to break the chain of infection,consists of four parts
» Virulence.» Numbers. » Susceptible host and » Portal of entry.
• Virulence- degree of pathogenicity or strength of that organisms ability to produce disease.
• Because a person cannot change the virulence. • He or she must rely on body defenses and specific
immunization (HBV, Measles)
Numbers
Related to the bioburden present.• To reduce these numbers .
• Sterilization of all dental instruments • Disinfection of all materials and surfaces that have
become contaminated during treatment
Susceptible host – One who is unable to resist infection by a
pathogen .• Therefore, staying healthy ,washing your hands
freqently and keeping your immunizations up to date to resist infection
Portal of entry • Pathogens must have an appropriate portal of
entry into the body • These include,
– Inhalation
Breathing aerosols generated from hand pieces or the air-water syringe or uncovered ultrasonic cleaning devices
Prevention –wear face masks
-Ingestion
swallowing droplets of blood or saliva spattered into the mouth
Prevention- wear face masks, wash hands frequently
• Mucous membranes– Droplets of blood or saliva spattered in to
eyes, nose or mouth.
Prevention
wear face masks and safty glasses