Highlights

Physical Hazards

The dentist and the clinical staff are at risk of physical injuries during many dental procedures. Sources of physical injury can include debris from the oral cavity striking the eyes, cuts from sharp instruments, or puncture wounds from needles or other sharp instruments.

Such injuries can result in the transmission of serious infectious disease to the dental worker. Needle stick injuries and cuts from sharp objects and instruments (percutaneous injuries) have been reported in 1-15% of surgical procedures mostly associated with suturing.

Eye injuries may occur from projectiles such as bits of calculus during scaling procedures and splatters from body fluids (bacterial and viral aerosols) while using high-speed hand pieces.

Another potential source of eye injury is the intense dental curing light. Users of dental curing lights should be advised to employ protective eyewear during use. The most common injuries reportedly experienced by the dentist are musculoskeletal in nature. The need to work in a fixed working position using a continuous repetitive motion can predispose the clinical dental worker to wrist ache, lower backache, and neck ache.

Potential Physical Hazards Summary of Major Control Strategies
w.r.t. Engineering (Technical aspect) w.r.t. Administrative w.r.t. Personal Protection Equipment (PPE)
Ergonomic hazards associated with computer use or workstation design Ergonomically designed workstations, chairs and equipment. Incorporate adjustable workstation to accommodate shared use by employees of various sizes. Adjustment of workstation and chair to fit user. Worker education regarding ergonomic hazards and control strategies. Self assessment tools to assist workers in identifying and controlling risk factors. Safe work procedures. Early reporting of signs and symptoms of ergonomic concerns. Stretches and micro-breaks. Purchasing standards for ergonomically designed computer workstations, chairs and equipment. Ergonomic assessments. Maintenance of workstations, chairs and equipment.
Ergonomic hazards associated with awkward sustained postures and repetition/duration. Ergonomically designed workstation, chairs, instruments and equipment. Use automatic and ultrasonic instruments and tools whenever possible. Use of indirect vision when treating maxillary teeth. Consider a non-traditional stool such as a saddle chair (improve posture and mobility). Minimize glare through the use of appropriate lighting and window coverings. Adjust the workstation to the patient and the worker each time. Schedule patients in an effort to reduce risk factors. Worker education regarding ergonomic hazards and control strategies. Safe work procedures. Early reporting of signs and symptoms of ergonomic concerns. Stretches and micro-breaks. Alternate working position frequently. Keep frequently used instruments in easy reach. Purchasing standards for ergonomically designed workstations, chairs, instruments and equipment. Maintenance of equipment.
Exposure to ionizing radiation when taking dental X-rays Workplace design to provide distance between worker and source. Appropriate shielding materials (permanent where possible). Interlock systems. Equipment design to minimize scatter. Positioning devices for patients. Audible signals on machines when exposure is ended. Replacement of older dental X-ray equipment with newer equipment with additional safety features. Worker education. Safe work procedures reduce exposure time (procedures requiring fewer workers in area, etc.). Scheduling. Radiation safety program. Exposure monitoring. Lead gloves, aprons, etc. as required.
Exposure to laser beams during dental procedures Ensure area has no reflective surfaces. Local exhaust ventilation. Fail-safe systems. Lock/key access for activation Radiation safety program. Worker education. Safe work procedures (including placing laser in standby mode when not in use, single-operator activation, activate laser only when tip is under direct observation by surgeon, etc.). Restricted work area. Laser safety program. Gloves, gowns, and eye protection based on specific parameters of laser in use (wavelength, pulse versus continuous, wattage, laser class/type)
Exposure to UV-A radiation when curing resin-based materials Equipment maintenance. Area design. Blue light filters. Worker education. Safe work procedures including review and attention to equipment manufacturer’s guidelines. Eye protection with UV filters.
Falling hazards associated with slips, trips and falls Install slip resistant flooring. Design stairwells according to accepted safety standards. Ensure adequate lighting. Perform regular maintenance on flooring, stairwells, hallways, handrails, etc. Inspect ladders prior to use. Worker education. Implement a spill cleanup program that includes prompt spill cleanup, use of warning signs, etc. Maintain good housekeeping practices and minimize clutter and tripping hazards. Appropriate footwear with gripping soles and good support.
Cuts from sharp instruments, including medical instruments and scissors Avoid use of sharps when not required. Replace sharps with Safety Engineered Medical Devices. Proper storage of sharps. Worker education. Safe work procedures. Gloves
Exposure to cryogenic agents in cryosurgical procedures Substitution (CO2 instead of N2O) where possible). Proper storage of containers, including exhaust ventilation, scavenging systems, storage away from moisture, ignition sources and flammable materials. Use of proper lifting and transfer devices (hand truck or cart). Containers with pressure relief valves. Equipment maintenance. Restricted access. Worker education. Safe work practices. Spill and exposure emergency response equipment and procedures. Oxygen depletion monitoring (depending upon hazard assessment). Face shields, goggles, insulated gloves, and protective clothing as required based on hazard assessment. Earplugs if venting gases.
Burns from handling recently heat-sterilized equipment Work process design to manage equipment turnover. Safe work procedures. Rotation of supplies. Heat-resistant gloves.
Fire, projectiles, or physical injury if compressed gas cylinders used for a variety of procedures and maintenance activities are damaged, dropped or mishandled Install protective valve caps when cylinder is not in use if the cylinder is equipped with a means of attaching caps. Secure and restrain cylinders Safe work procedures that includes use, care, maintenance, storage and transport. Worker training. PPE based on hazard assessment and type of compressed gas. Protective footwear for impact hazard when handling large cylinders.
Electrical hazards arising from use of electrical cords and appliances Ground fault circuit interrupters when used close to water sources. Safe work procedures that include use of electrical cords, power bars and appliances that includes facility approval requirements. Worker training.