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Dental hospital staff and students were observed during clinical work for their compliance with infection control procedures, as recommended by the British Dental Association. A total of 183 contacts between health care worker and patient were scrutinised during December 1990. Nearly all health care workers (96%) wore gloves to carry out dental treatment, but in some cases gloves were neither changed nor hands washed between patients. Only one half wore protective eyewear and about one third (38%) wore no mask. Some dental surgery assistants used heavy duty gloves and some even scrubbed dirty dental instruments without wearing any gloves. Strict audit is clearly needed in every clinical setting in order to ensure compliance with infection control.
PURPOSE: To provide a comprehensive assessment of the indoor environment of a representative dental office. METHODS: Health and comfort parameters, including carbon dioxide (CO2), respirable particulate matter (PM2.5), volatile organic compounds (VOCs), temperature, relative humidity, light and sound level, were measured at three sites over a 1-week period. Both real-time and integrated sampling methods were used, and clinic activities were recorded. Measurements were compared to guidelines and standards, and interactions between pollutant levels, emissions, and clinic activities were investigated using correlations, trend analyses, and a ventilation assessment. RESULTS: Comfort parameters were found to be within recommended values, with the exception of relative humidity, which was low but not unusual for the winter season investigated. Ventilation rates were within accepted guidelines. Integrated sampling showed that concentrations of VOCs were well below guidelines. However, PM2.5 levels exceeded ambient standards (by a factor of 2 to 6) throughout the building. Continuous trending allowed identification of peak levels, but correlations of clinic activities with measured concentrations were inconclusive. The results suggested that levels of air contaminants in dental clinics (with the exception of PM) are within guideline levels. With the recirculating ventilation systems found in most clinics and offices, particulate contaminants may rapidly disperse throughout a building. Improved capture, exhaust and filtration would decrease indoor PM concentrations. If contaminants are pathologic, the ramifications for practitioners may be considerable, and some specialists may be particularly at risk.
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AIM: To investigate the changes in the pattern of new patient referral and treatment at a dental hospital emergency clinic since the introduction of the new dental contract in 1989. DESIGN: A prospective survey and review of clinical records. SETTING: The examination and emergency clinic at Cardiff Dental Hospital. SUBJECTS: 500 consecutive new patients attending the clinic in May/June in 1989, 1993, 1994 and 1995. MAIN OUTCOME MEASURES: Numbers of referrals; source of referral; geographical distribution of patients; registration with general dental practitioners; type of dental disease; treatment received. RESULTS: New patient attendances increased by 56% since 1989. Referrals from family doctors and dentists decreased while self-referrals increased. Self-referral by patients not registered with family dentists increased by 56%. Extraction of teeth was the commonest form of treatment in all years and increased by 72%. CONCLUSIONS: Numbers of patients attending for dental treatment at this setting increased substantially after 1989. Increasing numbers of these patients were inappropriately self-referred for treatment. Patients increasingly selected extraction of teeth as the primary treatment rather than restorative procedures. These changes appeared to be unrelated both to the severity of dental disease at presentation and to socio-economic status.
The Electromyographic (EMG) Signal Acquisition and Analysis System is an integrated hardware and software system that digitizes multichannels of amplified EMG signals and stores them in user defined disc files before analysis. The software runs on all IBM PC and its compatibles with the appropriate analogue-to-digital (A/D) conversion board. Both time and frequency domain analyses can be computed on-line. This system provides a low cost method of digitizing and analysing EMG signals on real-time for clinical dental electromyography.
To evaluate the occupational hazard in use of mercury by dentists, the work environment and procedures of 22 dentists and their 33 assistants were surveyed. Determinations were made of a) the mercury vapour concentrations in the offices b) the urinary excretion of mercury by the 55 persons concerned c) the mercury concentration in blood. In three of the offices surveyed, mercury vapour concentration exceeded the threshold limit value of 0.05 mg/m3, implying a lack of care in handling mercury. Urinary mercury contents of one dentist and four dental assistants exceeded 0.05 mg/l i.e. the upper "normal" value for a population with no known exposure to mercury. The manner in preparation and handling of the amalgam were considered to be the predominant comtamination factor.
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