​Knowledge, Attitude, And Practice About Dental Waste Management Among Dentists In Pune - A Questionnaire Study

Introduction: Dental profession has expanded considerably, leading to a significant contribution to the production of biomedicalwaste (BMW). Hence, dentists ought to possess adequate knowledge about BMW management.Aim: This study aims to assess the knowledge, attitude, and practices about BMW management among private dentalpractitioners of Pune city.Materials and Methods: A cross-sectional questionnaire-based survey was conducted among 200 dentists of Pune. A closedended, validated, pretested questionnaire comprising four sections with questions on demographics, knowledge, attitude, andpractice of BMW management was distributed among 200 private practitioners. The results were expressed as numbers andpercentage for each question.Results: Of 200 dentists, 112 completely filled questionnaires were obtained. It was found that 94.6% of dentists were aware ofthe BMW management legislation; however, only 81.2% had registered with local BMW management service agency. 100% ofdentists considered improper management of dental waste to be hazardous to health. However, segregation and color codingof waste before disposal was followed by only 73.3% and 79.5% of dentists, respectively.Conclusion: It can be concluded from the present study that in spite of sufficient awareness about BMW management legislation;furthermore, training, awareness, educational, and motivational programs are required to attain better implementation of thelaws by the dentists.

Sustentabilidade ambiental: gerenciamento de resíduos odontológicos no Serviço Público / Sostenibilidad ambiental: gestión de residuos odontológicos en el Servicio Público / Environmental sustainability: dental waste management in the public service

Introdução: os Resíduos de Serviço de Saúde constituem um grande problema para a sociedade e para o meio ambiente, e o conhecimento de seu correto manejo é imprescindível para a formação do profissional da saúde. Objetivo: verificar o conhecimento dos profissionais de Odontologia atuantes nas Unidades Básicas de Saúde de municípios do noroeste do estado de São Paulo, Brasil, sobre o correto manejo dos Resíduos de Serviço de Saúde. Métodos: o instrumento de coleta de dados foi um questionário semiestruturado, preenchido durante as visitas nos estabelecimentos de saúde, a fim de verificar a conformidade do processo de gerenciamento de resíduos Odontológicos. Realizou-se análise descritiva. Além disso, aplicaram-se os testes do qui-quadrado e o Exato de Fisher para verificar associação entre o conhecimento do descarte de resíduos e a informação sobre o tema, ao nível de significância de 1 porcento. As análises foram realizadas no programa BioEstat 5.0. Resultado: do total (n= 74) dos profissionais, a maioria (97,3 porcento) diz saber o que são Resíduos de Serviço de Saúde e todos acreditam que eles podem fazem mal a saúde. No entanto, 41,9 porcento não responderam de forma correta como descartar os sugadores e luvas infectados e 20,3 porcento sobre o descarte de perfurocortantes. Em relação à informação sobre o tema, 40,5 porcento não obtiveram. Conclusão: o conhecimento sobre o correto descarte dos Resíduos de Serviço de Saúde por esses profissionais ainda é falho. Isso reflete a importância de capacitar os profissionais e propor formas de gerenciamento adequadas dos Resíduos de Serviço de Saúde(AU)

Introducción: los residuos de servicios de salud son un grave problema para la sociedad y el medio ambiente, y el conocimiento de su correcta gestión es esencial para la formación de los profesionales de la salud. Objetivo: evaluar el conocimiento de los profesionales de Odontología que trabajan en las Unidades Básicas de Salud de los municipios en el noroeste de São Paulo, Brasil, sobre el manejo adecuado de los residuos de servicios de salud. Métodos: el instrumento de recolección de datos fue un cuestionario semiestructurado, completado durante las visitas a los centros de salud, con el fin de verificar la conformidad del proceso de gestión de residuos dentales. Se realizó un análisis descriptivo. Además, se aplicó la prueba de chi cuadrado y exacta de Fisher para determinar la asociación entre la eliminación de residuos y los conocimientos e información sobre el tema, considerándose un nivel de significación del 1 por ciento. Los análisis se realizaron en BioEstat 5.0. Resultados: del total (n= 74) de los profesionales, la mayoría (97,3 por ciento) afirmó no saber cuáles son los residuos de servicios de salud y todos creyeron que pueden hacer mal a la salud. Sin embargo, el 41,9 por ciento no contestó correctamente sobre la eliminación de dispositivos de succión y guantes infectados, y el 20,3 por ciento sobre la eliminación de objetos punzantes. Con respecto a la información sobre el tema, el 40,5 por ciento no la obtuvo. Conclusiones: el conocimiento sobre la eliminación adecuada de los residuos de servicios de salud por estos profesionales todavía es deficiente. Esto refleja la importancia de la capacitación de los profesionales y proponer formas de gestión adecuadas de los residuos de servicios de salud(AU)

Introduction: medical waste is a serious problem for both society and the environment, and knowledge about its proper management is essential for the training of health care professionals. Objective: evaluate knowledge among dental professionals working in Basic Health Units from municipalities in northeast Sao Paulo, Brazil, about proper management of medical waste. Methods: the data collection tool used was a semi-structured questionnaire completed during visits to the health centers, aimed at verifying the adequacy of dental waste management. A descriptive analysis was performed. Additionally, chi-square and Fisher's exact tests were applied to determine the association between waste disposal, and knowledge and information about the subject, using a significance level of 1 percent. Analyses were conducted on BioEstat 5.0. Results: of the total professionals (n= 74), most (97.3 percent) stated not knowing which are the medical wastes, and all believed that they may be harmful to health. However, 41.9 percent did not provide a correct answer about disposal of infected gloves and suction devices, and 20.3 percent about sharps disposal. With respect to information about the subject, 40.5 percent did not obtain it. Conclusions: knowledge about proper disposal of medical waste is still deficient among these professionals, pointing to the importance of professional training and of proposing forms of proper management of medical waste(AU)

Amálgama dental e seu papel na Odontologia atual / Dental amalgam and its role in current dentistry

O Amálgama de Prata (AP) é um material restaurador consagrado pelo uso na Odontologia. Embora nos últimos anos tenha havido uma procura maior pelas restaurações estéticas, ao se considerar aspectos inerentes à eficácia, eficiência, custo e efetividade, particularmente em Saúde Pública, o AP, quando indicado, permanece como material de eleição para restaurações posteriores intracoronárias. Há uma tendência mundial de banir o uso do AP devido à toxicidade do mercúrio para o ambiente e para a saúde humana, mas não existem evidências científicas sobre isto. De concreto, há necessidade de realizar o gerenciamento de resíduos químicos de AP. Sendo assim, o objetivo deste estudo é revisar na literatura sobre o gerenciamento de resíduos do AP e colaborar nesta orientação, propondo um guia.

The Silver Amalgam (SA) is a restorative material established by custom in dentistry. Although in recent years there has been a greater demand for esthetic restorations, when considering issues related to the effectiveness, efficiency, cost-effectiveness, particularly in Public Health, the SA, when indicated, remains the material of choice for intra-coronary posterior restorations. There is a global trend to ban the use of SA due to the toxicity of mercury to the environment and to human health, but have no scientific evidence of this. Specifically, there is need for the management of chemical waste SA. Thus, the aim of this study is to review the literature on the SA waste management and collaborate in this direction by proposing a guide.

Establishing an Eco-friendly Dental Practice: A Review.

Have dentists paused to think as to where the gloves, fixer, plastic waste, mercury waste, and X-ray films used in the clinic end up after disposal? Or considered how much water, electricity, and other resources our dental clinics use? Dentists need to take off their tinted glasses and consider the effects of their dental practice on the planet. Though individual dentists generate only small amounts of dental waste, the accumulated waste produced by the profession may have significant environmental impact. Thus the concept of “green dentistry” or “ecofriendly dentistry” has evolved. Eco-friendly dentistry is an environmentally friendly way of practicing dentistry by using techniques and equipment to reduce waste, conserve energy, decrease pollution, and reduce our carbon footprint. The incorporation of eco-friendly dentistry to the dental practice is not only effective from an environmental perspective but is cost-effective for the dentist too. If a dental practitioner is looking for a way to distinguish his clinic from the others, eco-friendly dentistry could be the answer. This article reviews the scientific literature on eco-friendly dentistry and suggests comprehensive steps to start an eco-friendly dental practice.

A radiologia odontológica e o meio ambiente / The dental radiology and the environment

O descarte irregular de resíduos de saúde, especialmente o odontológico, está se tornando um um grande motivo de preocupação. O lixo proveniente de rejeitos no processo radiográfico não é diferente, uma vez que, além de resíduo contaminado, há rejeitos químicos, metais pesados e plásticos. Sendo eles: invólucro do filme radiográfico, soluções processadoras, lâminas de chumbo, películas dos filmes radiográficos - todos eles capazes de causar grande impacto no meio ambiente, se descartados de forma incorreta. Por esse motivo, é imprescindível conscientizar os cirurgiões-dentistas do impacto prejudicial no meio ambiente e, consequentemente, na saúde da população, atentando para a correta forma de descarte de cada rejeito do processo radiográfico

The irregular disposal of health waste, especially dental care, is becoming a great concern. The waste tailings from the radiographic process is not different, since, apart from contaminated waste, there are chemical waste, heavy metals and plastics. Namely: casing radiographic film, processing solutions, blade lead, radiographic films - all they with large capacity to cause impact on the environment if disposed incorrectly. For this reason it is essential to educate dentists in the harmful impact on the environment and consequently on the health of people, paying attention to the correct way to dispose of each reject of the radiographic process

Gerenciamento de resíduos odontológicos no serviço público / Dental waste management in the public service

OBJETIVO: Verificar o processo de gerenciamento dos resíduos odontológicos do serviço público de saúde em 11 municípios brasileiros. MATERIAL E MÉTODO: Uma única pesquisadora realizou as visitas e as observações foram anotadas em um roteiro previamente elaborado e testado. RESULTADO: Foram visitadas 50 unidades de saúde, sendo que nenhuma apresentou cópia do plano de gerenciamento de resíduos. Do total de estabelecimentos, 62% realizavam a correta segregação dos resíduos no momento da sua geração. A presença de recipientes adequados a cada tipo de resíduo gerado no consultório odontológico foi observada em 74% dos estabelecimentos e, destes, 94% apresentavam capacidade adequada ao tipo de resíduo gerado. A identificação do tipo de resíduo nas embalagens plásticas bem como anotações identificando o estabelecimento gerador dos resíduos foram encontradas em 8% e 6%, respectivamente. Somente 21% dos estabelecimentos apresentavam locais apropriados, de acordo com as normas vigentes, para o armazenamento dos resíduos até que fosse feita a coleta externa. CONCLUSÃO: Constatou-se na presente pesquisa que a rotina adotada pela rede pública de saúde bucal, no que tange ao gerenciamento de resíduos de saúde, apresentou falhas.

OBJECTIVE: was to investigate the process of waste management of dental public health service in eleven counties. MATERIAL AND METHOD: one researcher conducted the visits, and observations were recorded on a previously elaborated and tested. RESULT: We visited 50 health units, and none presented a copy of the waste management plan. Of the total 62% of businesses held the correct segregation of waste at the time of his generation. The presence of containers suitable for each type of waste generated at the dental office was observed in 74% and of those, 94% had adequate capacity for the type of waste generated. The identification of the type of waste in plastic containers and annotations identifying the establishment from which the waste was found in 8% and 6% respectively. Only 21% of establishments had appropriate locations, according to the current regulations for the storage of waste until collection was done outside. CONCLUSION: It was found in this study that the routine adopted by public oral health, regarding the management of healthcare waste had flaws.

Solid waste management in private dental practices / Gerenciamento dos resíduos sólidos em serviços odontológicos privados

Objective: To check the management of solid waste in dental practices that generates risks to health and the environment. With this in mind, the aim of this study was to ascertain the management of solid waste in private dental practices in the municipality of Quixadá, Ceará, Brazil in 2009. More specifically it was to ascertain its management, segregation, packing, collection, storage and final discording. Methods: This is a descriptive, exploratory and quantitative study. Out of a total of 15 dental practices in the municipality, 11 (73.3%) were included in the study. Data collection was conducted through a questionnaire applied to dentists in August 2009. Results: It was found that 81.8% of establishments do not have a Health Service Waste Management Plan. Nevertheless, 90.9% of professionals perform waste segregation, 45.5% of the dentists perform the packing of biological waste in plastic bags, 63.7% pack amalgam waste in glass with water, 60% dispose of developers and fixers directly into the sewerage system and for the sharps, 60% use cardboard boxes. Most dentists dispose of garbage on the sidewalk and the public collection is made by a truck, there being no separate collection service, and theywere transported to the landfill, where they do not receive the appropriate treatment. Conclusion: The lack of a Health Service Waste Management Plan leads to many failures and the involvement of the public authorities is essential in order to prevent harm to health and the environment.

Objetivo: Verificar o gerenciamento dos resíduos sólidos nos serviços odontológicos privados do Município de Quixadá, Ceará, no ano de 2009, mais especificamente, verificar esse gerenciamento, quanto à segregação, acondicionamento, coleta, armazenamento e destinação final.Métodos: Trata-se de um estudo descritivo, exploratório e predominantemente quantitativo. De um total de 15 serviços odontológicos do Município, 11 (73,3%) fizeram parte do estudo. A coleta de dados foi realizada por meio de um questionário, aplicado aos cirurgiões-dentistas, no mês de agosto de 2009. Resultados: Verificou-se que 81,8% dos estabelecimentos não possuem um Plano de Gerenciamento de Resíduos dos Serviços de Saúde, e ainda que 90,9% dos profissionais realizam a segregação dos resíduos e que 45,5% dos cirurgiões-dentistas realizam o acondicionamento dos resíduos biológicos em saco plástico comum, 63,7% acondicionam os resíduos de amálgama em vidros com água, 60% dispensam reveladores e fixadores diretamente na rede de esgoto e, para os resíduos perfurocortantes, 60% usam caixas de papelão. A maioria dos cirurgiões-dentistas acomoda o lixo na calçada e a coleta pública é feita por um caminhão, não havendo coleta diferenciada, sendo transportado para o aterro sanitário e sem tratamento correto. Conclusão: A falta do Plano de Gerenciamento de Resíduos dos Serviços de Saúde leva a muitas falhas e é importante a presença do poder público nosentido de prevenir os danos que podem causar à saúde e ao meio ambiente.

Optimizing the procedure for mercury recovery from dental amalgam

Mercury, as any other heavy metal, may cause environmental damages due to its accumulation and biotransformation. Dental offices, whether private or institutional, use dental amalgam as a restorative material on a daily basis. Dental amalgam is composed of mercury (50 percent), silver (30 percent) and other metals. Approximately 30 percent of the amalgam prepared in dental offices (0.6 g per capsule) are wasted and inadequately discarded without any treatment. Methods for mercury recovery have been proposed previously, using high temperatures through exposure to direct flame (650°C), long processing time, and hazardous reagents as potassium cyanide. The purpose of this study was to develop a method to replace the direct flame by an electrical mantle in the process of mercury recovery. Results showed an average mercury recovery of 90 percent from 2 kg of amalgam after 30 minutes of processing time, thus optimizing the procedure. The proposed modifications allowed a significant reduction in processing time and a mercury recovery with high purity. The modified process also provided minimization of operator exposure to physical, chemical and ergonomic hazards, representing a technological advance compared to the risks inherent to the original method. It also provided environmental health and economy of energy resources by replacing a finite energy source (fossil and organic) by a more environmentally appropriate electric source, resulting in significant improvement of the procedure for mercury recovery from dental amalgam.