A pilot survey on compliance with recommended infection control procedures in ninety dental practices in New Zealand.
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Biomedical subjects
Publications and source records attributed to G B Gibson.
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The prerequisite to understanding the need for infection control practices in dentistry is a sound knowledge of infectious disease and the potential for its transmission in the dental setting. To assess the infectious disease knowledge-base of dental practitioners, a questionnaire was developed and distributed to dentists in British Columbia. The survey results showed that many of the mechanisms, routes and risks for the transmission of viral pathogens in the dental setting are not clearly understood by dentists. Continuing education is needed to ensure that compliance with current infection control recommendations, and the provision of appropriate patient care, continues to be based on a clear understanding by dentists of the mechanisms of infection. By identifying the current infectious disease knowledge-base of dentists, this survey may permit more specifically-directed continuing education programs to be offered.
Over the last decade, in response to the heightened awareness of HBV and HIV infections, world health authorities have produced specific infection control recommendations for dental practices. Surveys have been done in various countries to investigate the level of compliance to these recommendations. This paper reports on the changes in compliance over a six year period among British Columbia dentists, as indicated from four volunteer surveys conducted between 1987 and 1993. During that period, the percentage of dentists who reported taking a medical history for each new patient increased from 70 per cent to 99 per cent. The routine use of gloves increased from 61 per cent to 95 per cent, and of face masks from 49 per cent to 83 per cent. In 1993, most dentists (91 per cent) used a new pair of gloves with each patient, up from 62 per cent three years earlier. Dentists also reported on their sterilization and hygiene methods. Autoclavable handpieces were used by 66 per cent of respondents in 1990, and by 74 per cent in 1993. High-speed autoclavable handpieces were used by 83 per cent of dentists in 1993, but only 62 per cent sterilized these handpieces. Similarly, 65 per cent reported using low-speed autoclavable handpieces, but only 47 per cent sterilized them. It is apparent that disinfection of handpieces and intraoral instruments is still an important part of regular operatory hygiene. Biologic monitors were used by 61.6 per cent of respondents to test the efficiency of their office sterilizer in 1993.(ABSTRACT TRUNCATED AT 250 WORDS)
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Dental professionals attending the annual meeting of the College of Dental Surgeons of British Columbia in June 1990 were involved in a survey to assess the prevalence of infection with Hepatitis B, Hepatitis C and Human Immunodeficiency viruses, the acceptance of vaccination for protection against Hepatitis B virus, and the compliance with infection control guidelines. Participation was voluntary and anonymous and required completion of a questionnaire and donation of a blood sample. Four hundred one of 1,995 convention attendees participated. Fourteen were found to have markers of Hepatitis B infection; 13 had antibodies to both Hepatitis B surface antigen and Hepatitis B core antigen, and one was positive for Hepatitis B surface antigen. One individual had markers for both Hepatitis C and Hepatitis B viruses. None tested positive for antibody to Human Immunodeficiency virus. Vaccination against Hepatitis B virus was reported overall by 67 percent of the participants, but dentists and hygienists had a higher rate of vaccination (82 percent and 81 percent, respectively) when compared to dental assistants (41 percent; P less than .001). Acceptance of infection control procedures was high, with 92 percent of participants reporting use of gloves for all patients and 82 percent reporting use of masks and eye protection.
In a survey carried out in 1987 and 1988 in Vancouver British Columbia, 704 dental professionals filled out an anonymous questionnaire and submitted a blood sample. Of those not immunized, 11% had infection with Hepatitis B, with dentists having a rate of 18%, significantly higher than other dental workers. Two carriers of HBsAg were detected and no individuals showed evidence of HIV infection. There were no differences in infection rates by the specific infection control practices. Oriental dental-care workers had a significantly higher rate of infection than other races surveyed. In a multivariate model, race and the number of years in practice were the only significant factors in predicting infection. The use of gloves did not show a protective effect, although a threefold protection rate for gloves is the smallest difference that could be reliably detected. The immunization rate with Hepatitis B vaccine averaged 46%, with fewer dentists being immunized than hygienists. Seroconversion rates were lower in older individuals. Dental professionals had a high risk of Hepatitis B and had not been adequately immunized. Reliance on gloves for operator protection appears to be inadequate.
A two-year study was conducted to compare the qualitative advantages, if any, of a conventional, cold-curing composite resin to amalgam in occlusal Class I cavities in posterior teeth. The composite was placed into modified, conservative cavity preparations using the acid etch technique. Sixty-one pairs of contralateral restorations were evaluated. Forty-six percent of the amalgams and 42.6% of the composites were considered sound. The major deficiency of each material was rough or chipped margins of the amalgams (38%) and worn surfaces of the composites (26%). The use of conservative cavity preparations and the acid-etch technique with bonding agent and final glaze improved the longevity of the composite restorations compared to previous studies. However, the improvement does not suggest that this method will have a long-term effect on clinical success nor does it indicate that composite is superior to amalgam other than in marginal integrity and esthetics.
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Explore the source record for details and available documents.
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Part 1 of this study describes the dental disorders and patient characteristics of 253 patients who presented as dental emergencies to the University Hospital dental clinic, Vancouver, BC, during a three-month period. Most patients had a true perception of what constitutes a dental emergency. Dental pain was the predominant reason for seeking help, and the pain existed for more than seven days prior to contact in more than 50% of patients. Patients were not always able to identify the number and location of painful teeth, and a perceived low cost for treatment was a major reason for contacting the hospital. Reliability of emergency patients in keeping scheduled appointments was very high. Almost 69% of patients did not see a dentist regularly. Referrals to the hospital dental service were most numerous in the summer months. Diagnosis of the complaints revealed infection to be the cause of pain in 76.7% of patients.
Two hundred and fifty-three patients treated for dental emergencies at the University Hospital dental clinic over a three-month period were surveyed by telephone 24 to 48 hours and one year after treatment. The purpose was to investigate the success of treatment in resolving the chief complaint of pain and to determine the compliance with further dental care for the original dental problem. The results of the telephone survey showed that: patients available for questioning totaled 49.1% at 24 to 48 hours and 28.9% at one year; an 80.7% success rate was recorded in resolving pain within 24 to 48 hours; and the original emergency problem did not motivate a large number of these patients to seek further dental care.