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PURPOSE: The cross-infection risks for dentists have been well recognised, and much has been published regarding the incidence of occupational exposures to patient body fluids. Less has been reported regarding the risks to dental assistants. The purpose of this study was to evaluate the incidence of occupational exposures to patient body fluids among dental assistants, to assess the rate of reporting of such incidents, and to evaluate the association of various factors with these exposures. METHOD: All 84 dental assistants working at Birmingham Dental Hospital were asked to complete a confidential questionnaire to provide retrospective information regarding the nature and incidence of any occupational exposures they had experienced. RESULTS: An overall response rate of 94% was achieved. Dental nurses experienced fewer occupational exposures than dental students at the same institution, and reported incidents more frequently. More injuries occurred after the treatment session. Handling local anaesthetic syringes was associated with more injuries, and percutaneous injuries predominated. Trainee nurses had experienced more occupational injuries in the preceding six months than their qualified colleagues. There was no significant association with any of the other factors evaluated. CONCLUSIONS: The general incidence of occupational exposures among the dental assistants in this survey was low in comparison to dental students at the same institution. A further reduction may be possible by increasing the training of unqualified nurses with particular regard to post-treatment handling of sharp dental instruments and equipment.
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The fluorescence of porcelain crowns recovered from the mouth of an unknown murder victim, and several control porcelain samples, were examined by fluorescent examination lamps. The fluorescence from two of the control samples was quite similar to that from the porcelain crowns recovered from the victim. To increase the objectivity of the results by quantitative analysis, the composition of each porcelain crown and control sample was also evaluated by wave dispersion X-ray microanalyser. The elements detected from the porcelain crowns of the victim matched those of two of the porcelain samples. Later, the antemortem dental records and radiographs of the victim were obtained through a dentist, who had recognized the name of the porcelain manufacturer in a postmortem dental information request placed on the Japanese Dental Association web page. Although component analysis of dental porcelain may be an effective means of assisting dental identification, a more rapid and non-destructive analysis for detecting the elements is required. The energy dispersive X-ray fluorescence (EDXRF) spectrometer was used for a pilot study of identification of porcelain composition.
1. The DAEI appears to be a useful instrument to evaluate dental assistant students in a reliable, uniform manner for the "core" dental assistant activities. 2. Calibration of the supervisors will be needed if the evaluation data are to be used on comparative bases from clinic to clinic or area to area. 3. Further study is needed to confirm the reliability and to establish the validity of the index. The current study should be considered an initial effort that should be continuously modified to maximize its usefulness. 4. Further study is needed to ascertain whether there is a real difference in the way dental auxiliaries view their job as compared to dentists. 5. Scores for dental assistants cannot be indiscriminately compared in a meaningful manner between auxiliaries at different locations. Even within a facility, caution should be applied before making conclusions based upon comparative scores. 6. The use of the DAEI for assessing the quality of the Dental Assistant Training Center was not adequately evaluated. The index may have this potential, but more study is required before it will be clear as to how the index might apply.
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