Evaluation of Knowledge and Attitude of Dental Hygienists and Dental Assistants Regarding People Living with HIV/AIDS and HIV-Associated Oral and Periodontal Lesions in Jeddah, Saudi Arabia.

BACKGROUND: Oral manifestations serve as important indicators of human immunodeficiency virus (HIV) infection, and dental healthcare practitioners play a pivotal role in preventing and managing HIV. This study aims to assess and compare the knowledge and attitude of dental assistants and dental hygienists concerning people with HIV/acquired Immunodeficiency syndrome (AIDS) patients in Jeddah province of Saudi Arabia. MATERIALS AND METHODS: This cross-sectional survey enrolled 160 dental hygienists and assistants practicing in Jeddah. Data was collected using a pretested, self-administered questionnaire comprising 50 questions that investigated knowledge about HIV/AIDS, awareness of HIV-associated oral and periodontal lesions, understanding of HIV transmission routes, and attitudes toward people with AIDS. RESULTS: In the study, 120 (75.0%) participants correctly recognized that individuals with HIV may appear healthy, while 123 (76.9%) participants admitted that HIV carriers have lower resistance to other diseases. Additionally, 126 (78.8%) participants confirmed an association between the virus and oral lesions, and 137 (85.6%) participants were aware of HIV transmission through blood. Moreover, 150 (93.7%) participants expressed their willingness to support, treat, and assist patients with AIDS, while only 10 (6.3%) participants expressed unwillingness. Notably, no statistically significant differences were found between dental assistants and hygienists in their knowledge and attitudes toward HIV/AIDS and people with AIDS. CONCLUSION: This study demonstrated that dental hygienists and assistants possess good general knowledge regarding HIV/AIDS and are well-informed about the disease's transmission routes. Moreover, a significant majority endorses the importance of treating and supporting AIDS patients.

Musculoskeletal disorders among dental assistants: a cross-sectional study.

BACKGROUND: This study aims to investigate the prevalence of musculoskeletal disorders (MSDs) and associated sociodemographic and work-related factors among dental assistants (DAs) in the hail province, Saudi Arabia. METHODS: Participants were 119 DAs with an average age of 28.9 years (SD ± 4.8 years), of whom 86.6% were females. A self-administered questionnaire which included Nordic Musculoskeletal questionnaire and questions on socio-demographic and work-related factors was used. Descriptive statistics were used to calculate the prevalence of MSDs during the past 12 months and 7 days. Multivariate binary logistic regression statistical tests were used to calculate the association between MSDs and socio-demographic and work-related factors. RESULTS: The overall prevalence of MSDs among DAs was significantly high, with 85.7% reporting symptoms during the past 12 months and 47.9% during the past 7 days. The shoulders, followed by the lower back, were the most common complaints among participants in the past 12 months and 7 days, followed by the upper back and neck. Multivariate binary logistic regression analysis results show significant associations between MSDs and age, Body-Mass-Index (BMI), physical demands during working hours, work environment and posture awareness, and years of experience. CONCLUSIONS: The prevalence of MSDs among DAs is high, and sociodemographic and work-related factors play an important role in exacerbation of MSDs in DAs.

Primary care dental professionals' experiences of sharp injuries in Qatar: A cross-sectional study.

Objectives: Very few studies assess sharp injuries solely among dental professionals globally. This study aims to understand the experiences of sharp injuries among primary care dental professionals in Qatar. Methods: This is a cross-sectional study where dental professionals working at the Primary Health Care Corporation (PHCC), a public sector healthcare organization and Qatar's largest primary care provider with 27 primary healthcare centers in Qatar, were invited to participate. An online questionnaire was administered to understand participants' experience of sharp injuries and access to occupational health services and training. Findings: A total of 114 dental professionals participated in this study. In total, 68.42% (N=78) of participants reported experiencing a sharp injury in the 12 months prior to the survey. Majority (N=58; 75.36%) of the reported causes of sharp injuries were related to dental explorers (N=31; 40.26%) and dental injection needles (N=27; 40.26%). Of those who had experienced a sharp injury, 84.47% (N=87) did not report them. Conclusion: In conclusion, the results highlight that sharp injuries are common among primary care dental professionals, and despite having good access to occupational support services, most dental professionals did not report their injuries. Continuous education and training programs must be implemented to improve knowledge and raise awareness to reduce the burden of sharp injuries among dental professionals. More studies from other dental settings are needed to better understand dental professionals' experiences of sharp injuries in Qatar and elsewhere.

Overview of dental assistants in Taiwan from 2009 to 2021.

Background/purpose: The development of dental assistants in Taiwan has been over a century. This study explored mainly the profile of dental assistants and the occupation survey about them in Taiwan from 2009 to 2021. Materials and methods: This study used the documentary analysis and secondary data analysis to survey mainly the changes of manpower of dental assistants in Taiwan from 2009 to 2021, and the association of their wages with economic indicators. Results: According to occupation survey from government, the number of dental assistants increased from 4315 in 2009-7909 in 2021. When estimated based on the data of the United States showing 1.86 dental assistants per dentist, the estimated number of dental assistants increased from 21,113 in 2009 to 28,698 in 2020. Although the mean monthly wage of dental assistants increased from 22,127 NT dollars in 2009 to 26,795 NT dollars in 2021, the proportion of the mean annual wage of dental assistants to the gross domestic product per capita decreased from 47.43% in 2009 to 34.78% in 2021. Moreover, the proportion of the mean monthly wage of dental assistants to the basic monthly wage of labor decreased from 128.05% in 2009 to 111.65% in 2021. Conclusion: In Taiwan, although the manpower and work content of dental assistants are important for dentists, they usually work with a low wage from 2009 to 2021. It is imperative to continue to promote the certification system for dental assistants to improve the professionalism and the wage structure of this occupation.

Dental Nurses' Mental Health in Germany: A Nationwide Survey during the COVID-19 Pandemic.

Several studies have found a rise in the rate of psychological discomfort among healthcare personnel since the COVID-19 pandemic outbreak. In this study, we analyzed the relationship between psychological variables of anxiety, depression, stress, avoidance, intrusion and hyperarousal and several factors among German dental nurses. For this poll, dental nurses were asked nationwide to take part via an online-based survey from July 2020 to January 2021. This survey gathered data on demographics, as well as psychological assessments through the Impact of Events Scale-Revised (IES-R) instrument, and the Depression Anxiety Stress Scales (DASS-21). The correlations between DASS-21/IES-R ratings and sociodemographic data were investigated using univariate analyses (Kruskal-Wallis and Mann-Whitney U tests). Single comparisons were performed using the Dunn-Bonferroni post hoc test if a relevant test result was significant followed by multiple linear regressions. Furthermore, 252 dental nurses took part in the study and showed overall normal or mild results of all psychological variables. Having immune-deficiency or chronic diseases, employment at a dental practice, being married, having no children and seeing the pandemic as a financial threat were presented as significant risk factors (p ≤ 0.05) with higher DASS-21 and IES-R scores. These results emphasize the aspects that must be considered to safeguard German dental nurses' mental wellbeing during the crisis.

Child Fluoride Varnish Programs Implementation: A Consensus Workshop and Actions to Increase Scale-Up in Australia.

This paper presents the findings of the National Fluoride Varnish Workshop in 2018 along with subsequent actions to scale-up the use of fluoride varnish nationally in Australia. The use of fluoride varnish programs to prevent dental caries in high-risk child populations is an evidence-based population health approach used internationally. Such programs have not been implemented at scale nationally in Australia. A National Fluoride Varnish Consensus Workshop was held in Sydney in November 2018 with an aim of sharing the current work in this area being undertaken by various Australian jurisdictions and seeking consensus on key actions to improve the scale-up nationally. Forty-four people attended the Workshop with oral health representatives from all Australian state and territory health departments, as well as the Australian Dental Association (ADA) at both NSW branch and Federal levels. There was strong support for further scale-up of fluoride varnish programs nationally and to see the wider use of having non-dental professionals apply the varnish. This case study identifies key actions required to ensure scale-up of systematic fluoride varnish programs as part of a strategic population oral health approach to preventing dental caries among high-risk children who may not routinely access dental care.

Perspectives from Dentists, Dental Assistants, Students, and Patients on Dental Care Adapted to the COVID-19 Pandemic: A Cross-Sectional Survey.

Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health care professionals may be exposed to additional physical and mental stress. The aim of this study was to assess the perspectives of all persons involved in dental care (dentists, dental assistants, students, and patients) regarding the aspects of safety measures, anxiety about self-infection and infecting others, and other prospects in the period March to December 2020 using a questionnaire. Data collection was performed between 14 December 2020 and 23 January 2021. A total of 35 dentists (response rate of 79.5%), 23 dental assistants (65.7%), 84 students (80%), and 51 patients (21.8%) completed the survey. The patients did not notice any changes in the care received. Dentists and dental assistants reported a higher workload due to additional safety measures. The majority of dentists, students, and patients agreed that normal patient care was maintained. One-third of dental assistants would have preferred emergency treatment alone and expressed significantly higher anxiety about COVID-19 infection than all other groups (p < 0.05). In conclusion, all groups showed a predominantly positive perspective on dental care, and anxiety about self-infection and infecting others was especially low. However, additional measures are time-consuming and compound daily patient care. This concept, based on well-established infection control, might be a viable proposal for current and future pandemics.

Child maltreatment in Dubai and the Northern United Arab Emirates: dental hygienists and assistants' knowledge.

PURPOSE: Dental assistants (DAs) and hygienists (DHs) should play an active role in the detection and reporting of child abuse and neglect (CAN). We aimed to investigate CAN knowledge of DAs and DHs in the United Arab Emirates (UAE) and some of the inhibiting factors to the process of CAN reporting. METHODS: A cross-sectional study design was utilized. We surveyed 186 DAs and DHs using a previously validated self-administered anonymous CAN knowledge questionnaire. Statistical analysis was performed using χ2-square, Fisher's exact test, t test/Mann-Whitney, and a ROC curve (p < 0.05). RESULTS: Among 186 DAs and DHs surveyed, satisfactory knowledge of CAN was demonstrated by 50.5%. DAs scored a significantly higher score of knowledge compared to DHs (p = 0.03). The most reported CAN referral inhibiting factor was "being afraid to get in trouble with parents". The recognition of a child with special needs and parents missing multiple appointments as risk factors for CAN was significantly higher in the DAs compared to DHs (p = 0.04, p = 0.024, respectively). Awareness of local laws was related to CAN knowledge in DAs (p = 0.012) and DHs (p = 0.008). CONCLUSION: The lack of appropriate knowledge regarding CAN necessitates a clear reporting process and better education for DAs and DHs in the UAE.

Costing the Scale-Up of a National Primary School-Based Fluoride Varnish Program for Aboriginal Children Using Dental Assistants in Australia.

There is good evidence that fluoride varnish programs are effective in preventing dental caries in children. This study aims to provide a costing for the scale-up of a child fluoride varnish program in New South Wales (NSW), Australia. Most child fluoride varnish programs are school-based, and a number of studies have examined the acceptability and cost effectiveness of using non-dental providers to apply the fluoride varnish. This paper describes the number of primary schools in Australia that could be targeted using a standard population-based risk criteria based on published data. A costing method was developed for various scenarios of school enrolment and provider types, along with potential revenue from the Child Dental Benefits Schedule (CDBS). Most of the costs of a school-based fluoride varnish program can be covered by the CDBS with assumptions of 80% child consent and 75% CDBS eligibility. While the scale-up of child fluoride varnish programs to prevent dental caries has been recommended by numerous strategic plans and reports, particularly for Aboriginal and Torres Strait Islander children, limited progress has been made. This paper concludes that using a standardized criteria for targeting schools using a combination of ICSEA and Aboriginal enrolments, and aiming at four applications a year, is feasible, and that the main costs of the program could be covered by using the CDBS.

Prevalence of Muscular Skeletal Disorders among Qualified Dental Assistants.

The occupation of dental assistants (DAs) involves many health risks of the musculoskeletal system due to static and prolonged work, which can lead to musculoskeletal disorders (MSDs). The aim of the study was to investigate the prevalence of MSDs in DAs in Germany. METHODS: For this purpose, an online questionnaire analyzed 406 (401 female participants and 5 male participants, 401w/5m) DAs. It was based on the Nordic Questionnaire (lifetime, 12-month, and seven-day MSDs' prevalence separated into neck, shoulder, elbow, wrist, upper back, lower back, hip, knee, and ankle), and occupational and sociodemographic questions as well as questions about specific medical conditions. RESULTS: 98.5% of the participants reported complaints of at least one body region in their lives, 97.5% reported at least one complaint in the last 12 months and 86.9% affirmed at least one complaint in the last seven days. For lifetime, 12-month and seven-day prevalence, the neck was the region that was most affected followed by the shoulder, the upper back and the lower back. CONCLUSION: The prevalence of MSDs among German (female) DAs was very high. The most affected area is the neck, followed by the shoulder, the lower back, and the upper back. It, therefore, seems necessary to devote more attention to ergonomics at the working practice of DAs as well in education and in dental work.

Relationships between the postures of dentists and chairside dental assistants.

INTRODUCTION: Dental professionals have been encouraged to maintain their neutral postures throughout their workday in order to maintain a healthy musculoskeletal system. However, with 4-handed dentistry, maintaining neutral postures becomes more challenging when the dentist and dental assistant work concurrently alongside the patient to complete dental procedures. PURPOSE: The purpose of this study was to determine whether relationships exist between the postures of dentists and dental assistants. METHODS: Upon institutional review board approval, this study used a cross-sectional research design of a convenience sample of 31 unique pairings of dentists and dental assistants. The Modified-Dental Operator Posture Assessment Instrument (M-DOPAI) and Rapid Upper Limb Assessment (RULA) were used to assess ergonomic scores and ergonomic risks of captured photographs of dentists and dental assistants performing 4-handed dentistry. The data were analyzed using descriptive statistics and correlational analysis. RESULTS: The dentists and dental assistants demonstrated higher ergonomic scores for the trunk, head, and arm positions and higher ergonomic risk scores for the neck/trunk/leg positions. The head position of dental assistants was positive correlated with hip position of dentists. The shoulder position of dental assistants was negatively correlated with the head position of dentists. CONCLUSION: Ergonomic risks scores indicated further investigations and potential changes in postures to reduce ergonomic risks. Multiple postural components of the dentists and dental assistants were related. Ergonomic training should include consideration of dentists and dental assisting working concurrently in 4-handed dentistry. More ergonomic training is needed with 4-handed dentistry among dental and dental assisting students and faculty members.

Prevalence and associated factors for needlestick and sharp injuries (NSIs) among dental assistants in Jeddah, Saudi Arabia.

BACKGROUND: Dental personnel are subject to exposure to a number of occupational factors including needlestick and sharp injuries (NSIs). Our study aims to address knowledge gaps on prevalence and associated factors for needlestick and sharp injuries (NSIs) for the first time in Saudi Arabia. METHODS: This cross-sectional study was conducted on a sample of 450 dental assistants recruited from 40 randomly selected private clinics in Jeddah, Saudi Arabia. Data on demographic characteristics, history of NSIs, nature of work, compliance with infection control protocols, and knowledge of infection control procedures and disease transmission were collected using a self-administered questionnaire. Logistic regression analysis was used to assess factors associated with NSIs; unadjusted and adjusted odds ratios (aORs) and their respective 95% confidence intervals (CIs) were computed. RESULTS: About three in ten dental assistants experienced at least one NSI (29.8%, 95% CI 25.6-34.2%) in private dental clinics. Lack of adequate knowledge of infection control procedures and disease transmission, non-compliance with infection control protocol of vaccination against hepatitis B virus, and attending 12 or less number of patients daily were significantly associated with increased risk of NSIs (p ≤ 0.05); adjusted odds ratios (95% CI) were 1.87 (1.18-2.97), 1.89 (1.05-3.41), and 1.63 (1.03-2.56), respectively. In addition, dental assistants working in 45.8% of dental clinics that had no infection control unit were positively associated with higher NSI risk (aOR = 2.28, 95% CI 1.45-3.57). CONCLUSION: Our study reported the prevalent nature of NSIs among dental assistants in Saudi Arabia and identified key factors that could be targeted to mitigate this preventable condition. Dental assistants would benefit from proper training on infection control protocols and procedures.

Enabling Aboriginal dental assistants to apply fluoride varnish for school children in communities with a high Aboriginal population in New South Wales, Australia: a study protocol for a feasibility study.

BACKGROUND: Australian Aboriginal children experience high levels of dental caries (tooth decay) and are less likely to access preventive dental health services. High-strength fluoride varnish has been shown to reduce the incidence of dental caries and is commonly used in community-based preventive dental health service programs. In New South Wales, Australia, the application of fluoride varnish is restricted to dental and medical professionals. This is problematic in communities with a high Aboriginal population and limited access to oral health services, contributing to the increased risk of developing dental caries in Aboriginal children. Dental assistants are essential members of the oral health team; however, they do not have a defined scope of practice in Australia. Other countries have created formal scopes of practice for dental assistants to include the application of fluoride varnish. This protocol presents a pathway for qualified Aboriginal dental assistants to undertake additional training to legally apply fluoride varnish in New South Wales. The primary objective of this study will be to evaluate the feasibility and acceptability of utilising Aboriginal dental assistants to apply fluoride varnish to Aboriginal children in a school setting at regular 3-month intervals. METHODS: Six schools across New South Wales (NSW) that enrol at least 12% Aboriginal children will be invited to participate in the 12-month study. Aboriginal children aged 5-12 years enrolled in these schools will be enrolled in the study. Six Aboriginal dental assistants will undertake training to apply fluoride varnish. Fluoride varnish (Duraphat) will be applied at 3-month intervals by the dental assistants to the teeth using a small brush. An evaluation will be undertaken to determine the feasibility and cost-effectiveness of this innovative approach. This study protocol has been approved by the NSW Aboriginal Health and Medical Research Council and the NSW State Education Research Application Process. DISCUSSION: A qualified Aboriginal dental assistant workforce in NSW (or Australia) legally approved to apply fluoride varnish may increase the sustainability and scalability of fluoride varnish programs and improve the oral health of Aboriginal children in Australia. TRIAL REGISTRATION: ISRCTN26746753.

Professional burnout and work stress among Israeli dental assistants.

Professional burnout and work-related stress are known problems that have been the subject of in-depth examination among dentists. Nevertheless, these issues have not been widely studied among dental assistants. The aims of this study were threefold: to confirm the structure of a Work Stress Inventory (WSI) for Dental Assistants which was originally developed for Jordanian dental assistants (factor analysis); to evaluate work stress and burnout among Israeli dental assistants and to discover the factors predicting Israeli assistants' burnout (regression analyses). The Maslach Burnout Inventory and the WSI were distributed by mail and in person. Varimax factor analysis revealed that the items which contribute to different aspects of work stress are similar among both Jordanian and Israeli populations. Among the 299 Israeli dental assistants who completed the questionnaires, the most stressful work-related factors were income, workload, and work hazards. Eighteen percent of the participants exhibited a high to very high level of burnout. Participants exhibited a moderate level of emotional exhaustion (EE), low level of depersonalization (DP), and high level of personal accomplishment (PA). Most WSI factors were found to correlate positively with EE and DP. Linear stepwise regression analyses revealed that the best predictor of EE was the dentist‒assistant relationship, followed by workload, patient type, and salary. The best predictor of DP was patient suffering followed by dentist‒assistant relationship, years of professional experience, and work hazards. Professional stress and burnout among dental assistants are important factors that can possibly affect the wellbeing of both dental personnel and their patients. Further studies are necessary to better understand these factors in addition to the effects of personal relationships on burnout among dentists and their assistants.

Cytogenetic Biomonitoring of Dental Technicians: A Cross-Sectional Study.

PURPOSE: This is a cross-sectional study to assess the incidence of micronuclei and other nuclear morphological changes in buccal epithelial cells of dental technicians. MATERIALS AND METHODS: The study was conducted on 45 dental technicians versus 2 control groups: 50 dentists and 50 dental assistants. DNA damage was analyzed in exfoliated buccal mucosa cells by micronucleus assay. The differences in the frequency of detected types of cytogenetic damage between experimental groups were analyzed by applying 2-way ANOVA with Tukey's HSD post-hoc test. RESULTS: Dentists and dental assistants have significantly lower incidence of micronucleated cells than technicians (mean ± SD: 0.68 ± 0.74, 0.58 ± 0.81, and 1.58 ± 2.07; p = 0.031 and p = 0.015, respectively), and this trend also holds for karyolitic cells (0.10 ± 0.30, 0.20 ± 0.49, and 1.42 ± 1.25; p < 0.001 and p < 0.001, respectively), condensed chromatin (0.16 ± 0.37, 0.14 ± 0.35, and 0.76 ± 0.98; p < 0.001 and p < 0.001, respectively), and pyknotic cells (0.04 ± 0.20, 0.08 ± 0.27, and 0.96 ± 1.24; p < 0.001 and p < 0.001, respectively). CONCLUSION: Cytogenetic biomarkers in dental technician buccal mucosa are increased compared with control groups. This increase may be associated with more extensive exposure to potentially harmful components of the materials used in everyday dental practice.

Prevalence and associated factors for needlestick and sharp injuries (NSIs) among dental assistants in Jeddah, Saudi Arabia

BACKGROUND@#Dental personnel are subject to exposure to a number of occupational factors including needlestick and sharp injuries (NSIs). Our study aims to address knowledge gaps on prevalence and associated factors for needlestick and sharp injuries (NSIs) for the first time in Saudi Arabia.@*METHODS@#This cross-sectional study was conducted on a sample of 450 dental assistants recruited from 40 randomly selected private clinics in Jeddah, Saudi Arabia. Data on demographic characteristics, history of NSIs, nature of work, compliance with infection control protocols, and knowledge of infection control procedures and disease transmission were collected using a self-administered questionnaire. Logistic regression analysis was used to assess factors associated with NSIs; unadjusted and adjusted odds ratios (aORs) and their respective 95% confidence intervals (CIs) were computed.@*RESULTS@#About three in ten dental assistants experienced at least one NSI (29.8%, 95% CI 25.6-34.2%) in private dental clinics. Lack of adequate knowledge of infection control procedures and disease transmission, non-compliance with infection control protocol of vaccination against hepatitis B virus, and attending 12 or less number of patients daily were significantly associated with increased risk of NSIs (p ≤ 0.05); adjusted odds ratios (95% CI) were 1.87 (1.18-2.97), 1.89 (1.05-3.41), and 1.63 (1.03-2.56), respectively. In addition, dental assistants working in 45.8% of dental clinics that had no infection control unit were positively associated with higher NSI risk (aOR = 2.28, 95% CI 1.45-3.57).@*CONCLUSION@#Our study reported the prevalent nature of NSIs among dental assistants in Saudi Arabia and identified key factors that could be targeted to mitigate this preventable condition. Dental assistants would benefit from proper training on infection control protocols and procedures.

Irradiance and radiant exposures delivered by led light-curing units used by a left and right-handed operator

Abstract The combination of the restoration location, the hand preference of the operator using the light-curing unit (LCU), and the design of the LCU all can have an impact on the amount of the light delivered to the restoration. To evaluate the effect of left-handed or right-handed users, the position of the operator (dentist or assistant), and the LCU design on the irradiance, radiant exposure and emission spectrum delivered to the same posterior tooth. Two light emitting diode (LED) LCUs were tested: an angulated monowave LCU Radii-Cal (SDI, Victoria, Australia) and a straight aligned multi-peak LCU Valo Cordless (Ultradent, South Jordan, UT, USA). The irradiance values (mW/cm2), radiant exposure (J/cm2) and emission spectrum were measured using a sensor in maxillary left second molar tooth. The irradiance and radiant exposure were analyzed using three-way ANOVA followed by Tukey test (a=0.05). The emission spectra (nm) were analyzed descriptively. The interaction between LCU design, operator position, and hand preference significantly influenced the irradiance and radiant exposure (P<0.001). In all cases, Valo delivered significantly higher irradiance than Radii-Cal. The handedness and the operator position affected the irradiance and radiant exposure delivered from Valo. Operator position and access affect the irradiance and radiant exposure delivered to the maxillary left second molar. The irradiance and radiant exposure can be greater when a right-hand operator is positioned on the right side of the chair and a left-hand operator is positioned on the left side of the chair. This may result in better resin composite polymerization.

Resumo A combinação da localização da restauração, a preferência de mão do operador ao utilizar aparelhos fotopolimerizadores (AFP) com luz emitida por diodo (LED) e o formato do AFP podem afetar a quantidade de luz fornecida à restauração. O objetivo foi avaliar o efeito de operadores canhotos e destros, a posição do operador (dentista ou auxiliar), e o formato do AFP na irradiância, energia radiante e espectro de luz entregue ao mesmo dente posterior. Dois AFP foram testados: um com formato angulado, onda única Radii-Cal (SDI, Victoria, Australia) e um formato reto multi-pico Valo Cordless (Ultradent, South Jordan, UT, USA). Os valores de irradiância (mW/cm²), energia radiante (J/cm²) e espectro de luz foram medidos utilizando um sensor no segundo molar superior esquerdo. A irradiância e energia radiante foram analisados utilizando ANOVA 3 fatores seguido por teste de Tukey (a=0.05). O espectro de luz (nm) foi analisado de forma descritiva. A interação entre o formato do AFP, posição do operador e preferência de mão foram significativamente influentes na irradiância e energia radiante (P<0.001). Em todos os casos, Valo teve irradiância significativamente maior que Radii-Cal. A mão dominante e a posição do operador afetaram a irradiância e energia radiante com o Valo. Posição do operador e acesso afetou a irradiância e exposição radiante entregue ao segundo molar superior esquerdo. A irradiância e exposição radiante teve melhores resultados quando AFP foi utilizado com a mão direita pelo operador posicionado na cadeira do lado direito e mão esquerda do operador posicionado do lado esquerdo da cadeira. Estes resultados podem levar a uma melhor polimerização da resina composta.

Observance of Sterilization Protocol Guideline Procedures of Critical Instruments for Preventing Iatrogenic Transmission of Creutzfeldt-Jakob Disease in Dental Practice in France, 2017.

Effective sterilization of reusable instruments contaminated by Creutzfeldt⁻Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non-compliance are needed.

Cobertura vacinal e imunidade contra hepatite B em profissionais de saúde da rede pública / Vaccination coverage and immunity against hepatitis B in public health workers

A hepatite B representa um sério problema de saúde pública, devido ao número elevado de indivíduos portadores da doença e às complicações decorrentes de sua evolução. A vacinação é a principal forma de prevenção e torna-se primordial, especialmente, entre os cirurgiões-dentistas e as auxiliares em saúde bucal, devido à exposição frequente à materiais biológicos, instrumentais e ambientes contaminados. O teste anti-HBs, para verificação da imunidade, ainda é um método pouco utilizado pelos profissionais da saúde, pois é pouco relatado na literatura. Considerando a importância da prevenção da hepatite B e a escassez de pesquisas sobre a verificação da imunidade dos profissionais de saúde, no presente estudo objetivou-se avaliar a cobertura vacinal da hepatite B, o resultado do teste anti-HBs, a realização prévia do teste, a interpretação do resultado do mesmo e o recebimento de orientações sobre a doença em cirurgiões-dentistas e auxiliares em saúde bucal do Sistema Único de Saúde de 9 cidades do Noroeste Paulista. Para este propósito, foi aplicado um questionário semiestruturado e auto administrado com questões referentes ao perfil sóciodemográfico, cobertura vacinal, verificação da imunidade e recebimento de orientações sobre a patologia. Para verificar a imunidade à doença, foi utilizado o método imunocromatográfico, por meio do teste anti-HBs. A análise estatística descritiva e os testes Qui-quadrado e Exato de Fisher, ao nível de significância de 5% foram realizados. Do total de 74 cirurgiões-dentistas, 64 (86,48%) aceitaram participar do estudo. A maioria (77,77%) havia realizado o esquema vacinal completo e recebido orientações sobre a doença (78,69%), contudo uma parcela considerável apresentou resultado negativo (37,50%) ao teste anti-HBs. Verificou-se que 60,93% nunca havia realizado o teste e dentre os que já haviam realizado, 40% não sabiam interpretar corretamente o resultado. Em relação aos auxiliares em saúde bucal, do total de 70 profissionais, 63 (90,00%) aceitaram participar do estudo. Embora tenha sido observada associação significativa (p<0,05) entre a realização do esquema vacinal e o recebimento de orientações sobre a doença, apenas 55,56% dos profissionais havia completado o esquema vacinal. Uma parcela considerável (46,03%) apresentou resultado negativo ao teste antiHBs. Apenas 25,40% dos participantes havia realizado o teste anteriormente ao estudo e destes, somente 31,25% tinham conhecimento sobre o significado correto do resultado. Ocorrência de acidentes com instrumental perfurocortante foi relatada por 50,79% dos profissionais e destes, 46,03% apresentou resultado negativo ao teste de imunidade. Conclui-se que uma parcela considerável dos profissionais não havia realizado o esquema vacinal completo e apresentou resultado negativo para o teste anti-HBs. A maioria dos profissionais havia sofrido algum acidente com instrumental perfurocortante e recebido informações sobre a doença. Apenas uma pequena parte havia realizado o teste anteriormente e sabia interpretar corretamente o resultado. Estes achados evidenciam uma realidade preocupante que sugere que uma parte significativa dos cirurgiões-dentistas e auxiliares em saúde bucal está atuando sem a proteção adequada ao risco de infecção pela hepatite B(AU)

Hepatitis B is a serious public health problem due to the high number of individuals with the disease and complications due to its evolution. Vaccination is the main form of prevention and is especially important among dentists and dental auxiliaries due to frequent exposure to contaminated biological materials, instrumental and environments. The anti-HBs test, for the verification of immunity, is still a method little used by the health professionals, because this approach is few reported in the literature. Considering the importance of the prevention of hepatitis B and the scarcity of researches about the verification of the immunity of health professionals, the present study aimed to evaluate vaccine coverage, anti-HBs test result, previous test performance, interpretation of the result of the test and the receipt of guidelines about hepatitis B in dentists and dental auxiliaries of the Brazil's national health system of 9 cities of the Northwest of the São Paulo state. For this purpose, a semi-structured and self-administered questionnaire was applied with questions regarding sociodemographic profile, vaccination coverage, verification of immunity and receipt of guidelines about the pathology. Then, to verify the presence of antibodies against the disease, the immunochromatographic method was used by the anti-HBs test. Descriptive statistical analysis and Fisher's exact test and Chi-square test at a significance level of 5% were performed. Of the 74 dentists, 64 (86.48%) accepted to participate in the study. It was observed that the majority of (77.77%) had completed the complete vaccination scheme and received guidance about the disease (78.69%); however, a considerable number showed negative result (37.50%) to antiHBs test. It was verified that 60.93% had never performed the test and of those who had already performed, 40% did not know how to correctly interpret the result. Regarding dental auxiliaries, of 70 professionals, 63 (90.00%) accepted to participate of the study. Although an association (p <0.05) was observed between the accomplishment of the vaccination scheme and the receipt of guidelines on the disease, only 55.56% had completed the vaccination scheme. A considerable portion (46.03%) showed negative result to the anti-HBs test. It was observed that only 25.40% of the participants had performed the test previously to the study and of these, only 31.25% had knowledge about the correct meaning of the result. Occurrence of accidents with instruments was reported by 50.79% of the professionals and of these, 46.03% showed negative result to the test. It was concluded that a considerable number of professionals did not complete the complete vaccination schedule and showed negative result for the anti-HBs test. Most of the professionals had suffered an accident with instruments and received information about the disease. Only a small part had performed the test previously and knew how to correctly interpret the result. These findings highlight a worrying reality that suggests that a significant proportion of dentists and dental auxiliaries are working without adequate protection against the risk of hepatitis B infection(AU)