occupational hazards in dentistry

1. DEPARTMENT OF PUBLIC HEALTH DENTISTRY
Occupational Hazards In Dentistry
UNDER THE GUIDANCE OF:-
DR. SHITANSHU MALHOTRA
SUBMITTED BY:-
MOHD WAMIK
FINAL YEAR (2012-13)

2. SUBMITTED BY:-
MOHD WAMIK
FINAL YEAR (2012-13)
UNDER THE GUIDANCE OF:-
DR. SHITANSHU MALHOTRA

3. It can be defined as a risk to a person usually
arising out of employment it can also refer to a work
material, substance, process or situation that
predisposes or itself causes accidents or disease at a
work place

4. HISTORY
‘Bernadino Ramzzani’ also known as ‘Father
of occupational hazards’

5. HAZARDS IN DENTISTRY
 Biological health hazards
 Physical hazards
 Chemical hazards
 Psychological hazards

6. Biological Health
Hazards
•The dental environment is associated with a significant risk of
exposure to various microorganisms.
•Many infectious agents may be present in blood or saliva, as a
consequences of bacteremia or viremia associated with systemic
infections.
•Infectious agents like Viruses, Bacteria, fungi, prions
•Transmissible disease greatly concern in dental profession are HBV,
HCV, HSV, and TV
•Vaccination is the best prevention

7. The known virus which infects humans
Herpes simplex Herpes labialis and keratitis, cold sores,
Virus (HSV) -1
Herpes simplex Genital Herpes, neonatal infection
Virus (HSV) -2
Vericella Zoster Chicken pox
Virus
Ebstein bar infectious mononucleosis
virus
Cyto –Megalo Mononucleosis- type syndrome
Virus
Human Herpes Fever with rash, Encephalistis , Myocarditis
Virus (HHV)-6 Lymphadenopathy

8. Human Herpes It has yet to be conclusively associated
Virus(HHV)- 7 with any disease
Human Herpes It has been identified in all AIDS and
Virus(HHV)- 8 non- AIDS releated Koposi’s sarcoma
lesions

9. ACUTE VIRAL HAPATITIS
The viral hepatitis is currently divided into five primary types A, B, C, D,
E.
HEPATITIS-A :- Blood and secretions probably transmit hepatitis-A. The
incubation period is 2-6 weeks
HEPATITIS-C :- It is also called parenterally transmitted non-A, non-B
hepatitis (PT-NANB). It can be transmitted by blood. The incubation
period is 2-25 weeks.
HEPATITIS-D :- It was recogniszed as an infection dependent on HBV by
Rizetto in early 1980’s. Appear only in individuals if he is infected
simultaneously with hepatitis B or carrier of Hepatitis B
HEPATITIS-E :- It is the epidemic endemic form of a non –A non- B
hepatitis. It was first discribed in 1965.

10. HEPATITIS-B :- The hepatitis virus was first described in 1965.
Globally, there is more than 300 million carriers of the virus.
It is highly endemic in China and South East Asia , Africa , most of the
pacific island, part of the middle east and Amazon Basin.
HBV can be transmitted by both percutaneoulsy and non percutaneously.
PERCUTANEOUSLY:- Dental treatment involves the use of small, sharp,
contaminated instruments transferred between dental care provider
during treatment.
NON- PERCUTANIOUS:- transmission in the dental care enviroment
includes transfer of infectious bodily secretions such as saliva, blood
and crevicular fluid.
PREVENTION OF TRANMISSION OF HBV:-
hepatitis B vaccine:-
 PLASMA- DERIVED VACCINE
 RECOMBINANAT DNA VACCINE

11. HIV INFECTION/ ACQUIRED IMMUNODEFICIENCY
SYNDROME(AIDS)
HIV is member of the retro virus family that can lead to acquired
immunodeficiency syndrome. A condition in which the immune system begins
to fall leading to life threatening oppourtnistic infections.
TRANSMISSION:- Through contact with blood and other body fluids.
CLINICAL FEATURES :- unexplained diarrhea lasting longer than 1 month,
malaise, Fatigue, loss of more the 10% body weight, night sweat,oral thrust.

12. PREVENTION AND MANAGEMENT OF
BIOLOGICAL HAZARDS
 In general, workers should be aware of potential hazards
 Proper medical history of the patient
 Worker education
 Awareness about diseases
 Use of barrier techniques by using gloves, mask, eye ware,
face shields, high power suction

13.  Proper disinfection techniques should be followed
 Proper waste disposal
 Equipments to provide minimum aerosols
 Maintenance of proper ventilation
 Identifying high risk patients
 Use of double mask, double gloves techniques for high risk
patient
 The patient should be given the last appointment
 Practitioner with any laceration or cuts on epidermis of
hands should be prohibited from attending the operative
procedures
 Proper disinfection technique and proper disposal
Prevention is better than cure…..
 Proper immunization of the workers

14.  Chemicals and substance used in dental clinic poses a
major health hazard to a dental practitioner
CHEMICAL HAZARDS

15. Amalgam used in dentistry contain mercury Which
is a highly toxic metal-may lead to
mercury poisoning

16.  Direct contact with chemicals such as- Eugenol,
Phenol, Iodine, formalin, some impression material,
topical anesthesia can cause adversereaction in the
practitioner like contact dermatitis

17. Latex hypersensitivity

18. PREVENTION AND MANAGEMENT
 Proper education for the workers
 Developing safe work procedures
 Substitution of harmful products with less harmful
products ex. Latex gloves can be substituted by vinyl
gloves , use of dust-free alginate
 Monitor leakage or spillage of any potentially
hazardous substance
 Proper storage products
 Medical monitoring of workers periodically

19. Dealing safe with Hg-
 Use of water sprays, high velocity evacuation
 and rubber dam to reduce exposure
 Dental staff should wear face-mask
 Carpeting and rugs should be avoided as it is a major
repository for mercury
 Never rinse elemental mercury down the drain
 Never dispose elemental mercury in the trash
 Never dispose elemental mercury in the sharp
container or as medical waste
 Keep the filling cool during removal

20. PHYSICAL HAZARDS
 Dentists are at a high risk of physical injuries during
treatment
 Use of sharp may cause physical injuries to the
Practitioner
 Debris from the oral cavity might strike the eye
 Cut from sharp instrument
 Puncture wounds from needles and sharp objects

21. EXPOSURE TO CRYOGENIC AGENTS IN
CRYOSURGICAL PROCEDURES
 Oxygen depletion monitoring (depending upon hazard
assessment)
 Containers with pressure relief valves.
 Equipment maintenance.
 Restricted access.
 Worker education.
 Safe work practices.

22. POOR INDOOR AIR QUALITY
 Proper ventilation system design.
 Isolation/segretion of work processes that may create
contaminants.
 Infection prevention and controls standards.
 Procedures to report and investigate indoor air quality

23. EXPOSURE TO UV-A RADIATION WHEN
CURING RASIN BASED MATERIALS
 Equipment maintenance.
 Blue light filters.
 Safe work procedures including review and attention
to equipment manufacturer’s guidelines.

24. ELECTRICAL HAZARDS
 Ground fault circuit interrupters when used close to
water sources.
 Safe work procedures that include of electrical
cords,power bars and appliances that includes facility
approval requirements.
 Worker training.

25. CUTS FROM SHARP INSTRUMENTS
 Proper storage of sharps.
 Worker education.
 Safe work procedure

26. EXPOSURE TO LASER BEAMS
DURING DENTAL PROCEDURES
 Ensure area has no reflective surfaces
 Local exhaust ventilation
 Lock/key access for activation
 Restricted working area
 Worker education
Naver hold the X- ray
tubehead with hand while
shooting Raadiograph.

27. Exposure to ionizing radiation when
taking dental x-rays
 Workplace design to provide distance between worker
and source
 Equipment design to minimize scatter.
 Positioning devices to patient
 Replacement of older dental x-ray equipment with
newer equipment with additional safety features.

28. PREVENETIVE STRATEGIES
 Exposure to radiation can result in harm, categorized as either
Deterministic or Stochastic.
 Deterministic effects occur above a certain threshold of radiation e.g.
BURNS, CATARACTS.
 Stochastic events are radiation as there is not a threshold dose above which
they will occur e.g. CARCINOGENESIS.
 Additional exposure for medical purposes should be limited to where
benefit out weights risk to both staff and patients.
Radiation dermatitis
on hands
Squamous cell carcinoma
on figures

29. Prevention and management
 Proper storage of sharp instrument
 Equipment maintenance
 Proper managing and handling
 Carefully carried out procedures

30. NEEDLE STICK INJURY
 Ensuring the needle and surgical blade are
sheathed/covered when not in use
 Keeping full control of sharp instruments and retaining
 full concentration while handling such instruments
 Keeping gloved fingers behind the cutting edge of surgical
blades and elevators or the points of probe or needles
 Adequate retraction of tissues and appropriate instruments
 Placing needles in sharp safe box
 Taking care when cleaning away the surgical sharps, wires,
etc.
 Overgloving or using double gloves, whenever indicated

31.  Worker education about the signs and symptoms of
depression, anxiety,sleep depriviation, other mental
illness
 Elimination of workplace risk factors for depression
,anxiety, sllep disorder other mental illness
 Provision of support service and program
 Appropriate sleep habits
PSYCHOLOGICAL HAZARDS

32. TECHNOSTRESS
Related to the introduction of new technology
Management & prevention :-
 Self – education concerning new technologies
 Design of instruments or equipments with user – friendly features.
 Time managements strategies
 Back-up plans in the events of failures
 Healthy lifestyle

33. CONCLUSION
Dental health workers are exposed to many occupational
hazards ranging from threat of infectious disease,
toxicity to chemical routinely used in dentistry.
By identifying the control that will eliminate or reduce
the risk, we can significantly reduce the occupational
hazards.