This document discusses various chemical and psychological hazards present in dentistry and methods for their control. It outlines mercury exposure from dental amalgam and environmental concerns related to its disposal. It also discusses exposure risks and control measures for nitrous oxide, acrylates, latex, disinfectants, glutaraldehyde and other chemicals. Psychological hazards like stress, burnout, anxiety and depression from factors such as difficult patients, overwork and noise are also covered. Suggested controls include relaxation techniques, managing difficult patients, flexible schedules and making work-life balance.

1. CHEMICAL HAZARDS IN DENTISTRY AND ITS
CONTROL

2. 1/ Mercury exposure “Dental Amalgam”
• Dental amalgams are metal alloys composed
primarily of mercury (42%-58%), silver (21%-40%),
tin (5%-17%) and copper (1%-16%).
• Mercury is the largest component in a silver filling.
• Current scientific evidence supports dental amalgam
as a safe and effective dental filling.
• However, it represent a significant biological source
of environmental mercury.
• Exposure is through : inhalation of vapors, ingestion
and skin absorption. Skin sensitizer.

3. Environmental concerns
• The WHO reports that one-third of the mercury in the sewage system
comes from dental amalgam flushed down the drain.
• It is estimated that about half of the mercury released from current
and historical dental amalgam use potentially making all individuals
exposed to mercury pollution to some degree.

4. Mercury exposure control
1. Elimination of mercury containing equipment. Substitution with less
harmful product.
2. Mechanical amalgamators to ensure no physical contact.
3. Protective clothing, gloves, eye and face protection, and respiratory
protection based on hazard assessment.

5. 4. Properly designed and maintained ventilation systems.
5. Appropriate storage of products to decrease exposure.

6. 2/ Nitrous Oxide (N2O)
• Commonly called laughing gas, is exists as colourless, nonexplosive,
non-flammable gas at room temperature.
• Is an anaesthetic agent Dental workers are exposed to Nitrous Oxide
(N2O) during administration of this anaesthetic gas to patients.

7. 3/ Acrylate and its Compounds
• Dental polymer materials based on Methacrylate, used as a filler,
seem to be a major cause of contact dermatitis in dental personnel
and also a cause of occupational asthma.
Methyl methacrylate (MMA)
• Also known as methyl methacrylate monomer (or just‘monomer’).
Used in making dentures and plates, it can be absorbed into the body
by inhalation, through the skin, and by ingestion.
• Over exposure may lead to development of persistent
olfactory disorders in dental laboratory workers.

8. Where possible, substitution with less harmful product, maintain
adequate general ventilation, enclosed mixing devices

9. 4/ Latex
• Latex allergy was reported in 9% of dental personnel in a dental
school in Australia.
• Natural rubber latex (NRL) can cause asthma and dermatitis.
• Latex is used in medical gloves, but is also found in medical products
(for example rubber dam equipment, elasticised bandages, dressings)

10. • Using powder-free gloves is unlikely to lead to latex allergy;
• Individuals with existing latex allergy should continue to take latex-
free measures by use vinyl gloves

11. 5/ Direct contact with chemicals such as- Eugenol, Phenol, Iodine,
formalin, some impression material, topical anesthesia can cause
adverse reaction in the practitioner like contact dermatitis, or
asthmatic changes by inhalation or accidental ingestion

12. 5-Alcohol hand sanitizers
• May cause skin dryness.
• Product is flammable.
• Appropriate storage of product (away from ignition sources and
incompatible products). Provision of hand cream to soothe hand
dryness.

13. 6- Detergents and Disinfectants
• Possible eye, skin, and respiratory irritants.
• Some products may cause allergic dermatitis or contain sensitizers
such as nickel or limonene. May react with other products to create
hazardous products.

14. 7- Glutaraldehyde
• High level disinfection of medical devices. May also be used in tissue
processing
• Contact allergen, may cause occupational asthma and respiratory and
skin sensitization.

15. Psychological hazards in dentistry and its control

16. Dentistry is unequivocally a highly demanding profession in
which dentists struggle to manage long working hours, anxieties
regarding cross-infection control, pain control, stressful noise
pollution, communication with patients, medically compromised
cases.

17. Not only physical impairments, but job-related psychological
disorders may also affect dentist's health.
Risk factors affect dentist's psychological conditions that include
job-related stress, tension, depression, emotional exhaustion, and
depersonalization.

18. FACTORS PREDISPOSING TO PSYCHOLOGICAL
PROBLEMS
Dentistry is considered by many healthcare workers and general
public as a stressful profession.
Dealing with anxious patients,
 strict time schedule,
unanticipated emergencies,
 and painful treatments procedures connected with anesthetization
of patients, or procedures with hesitant prognosis are frequently
referred to as major stressors.

19. TYPES OF PSYCHOLOGICAL HAZARDS
The social and psychological hazards challenging dentists
include 1.burnout,
2. decline in professional performance, job control,
3. Stress
 4.depression,
5. effects on family life,
6. early retirement

20. Psychological hazards
Stress: coping with difficult or uncooperative patients, over workload,
constant drive for technical perfection, underuse of skills and
challenging environment are important factors contributing to stress
among dentist.

21. According to a study done 2012, 83% of dentists believe dentistry is
“very stressful”
Some of the main sources of stress in dentistry include:
Overcoming pain and fear of patients
Administration of anesthesia
Patient dissatisfaction with treatment
Running behind schedule
Work–life balance
“Technostress”(stress caused by technology uses)

22. Burnout syndrome
One of the important psychological issues confronted by dental
practitioners
It is a particular type of job related chronic stress reaction
characterized by emotional exhaustion, depersonalization and
reduced personal accomplishment.
It is also a response to the chronic emotional strain of dealing
extensively with other human beings, particularly when they are
troubled or having problems.

23. Anxiety disorder and Depression
are accompanied by intense physical symptoms like feeling
sweaty, weak, faint, dizzy, flushed or chilled; having nausea, chest pain,
smothering sensations, or a tingly or numb feeling in the hands

24. Abuse by patients or clients:
miserable or problem making patients are source of trouble in
dentistry.
Isolation of such kind of patients needed

25. Ways to reduce psychological hazards:
Deep breathing exercises, relaxation, hypnosis and desensitization
technique, stress management workshops.
Managing abuse clients
Flexible time arrangements including alternative work schedules,
decrease compressed work week.
Get benefit of shift work schedule if it is possible

26. Limit shifts of working not to be more than 8 hours
Combining technology to your work to ease some duties
Arrange working area design to be more comfortable and relaxing,
the furniture should placed in way not to disturb working zone
Listen to music if possible
Take breaks between patients
Make work-life balance