OCCUPATIONAL HAZARDS FOR DENTISTS

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  • #10032

    Dental professionals are susceptible to a number of occupational hazards. Relying on relevant literature, the present paper discusses selected occupational hazards – occupational biohazards, stressful situations, and latex hypersensitivity, as well as factors leading to the musculoskeletal system diseases and diseases of the peripheral nervous system.

    Potential sources for occupational hazards to dentists 1-Working for long periods of time in physiologically improper positions. 2-Contact with patients. 3-Contact with certain chemicals and materials used in dental practice. 4-Contact with X-ray.

    :
    1- Working for long periods of time in physiologically improper positions. This can affect the dentists’ legs spines and shoulders Leg spine shoulder pain flat foot drooping curvature varicositiy

    To avoid or minimize such effects dentists should strictly apply the following: 1- As long as possible working should be in a seated position using an operating stool. 2- If standing position is mandatory while working, it should be in an erect posture. 3- Not to frequently bow the back for better inspection or access to different areas in oral cavity while seated or standing. 4- Not to work for a long time in a fixed position in order to avoid varicosity of the lower extremities.
    2-Contact with patients. Infection Harmful effects Eye injury and/ or inflammation Mental fatigue

    Infection Aerosolization is a process whereby mechanically generated particles ( droplet nuclei ) remain suspended in the air for prolonged time periods and may be capable of transmitting an airborne infection via inhalation Aerosols are airborne particles, generally 5-10 µm in diameter, that may travel for long distances. They may occur in liquid or solid forms. Splash and spatter are large droplets that remain airborne but contribute to infection of horizontal surfaces (indirect contact)

    Infection can be transmitted to dentist from infected patients who have infectious potential. Infection transmission: A- Airborne: influenza, common cold, T.B . (Aerosols) B- Bloodborne : Syphilis, Hepatitis B and C, and AIDS. Infected blood should contact dentist’s blood (needle prick after patient injection, wound in dentist’s hands) C- Direct contact of hands with oral mucosal lesions : syphilis and herpes simplex infection. Saliva and hepatitis C ?

    Certain precautions should be taken to minimizing the risk of such infections to dentists: 1-In dealing with T.B. patient, or a patient suffering from common cold or influenza, the dental surgeon should wear a face mask 2-The use of high speed hand pieces with T.B. patients should be avoided to minimize aerosols. 3-In dealing with a syphilitic patient, the dental surgeon should wear rubber or vinyl gloves. The dentist should not scrub his hands with a brush before or after working on these patients, since scrubbing may produce minute abrasions which serve as a portal of entry for microorganisms

    4-During clinical examination, mucosal lesions should never be touched without gloves. 5-Careful handling of sharp instruments during treating hepatitis and AIDS patients. It should be always remembered that blood and blood products of hepatitis and AIDS patients carry diseases of no known cure. However, it is not possible to identify all infectious cases that seek dental help. Thus, as a golden role “All patients should be treated as if they are infectious and routine cross-infection control is necessary when dealing with every patient”

    Eye injury and inflammation: During treatments of the patient , it may happen that patient’s blood, salivary droplets (splash), calculus, or fragments of a tooth or amalgam filling might accidentally hit the eyes of the dentist. This might lead to minor trauma and/or inflammation. In such case the dentist should wash his eye(s) immediately with sterile saline, and seek the help of an ophthalmologist for any further indicated management. To avoid such hazards eye glasses should always be used while treating the patients.

    Mental fatigue: – This results from communication and dealing with the patients, added to realization of professional abilities. – Although this is not a disease, but unfortunately, it is sometimes unavoidable and it might adversely affect the quality of the dentist’s work.

    3-Contact with certain chemicals and materials used in dental practice. Direct contact with materials such as eugenol, phenol, iodine, formalin, some impression materials, topical anaesthia and others allergic dermatitis This direct contact could simply be avoided by sticking to wearing gloves. Amalgam?

    4- Contact with X-ray X-ray is an ionizing radiation that is capable of initiating and producing damage to body cells, as well as carcinogenic and genetic changes. Careless dentists used to hold the dental X-ray films inside the patient’s mouth (for obtaining better quality of image) are at risk for developing radiation dermatitis on hands, or on a long run squamous cell carcinoma of the figures.

    For protection from radiation hazards, principles and means of radiation protection should be applied and used during radiation exposure. Dentist should not hold the film in patient’s mouth. -Dentist should avoid direct exposure to X-ray beam, and proper position of the dentist in relation to either the X-ray machine or the patients should be strictly applied. -Regular checking of leakage from X-ray machine should always be performed.

    #14668

    back pain is one of the main hazards.

    a dentist who does not have back pain does not have patients

    #14669

    Most commonly back pain is while working on upper teeth
    That s the reason one must put the habit of working in indirect vision

    #14670

    Myofascial Release
    John Barnes popularized this technique and I’ve read that it’s very effective for people with chronic pain and those who are recovering from trauma. The therapy is very gentle — so gentle that it sometimes seems like there’s no way it could help. Yet, it made an incredible difference in my mobility and pain level. It helped me get things unstuck where they’d been in the same position for too long or gotten into a bad pattern with me not moving very much while I was in bed. Some yoga programs incorporate Myofascial release techniques as do some massage therapists and physical therapists.

    McKenzie
    Robin McKenzie is a doctor who revolutionized back care and has written a book called “Treat your own back”. The treatment consists of very gentle exercises that move your spine back into alignment. I found it helpful to have the book in addition to the physical therapy as I was able to understand why the exercises worked and it helped me to remember the exercises at home.

    McConnell Taping
    Natural pain relief. The therapist tapes your body so that it holds the muscles in the correct position. The tape gives your muscles a little bit of additional support and keeps you from getting into bad postures. I thought this was crazy when the therapist first did it, but it worked wonders and over time I learned to tape myself in between therapy sessions

    General thoughts
    I looked for a physical therapist who was trained in the McKenzie technique. She had been practicing for over 20 years. For those in the Seattle Area, my therapist was Robin Angus at Movement Systems physical therapy in Eastlake. The PT department at Group Health is also trained in McKenzie.

    #14671

    Natural drugs and supplements.
    Topricin
    Dietary Supplements

    Prescription Pain Relief
    Vioxx
    Darvocet
    Prescription Topical Muscle Relaxant
    Effexor
    pain relief devices, including TENS, Ice Pack, Saunders Home Traction, and Electrostim

    #14672

    image of acupuncture and physiotherapy for back pain

    #14677

    Dental professionals may be at risk for exposure to numerous workplace hazards. These hazards include but are not limited to the spectrum of bloodborne pathogens, pharmaceuticals and other chemical agents, human factors, ergonomic hazards, noise, vibration, and workplace violence.

    There are currently no specific standards for dentistry. However, exposure to numerous biological, chemical, environmental, physical, and psychological workplace hazards that may apply to dentistry are addressed in specific standards for the general industry.

    OSHA Standards

    This section highlights OSHA standards, directives (instructions for compliance officers), and standard interpretations (official letters of interpretation of the standards) related to dentistry.

    Note: Twenty-five states, Puerto Rico and the Virgin Islands have OSHA-approved State Plans and have adopted their own standards and enforcement policies. For the most part, these States adopt standards that are identical to Federal OSHA. However, some States have adopted different standards applicable to this topic or may have different enforcement policies.

    #14678

    80% of dentists retire early due to the occupational hazards of their profession. Some of the occupational hazards include:

    Back Pain
    Toxins
    Neck Pain
    Mercury Poisoning
    Carpal Tunnel Syndrome
    Varicose Veins
    Hemorrhoids
    Herpetic Whitlow

    #14681
    Anonymous

    Herpetic Whitlow

    A herpetic whitlow is a lesion (whitlow) on a finger or thumb caused by the herpes simplex virus. It is a painful infection that typically affects the fingers or thumbs. Occasionally infection occurs on the toes or on the nail cuticle. Herpes whitlow can be caused by infection by HSV-1 or HSV-2. HSV-1 whitlow is often contracted by health care workers that come in contact with the virus; it is most commonly contracted by dental workers and medical workers exposed to oral secretions. It is also often observed in thumb-sucking children with primary HSV-1 oral infection (autoinoculation) prior to seroconversion, and in adults aged 20 to 30 following contact with HSV-2-infected genitals. Symptoms of herpetic whitlow include swelling, reddening and tenderness of the skin of infected finger. This may be accompanied by fever and swollen lymph nodes. Small, clear vesicles initially form individually, then merge and become cloudy. Associated pain often seems large relative to the physical symptoms. The herpes whitlow lesion usually heals in two to three weeks.

    In children the primary source of infection is the orofacial area, and it is commonly inferred that the virus (in this case commonly HSV-1) is transferred by the chewing or sucking of fingers or thumbs.
    In adults it is more common for the primary source to be the genital region, with a corresponding preponderance of HSV-2. It is also seen in adult health care workers such as dentists because of increased exposure to the herpes virus.

    Treatment

    Although it is a self-limited illness, antiviral treatments applied to the infected skin, particularly topical acyclovir, have been shown to be effective in decreasing the duration of symptoms. Lancing or surgically debriding the lesion may make it worse by causing a superinfection or encephalitis.

    #14682
    Anonymous
    #14686
    Anonymous

    Exposure to radiation and mercury inhalation are are on other lists

    #14688

    exposure to radiation is not much of a problem if basic precautions are taken.

    exposure to mercury is

    #14695
    Anonymous

    Regular yogic exercises help.

    #14696
    Anonymous

    Vakrasan, tadasan and parvat asan are good for the back. Dentists must be taught these in the 3rd year itself

    #14744

    Myofascial Pain Syndrome
    Myofascial Pain Syndrome will vary in severity. For this reason, please take the time to read about the following information about this condition before you decide what approach to take for helping with treatment and prevention:

    *Health Disclaimer
    Any information given about back related conditions, treatments, and products are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the #1 Back Pain Site! See *Site disclaimer for more information.

    Table Of Contents:

    All About Myofascial Pain Syndrome & Approach Treatment
    Therapies, Products, and Activities to Help Your Condition
    1. Choosing the Correct Mattress for Better Back Support
    2. Finding the Right Chair or Seat Insert Cushion
    3 Soft Back Braces
    4. Traction Devices
    5. Electric Stimulation Devices
    6. Ultrasound
    7. Ice packs
    8. Hot Packs
    9. Whirlpool and Jacuzzi Water Therapy
    10. Mechanical Massage Devices
    11. Topical Analgesics for Pain Relief
    12. Vitamin, Mineral and Herb Supplementation
    13. Nutritional Aid in the Healing Process
    14. Medications
    15. Exercises and Stretches for Your Back Condition
    16. Yoga and Meditation to Relax the Back
    17. Correct Shoes for Avoiding Back Pain
    18. When to Use a Heel Lift or Orthotic Shoe Insert
    Deciding on the Best Health Care for you
    1. Chiropractic
    2. Massage Therapy
    3. Acupuncture
    4. Physical Therapy
    5. Medical Practitioners

    All About Myofascial Pain Syndrome & Approach to treatment
    Sponsored by: Relief-Mart – Quality health products for the back and spine.

    When the muscles of the back become injured from prolonged irritation, they can develop a reactive inflammation called myofascitis. Myofascial pain syndrome refers to a condition where the myofascitis occurs on a constant basis and becomes chronic over a long period of time.

    Muscles of the back may be injured initially through traumatic tearing of the fibers, repetitive strain, and through pre-existing conditions which cause the muscles to be weakened and inflamed without provocation. Fibromyalgia is one such condition in which multiple muscles of the body are in a constant irritated state, and demonstrate myofascial pain syndrome. While traumatic injuries are easily identified, repetitive strains can be more difficult to ascertain. These strains can begin with a repetitive movement where the muscles are being irritated over a long period of time until they become vulnerable to tearing from a simple change in the position of the back. For example, a person who has improper posture at a computer on a regular basis, or a golfer who plays frequently with bad form may have their muscles tighten over time and form micro-tearing and inflammation as a result. Approximately 5 days after an injury, scar tissue will then form to act like glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe back strains. In cases where the repetitive irritation is not halted, or if the area does not heal properly and the scar tissue does not break down, myofascial irritation will persist.

    The initial approach to treating myofascial pain syndrome is to support and protect the muscles, help them to loosen up and lessen the pain and minimize any inflammation. Due to the stiffness which accompanies scar tissue, it will be important to perform procedures which help break down the scaring in the muscle, so as to let the muscle regain its normal flexibility and lessen the chance of further injury. While exercise is appropriate for breaking down scar tissue once the area has healed, it may further irritate the area during the initial stages of a re-irritated myofascial pain syndrome. Therefore, other methods such as ultrasound, massage, and chiropractic adjustments may be safely used to accomplish this early on in the injury. The listed Therapies, Products and Activities section will give more information on how to help your condition, however, as each Myofascial Pain Syndrome condition is different, always consult your doctor to determine what treatment is right for your particular situation.

    Therapies, Products, and Activities to Help Your Condition:

    Choosing the Correct Mattress
    A good mattress will protect the back for the many hours that you are in bed. A mattress that properly supports the body will also be a very important element in helping relieve stress on the muscles and joints of the back. The most important information needed for finding a correct mattress to support the back involves knowing what position you sleep in. The menu below will help you to search for a mattress that is right for you.

    Choose a sleeping position:

    Back Side Stomach All Positions

    Finding the Right Chair or Seat Insert Cushion
    Whether you sit for minutes or hours, you can’t underestimate the value of proper posture while sitting. It has been demonstrated that at times there can be as much as six times the amount of stress on your back when you sit than while lying down. Fortunately you can lower the amount of stress placed on the spine with proper back support. To accomplish this, first you must decide whether the chair you use presently is adequate for your needs. A good chair will be able to provide your lower back with proper lumbar pressure. This pressure will keep the curve of the spine in this area supported in the normal position. When a proper lumbar support is not provided with your chair, an insert lumbar cushion can accomplish this. The size of the cushion is very important, as too much lumbar support can compress and irritate the spine. A good working ergonomic type of chair can be adjusted to allow tilting and height control of the seat and chair back. Here are some tips for adjusting your chair properly: Adjust the height of the chair to allow your feet to rest comfortably on the floor. Adjusting the tilt angle of the seat will change the position of your pelvis, thereby shifting the back towards or away from the seat back. Tilting the front of the seat downward will bring your lower back into extension and thus increase the lower lumbar curve. Tilting the front of the seat upward will bring your lower back into flexion and thus decrease your lumbar curve. Combine the seat angle tilt with the seat back tilt for optimal support of the back. If the seat back height can be adjusted, make sure the small of your back fits with the part of the seat back which curves outward to support the lower back. If these adjustments still do not support the spine properly, you will definitely need a lumbar insert cushion or more ergonomically correct chair. Insert cushions will need to have height adjustability to fit correctly. This is usually achieved with a strap that allows you to set the height of the cushion to the thickest part against the small of your back. Each person’s spine curves differently, so another important feature that some back support cushions provide is the ability to adjust the size of the lumbar thickness to customize the fit.

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