dental erosion for factory workers

1. S.NEPPOLIYAN
CRRI

2. CONTENTS
 Introduction
 Materials and Methods
 Results
 Discussion
 Limitations of the study
 Conclusion

3. Introduction
 Majority of people employed in various industries are
exposed to hazardous environment.
 Exposure to chemical agents in the workplace can
result in adverse effects on workers.
 This exposure deteriorates the general and oral health
of people, working in industries for long hours.
 The aim is to assess the prevalence and severity of
dental erosion among battery manufacturing factory
workers

4.  The surface loss of dental hard tissues other than
by caries, trauma, or developmental aberration is
termed tooth wear.
 Based on etiological factors, tooth wear has
traditionally been divided into three categories:
attrition, abrasion, and erosion.
 Among the three categories, dental erosion is
known to cause more damage to tooth structure.

5.  Dental erosion is defined as the loss of tooth structure
usually caused by acids, without the involvement of
bacteria.
 Dental erosion is caused by extrinsic factors, intrinsic
factors, and occupational hazards.
 Industrial environmental factors may be considered
responsible for dental erosion among battery workers
since they were exposed to sulfuric acid.

6.  There are few studies done on factory workers and
their oral health status in Indian scenario.
 Among the majority of the studies, there was very little
information about tooth wear which constitutes major
occupational hazard among the factory workers in
Indian scenario.
 A study was conducted to assess the prevalence and
severity of dental erosion among battery
manufacturing factory workers

7. Materials and Methods
 A cross - sectional, comparative study was conducted
at battery factory workers.
 Before starting the survey, the ethical clearance was
obtained from the Institutional Ethical Committee of
dental institution.
 The study population informed about the purpose of
the study and written informed consent was obtained
from them before their participation in the study
according to the WHO informed consent criteria for
qualitative research.

8.  There were a total of 175 workers employed at jeep
battery manufacturing factory. All the workers were
invited to participate in the study.
 The battery units had two types of workers, those
exposed to acid fumes or mists (113 [64%]) (working in
battery production site) and those who are not
exposed to acid fumes (62 [36%]) (working in
maintenance, administration, purchase, and
engineering office) which formed the basis for division
into study and comparison group.

9.  Battery factory workers of all ages, available at the
time of examination, were included in this study.
 The examiners and recording assistants were
trained and calibrated in the Department of Public
Health Dentistry, under the supervision of the
staff members.
 A detailed blueprint of the survey was prepared
well in advance.

10.  Information regarding departments in the battery
factory, duration of the job, and exposure to
various working conditions were recorded along
with the demographic details.
 Smith and Knight tooth wear index was used to
assess dental erosion.
 Clinical examination was done by the investigators
with the study participants seated on an ordinary
chair using natural daylight.

11.  Those workers who needed any care were referred
to dental college.
 The data were tabulated using the Microsoft Excel
spreadsheet software (Microsoft).
 The data were analyzed using Statistical Package
for the Social Sciences (SPSS Inc., Chicago, IL,
USA)

12. Results
 All the study participants in the study were males.
Majority of workers in the comparison group were
aged between 25 and 34 years (85%), whereas among
study group, 46.9% of workers were aged above 45
years. The difference was found to be statistically
significant (P < 0.01) [Table 1].

13.  As compared to study group, in the comparison group,
the period of exposure was statistically significantly
lower (P < 0.001). It was seen that in the comparison
group more than two-third (65.5%) of the respondents
had up to 5 years of experience, whereas in study
group, the period of exposure was more than 10 years
in 90% of participants [Table 2]. The difference was
statistically significant (P < 0.001).

14.  None of the participants in the study group had erosion
score of 0 as compared to comparison group where 35
(56.5%) participants had erosion score of 0 in comparison
group. Of the remaining 27 comparison participants, 16
(59.2%) had erosion score of 1, whereas 11 (40.7%) had
erosion score of 2.
 In contrast, 58 (51.3%) study participants had erosion score
of 3 and around 20 (17.6%) had erosion score of 4 [Table 3]
Statistically, a significant difference was observed between
the two groups (P < 0.001).

15. Discussion
 The survey was carried on battery workers at jeep
battery manufacturing factory.
 The response rate in the survey was 100%. All the
workers surveyed on the day of examination were
males.
 Majority of workers in the comparison group were
aged between 25 and 34 years (85%), whereas among
study group, 46.9% of workers were aged above 45
years.

16.  Majority of the participant in the study group (about
90%) had more than 10 years of experience working in
the battery factory when compared to comparison
group, where majority of workers had a maximum
work experience of about 5 years.
 In our study, dental erosion was observed on the
surfaces of the teeth most exposed to the atmosphere
that is incisal one-third to one-half of the labial
surfaces of the front teeth. No erosion of the posterior
teeth was seen.

17.  About 55% of the study group had Grade-3 erosion and
20% had Grade-4 erosion.
 In the comparison group, majority of about 85% had
only Grade-1 dental erosion and remaining 15% had
Grade-2 dental erosion.

18. Limitations of the study
 Sample size of the present study was small; studies on
larger samples would help to better understand the
dental erosion prevalence and severity.
 To understand the cause - effect dynamics between
these variables, analytical epidemiological studies are
required.

19.  In the light of the present alarming finding associated
with excessive exposure to acid fumes in the workplace
resulting in dental erosion.
 The management of the factory are invited to
implement effective safety measures, including:
efficient surveillance and routine monitoring of acid
fumes in workplace air; installation of efficient
ventilation and exhaust systems of the worksites;
 Implementation and mandatory use of protective
masks, mouth guards, goggles, and face guards; and
providing medical and dental care services at regular
intervals.

20. Conclusion
 Majority of the study participants had higher
prevalence and higher scores of dental erosion when
compared to the comparison group.

21. THANK YOU