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Occupational Hazards and Emergencies in Dentistry
1.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 14 Occupational Hazards and Emergencies
2.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Objectives • Upon completion of this chapter, you will be able to: – Explain the hazards of mercury contamination – Explain how to prevent mercury contamination – Describe how to avoid the hazards of ionizing radiation – Describe universal precautions and PPE 2
3.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Objectives (cont’d.) – Describe how to prevent breakage of an anesthetic needle – Explain the treatment needed to remove a broken endodontic file or reamer – Explain how the auxiliary can help prevent soft-tissue injuries 3
4.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Objectives (cont’d.) – Describe ways to prevent the patient from aspirating foreign objects – Describe the hazards of nitrous oxide/oxygen conscious sedation 4
5.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel • Use of amalgam has decreased but still remains a restorative material – One of the major components is mercury – Auxiliary should know the protocol for mercury hygiene 5
6.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) – Mercury can be absorbed through the skin or vapors inhaled • Can cause birth defects, brain dysfunction, kidney problems, and other problems • To prevent mercury poisoning: – Never touch amalgam or mercury with bare hands 6
7.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) – Enclose scrap amalgam in a tight container with used x-ray fixer or a specially prepared mercury solution – Try to prevent mercury spills – If a spill happens: • Use one of the several devices that can be purchased for the purpose to collect a spill • Never use high volume evacuation system or vacuum cleaner 7
8.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) – Use water with a high-speed handpiece when removing worn or broken amalgam • High volume evacuator tip should be place close to the operative side to catch any debris – Routinely have government agency come into the dental office to monitor mercury levels 8
9.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) • Radiation – To prevent excessive radiation exposure: • Never stand in the room with the radiograph unless there is a lead-lined screen to stand behind • Always be at least six feet away from the x-ray head • Never hold the film in the patient’s mouth • Wear a personal monitoring device 9
10.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) • Biological hazards: – Auxiliary is exposed to biological blood-borne or saliva-borne pathogens – Treat each patient with universal precautions • All patients are treated as if they have infections 10
11.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hazards to Dental Personnel (cont’d.) – Use personal protective equipment (PPE) • Protective eyewear • Gloves • Masks • Protective clothing 11
12.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Personal Protective Equipment Figure14-2A: Protective eyewear 12
13.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Personal Protective Equipment (cont’d.) Figure14-2B: Vinyl and latex gloves 13
14.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Personal Protective Equipment (cont’d.) Figure14-2C: Face masks used in dentistry 14
15.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Dental Emergencies • Broken anesthetic needle: – Patient should be notified by the dentist – Patient should be kept calm – Patient may have to be referred to an oral surgeon for removal 15
16.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Dental Emergencies (cont’d.) – Auxiliary can help prevent this by: • Examining the needle prior to the injection • Keep the patient from hitting or grabbing the dentist’s hand during the injection • Separated endodontic reamer or file: – During endodontic therapy, the endodontic file may separate and remain in the root canal of the tooth 16
17.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Dental Emergencies (cont’d.) – Auxiliary must be prepared to assist the dentist in removing the fragment • Soft tissue injury: – A sharp surgical instrument may slip off the tooth and lacerate the surrounding soft tissues – Auxiliary should be prepared to assist the dentist with any necessary procedure to treat the wound 17
18.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Dental Emergencies (cont’d.) – Auxiliary can help prevent some situations by proficient suctioning of the area being treated • Nitrous oxide/oxygen conscious sedation: – If the dosage is incorrect, it becomes a general anesthetic and the patient loses consciousness 18
19.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Dental Emergencies (cont’d.) – The dental team must properly explain its effects of conscious sedation to the patient – Gas should be introduced slowly • Patients can injure themselves • Patient can vomit with too high a dosage 19
20.
©2013 Delmar, Cengage
Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Summary • The dental office can present the dental team and the patient with hazardous situations • Most of these situations can be prevented • Auxiliary needs to know how to handle emergencies in case they occur 20
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