occupational hazards in dentistry
TRANSCRIPT
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OCCUPATIONAL HAZARDS IN DENTISTRY DUE TO DENTAL-
AMALGAM AND METHACRYLATES
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Introduction:Dental Amalgam and Methacrylates are
materials used in the Dentistry and are called ‘restorative materials’.
Used when the teeth are decayed or have got traumatized.
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Dental Amalgam = Mercury + Silver Alloy (Ag + Cu + Sn
etc;)
At least 50% of the final solid product Mercury!
Photo courtesy: http://www.samsondentalclinic.blosgspot.com
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The Methacrylates used in dentistry are called ‘Composite Resins’ or simply ‘Composites’ which are used in ‘Tooth-colored fillings’.
HEMA, UEDMA, TEGDMA, BIS GMA etc;
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‘Silver fillings’ & ‘White fillings’
Photo courtesy: http://www.wongdds.com/filling1.gif
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The ‘Amalgam Controversy’An article published in the FASEB journal Wide-spread media attention
Extensive research being conducted to obtain conclusive evidence.
Photo courtesy: www.dentalamalgamguide.com
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Occupational Hazards Amalgam
I. Routes of exposure:
- Skin contact- Breathing mercury vapor
II. Hazards:
I. CNS disorders- Psychosomatic symptomsExcessive salivation, sleeplessness, and loss of appetite
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- Changes in emotional liabilityMood swings, irritability, fatigue, loss of interest,
withdrawal, sweating . .
- Diminished abilities to perform activitiesDue to lack of coordination, imbalance. . .
- Diminished abilities to perform fine motor movements
II. Reproductive disorders
III. Immunological disorders
III. Renal disorders
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Methacrylates:
• Routes of Exposure:- Skin contact- Inhalation of methacrylate dust
Hazards:- Contact dermatitis (inflammation of the skin)
- Respiratory disordersWork-related cough & phlegm formation, increased risk of
adult onset asthma, respiratory hypersensitivity reactions
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Preventive Measures:
Avoiding contact with the materials by use of appropriate PPE
- Usage of suitable gloves, mouth-masks, proper respiratory and eye protective equipment
Usage of instruments like ‘Amalgamators’.
Education on hazards to the dental personnel.
Testing for hypersensitivity.
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Applicable laws
The EPA – responsible for regulating discharges into the environment
FDA – Responsible for regulating mercury content in drugs, cosmetics and medical devices (dental amalgam )
OSHA – Regulating workplace mercury and methacrylate levels & worker-exposure levels.
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OSHA’s mandate for mercury exposure permissible in the work place
PEL 50 micrograms per cubic meter of air
The PEL for MMA is 100 ppm
Several states including New Hampshire, New York and Oregon, have introduced laws requiring dental offices to install amalgam separators on their wastewater discharges to prevent contamination
Countries which have totally banned the use of dental amalgams
- Norway, Denmark and Sweden
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Conclusion:Very difficult to arrive to a conclusion on the
ill-effects of the use of dental amalgams for governments and health care organizations due to the lack of conclusive evidence in literature.
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References: http://books.google.com/books?id=5uvuvNKpIkQC&printsec=fron
tcover&dq=Dental+materials+text+book&hl=en&ei=g3v-TLnhHIT78Ab65MSvBw&sa=X&oi=book_result&ct
Edlich RF, Greene JA, Cochran AA, Kelley AR, Gubler KD, Olson BM, Hudson MA, Woode DR, Long W.B., McGregor W., Yoder C., Hopkins D.B., Saepoff J.P. (2007). Need for informed consent for dentists who use mercury amalgam restorative material as well as technical considerations. Journal of Environmental Pathology and Toxicology 26 (4):305-322
World Health Organization, (2003). Concise International Chemical Assessment Document 50: Elemental Mercury and Inorganic Mercury Compounds: Human Health Aspects. Geneva, Switzerland
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Jaakkola M. S., Leino T., Tammilehto L., Ylcstalo P., Kuosma E., Alanko K., 2007 Respiratory effects of exposure to methacrylates among dental assistants European Journal of Allergy and Clinical Immunology 2007: 62: 648-654. DOI: 10.1111/j.1398-9995.2007.01379.x Retrieved on November 26, 2010 from http://www.ncbi.nlm.nih.gov/pubmed/17508969
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