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Introduction
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)
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
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
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.