Occupational diseases

Occupational diseases

Occupational diseases

1.  Introduction :

Like all healthcare personnel, dental surgeons and assistants are exposed to numerous risks that lead to occupational illnesses.

Definition :

An occupational disease results from exposure to a risk to which a person is exposed at their workplace.

They are divided into four risk categories: physical, infectious, chemical and psychological.

2.  Physical risks:
   1. Musculoskeletal disorders (MSDs): MSDs primarily result in pain and functional discomfort, most often occurring in the back and upper limbs. They are particularly due to prolonged inappropriate postures or repetitive movements.
      1. Lower back pain, neck pain, back pain:

“Back pain” which can affect the cervical, dorsal or lumbar spine is a direct consequence of the working posture of the dental surgeon

Low back pain , intense pain in the lumbar vertebrae, can be triggered by a “false movement” or poor posture.

As with lower back pain, neck pain is caused by poor posture, incorrect movement, or even osteoarthritis, and results in sharp pain in the neck.

Back pain , which occurs between the first and twelfth thoracic vertebrae, is also one of the painful manifestations of the dentist’s postures.

Prevention of MSDs: this involves, above all, finding the most suitable ergonomics in terms of setting up the treatment station and improving working positions, the two being closely linked.

Treatment of MSDs: can be relieved, depending on its location, intensity and age, by small adapted exercises, treatments or wearing a splint for example.

Pain related to MSDs is treated on a case-by-case basis by the attending physician, possibly in coordination with specialists.

Prescription of painkillers or anti-inflammatories is usually necessary. But these

medications are ineffective when the pain is persistent and requires the combination of other non-drug techniques: physical exercises, equipment, relaxation, osteopathy, acupuncture, etc.

2.  carpal tunnel syndrome:

Carpal tunnel is defined as “a tunnel in the wrist through which passes the median nerve responsible for the syndrome and the tendons that allow the fingers to flex, called flexor tendons.

Carpal tunnel syndrome is caused by compression of the median nerve in the wrist and results in numbness, tingling, pain, and decreased muscle strength in the hand and wrist.

In the dentist, this syndrome is favored by the combination of extensions, flexions,

in particular the use of the thumb-index clamp as well as a constraint on the wrist when holding the instruments.

Prevention of this syndrome is achieved by respecting ergonomic wrist movements.

Treatment: When symptoms are mild, rest, wearing a splint, or a corticosteroid injection can alleviate symptoms. In other cases, surgery is necessary.

3.  Visual disturbances:

The eye is the primary working tool of the dentist. Its activity requires great visual acuity, but prolonged attention, accommodation efforts, and glare are sources of

eye strain . The practitioner’s eyes can also be affected by traumatic accidents or

infections related to dental practice.

Eye strain can cause simple redness and itchy eyes, but also more extensive vision problems and headaches.

This visual fatigue is particularly caused by the artificial light in the treatment room, as you continually move from one brightly lit area (the oral cavity) to another.

less lit areas of the office (floors, walls, furniture): the iris opens and closes with each passage.

Accidents, particularly from projectiles sent by rotating instruments (turbines for example), can occur and cause trauma and injuries.

A projection can also be a factor in infection (conjunctivitis, hepatitis, etc.), chemical burns (acidic, toxic products, etc.).

Prevention: To reduce visual disturbances, it is important to ensure visual comfort, particularly by choosing suitable lighting to avoid the risk of glare and eye fatigue.

Avoid blue light from LEDs which is very harmful to the eyes, take breaks between treating two patients to rest the eyes, wear protective glasses or a visor to avoid projections into the eye.

Treatment: “Today, optical aids are an integral part of the dental surgeon’s therapeutic arsenal.” The use of these aids, surgical glasses or binocular loupes by

For example, they provide a solution to the visual and ergonomic constraints faced by dentists. They also help correct posture.

Eye burns from chemical splashes are medical emergencies that should be treated immediately with eye wash.

4.  hearing problems:

In the workplace, hearing problems occur when the ear is exposed to sound levels above 80 dB, which is considered “tiring/painful”.

Depending on the instruments used, suction, turbine, compressor, scaler, ultrasound, etc., the noise level in a dental office is between 78 and 85 dB, which therefore constitutes a factor of difficulty.

In addition to the noise in the treatment room, there are external noises such as the telephone ringing, the front door ringing, the waiting room, background music, etc. These noise attacks constitute an omnipresent acoustic environment which contributes to auditory fatigue , tinnitus and is sometimes accompanied by hearing loss .

This auditory fatigue is insidiously reinforced by the frequency and duration of these harmful sounds. It is essential, in fact, to emphasize the relationship between intensity and duration limit.

exhibition.

However, noise, beyond hearing problems, is a source of irritability, headaches, stress, etc.

Prevention and treatment: To reduce the noise level in the dental office, it is essential to ensure that the instruments used are in good condition. Proper soundproofing of the office also contributes to a better acoustic environment.

During professional practice, it is recommended that the dental surgeon use hearing protection, including earplugs or noise-cancelling headphones that reduce noise pollution without interfering with communication.

Hearing loss requires the use of hearing aids.

5.  radiological risks: Taking radiological images generates two types of ionizing radiation produced by the X-ray tube

“Direct” (or primary) radiation which comes directly from the X-ray tube and can pose a risk to the dentist if, for example, the sensor is left in the patient’s oral cavity.

The “diffused” radiation which disperses around the patient and affects anyone present in the treatment room without suitable protection.

X-rays are ionizing radiations that can pass through the body and have very harmful effects on health for long or repeated exposure times and/or for high intensities: skin, ophthalmological, hematological, cellular damage that can cause cancers, malformations. Endo-oral X-ray devices generate low doses of X-rays and therefore the risk for the dentist is low but still exists.

Radiation Protection in Dental Surgery: The dangers are minimal, the precautions are as follows

-Wearing a lead apron.

-Operator position must be at an angle between 90 and 135° to the primary beam.

3.  Infectious risks:

An infection occurs when a pathogenic microorganism (bacteria, virus, fungus, or parasite) enters and multiplies in the body. Transmission occurs through the air and parenterally:

– Direct airborne contamination, favored by the extreme proximity of the contaminant and the contaminated during dental care via aerosols generated by the care: blood, biological fluids, mains water, etc.)

-Direct parenteral contamination through contact between infected blood or saliva and even a small cut on the practitioner’s hands.

-Indirect contamination through an instrument or needle soiled with blood or saliva.

Consequences :

• respiratory infections: viral diseases, tuberculosis (for example, when the patient coughs)
• viral keratoconjunctivitis (eye contamination)
• blood exposure accidents: HIV, hepatitis B and C

Blood Exposure Accident (BEA):

“An AES is defined as any contact with blood or a biological fluid containing blood and involving either a break in the skin (prick, cut) or a projection onto a mucous membrane (eye) or damaged skin.

Accidents occurring in the same circumstances with other biological fluids (saliva) considered potentially contaminating, even if they are not visibly soiled with blood, are considered to be AES.

Prophylactic measures

Prophylactic measures must be applied daily in the dental practice to minimize all risks of infection, for staff, their entourage, and patients. These measures consist of:

• Apply hygiene and sterilization rules,

– Screen at-risk patients,

• Take strict operating precautions,

-Vaccinate all healthcare staff.

CAT in front of (AES): (see course on infection control in the dental office)

4.  Chemical risks:
   1.  Latex allergy:

Latex allergy is very common, especially among dentists who wear latex gloves for long periods of time during their professional practice.

The proteins contained in natural latex can trigger allergic reactions, but it is also necessary to take into account the various additives used in the manufacture of latex.

rubber (vulcanization accelerators, preservatives and antioxidants) and on the other hand slip agents (talc and starch, corn or wheat powder for gloves).

Contamination occurs mainly through the skin, but inhalation of airborne latex particles is also possible.

Allergic mechanisms linked to latex can give rise to numerous conditions:

-Contact urticaria;

-Rhinitis, asthma, acute conjunctivitis;

-Quincke’s edema;

-Eczematous lesions.

Treatment: For latex allergies, it is important to treat the symptom itself and reduce or completely eliminate latex exposure. Symptoms improve quickly after removing the allergen.

Use equivalent non-latex products, such as polyisoprene, copolymer or nitrile gloves.

2. Risks related to metals: nickel, chromium, cobalt and mercury:

Despite the development of composite resins and ceramics, various metals used in the manufacture of prostheses, filling products or instruments can induce toxic or allergic reactions. The dental surgeon is affected to a lesser extent than the prosthetist,

Mercury is extremely toxic to the liver, kidneys, and brain, and can cause serious neurological conditions. Mercury emits vapors at room temperature, and these emissions are particularly toxic.

Prevention: Mercury risk is avoided by:

-Use of pre-dosed capsule packaging;

-Performing milling or repolishing operations under irrigation, suction and as much as possible with a dental dam.

5.  psychological risks:

A poor working environment and degraded working conditions can lead to fatigue, stress and burnout, and lead to a deterioration in the quality and safety of care.

1.  stress :

“Work stress corresponds to the imbalance felt between the professional objective to be achieved and the resources to meet it.”

In 2011, the WHO ranked “the profession of dental surgeon among the most subject to stress. Indeed, in addition to their own stress linked, for example, to the practice of a precision surgical procedure or to the management of their private practice, the practitioner must also manage the stress of their patients.

Stress manifests itself through: emotional symptoms (nervousness, anxiety, sadness, etc.), intellectual symptoms (concentration problems, forgetfulness, etc.) as well as physical symptoms (headaches, MSDs, sleep disorders, etc.)

Over time, chronic stress can have serious repercussions on health and lead to burnout.

2. Burnout:

Burnout refers to professional exhaustion (physical, emotional and mental exhaustion) resulting from chronic stress at work .

According to the WHO, it is characterized by three dimensions:

-A feeling of lack of energy or exhaustion;

-A withdrawal from work or feelings of negativity or cynicism related to work;

-A loss of professional efficiency

Burnout is associated with depressive disorders as well as anxiety disorders, along with sleep disorders,

Prevention of mental illnesses:

-Prevention involves reducing stress factors.

-The dentist’s own stress relief, both during and outside of his or her professional activity, remains a key element. The dentist must do everything possible to relieve stress through exercise and regular breaks during work hours.

-He should also practice relaxing activities, take vacations and allow himself time for leisure in order to reduce tension.

– Getting help, support and support is one of the most effective ways to prevent mental illness.

-A better lifestyle is often essential, with particular emphasis on: sleep, a balanced diet, reducing or eliminating tobacco, alcohol, coffee,

Treatment: When a mental illness is confirmed, psychological or psychotherapeutic methods are the first line of defense against it; rest and time off work may be recommended. In the most serious situations, a psychiatrist may prescribe medication based on anxiolytics and antidepressants.

6.  conclusion

Identifying risk factors among dental surgeons should enable the implementation of preventive measures, corrective measures and/or treatments. However, it should be remembered that

The identification and prevention of these pathologies are an integral part of the training of the dentist .

Occupational diseases

  Wisdom teeth can cause pain if they erupt crooked.
Ceramic crowns offer a natural appearance and great strength.
Bleeding gums when brushing may indicate gingivitis.
Short orthodontic treatments quickly correct minor misalignments.
Composite dental fillings are discreet and long-lasting.
Interdental brushes are essential for cleaning narrow spaces.
A vitamin-rich diet strengthens teeth and gums.

Occupational diseases