Dental Students and Bloodborne Pathogens: Occupational Exposures, Knowledge, and Attitudes

Knowledge, Attitudes, and Practices of Undergraduate Dental Students About Sterilization, Disinfection, and Infection Control: A Questionnaire-Based Study

BACKGROUND

The core of infection control in dental settings involves minimizing potential cross-infection risks between patients and from patients to other workers in health care. Infection control is important for promoting enhanced adherence to protocols through sterilization, disinfection, and infection control knowledge, attitudes, and practices (KAP) among undergraduate dental students.

MATERIALS AND METHODS

A cross-sectional survey among 222 undergraduates of Dental Students and Interns of the Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, India, was conducted. KAP of participants related to sterilization and disinfection were assessed before and after educational lectures using a pre-fabricated questionnaire.

RESULTS

All 182 respondents considered the importance of sterilization and disinfection during the dental procedure. While 98.8% had adequate knowledge about isolation and immunization, only 3.8% were vaccinated against hepatitis B virus (HBV). They were perfect in hand hygiene compliance (100%) and awareness regarding autoclave sterilization stood at 78.8%. Mean KAP scores were 7.03 ± 1.39, 10.15 ± 1.40, and 9.

CONCLUSION

The undergraduate dental students showed a high level of awareness but wide gaps between practice and attitude of sterilization protocols. Therefore, there is a need for interventions that could bridge the theory-practice gap to improve adherence to infection control measures.

Prevalence and characteristics of needlestick injuries among dental interns during their first-year clinical training: an observational study

BACKGROUND

Dental interns are vulnerable to needlestick injuries (NSI). The objectives of this study were to examine the prevalence and characteristics of NSI exposures among dental interns during their first-year clinical training, assess risk factors, and evaluate reporting behaviours.

METHODS

An online survey was conducted among dental interns of Class 2011-2017 at Peking University School and Hospital of Stomatology (PKUSS), China. The self-administrated questionnaire consisted of information on demographic profiles, NSI characteristics, and reporting practices. The outcomes were presented by descriptive statistics. A multivariate regression analysis was performed to assess NSI sources using a forward step-wise approach.

RESULTS

A total of 407 dental interns completed the survey (response rate 91.9%, 407/443), and 23.8% sustained at least one NSI. The mean number of NSIs per intern was 0.28 during the first clinical year. More occupation exposures occurred from October to December, between 13:00-15:00. Syringe needles were the most frequent sources, followed by dental burs, suture needles, and ultrasonic chips. The risk of peer-inflicted NSIs in the department of Paediatric Dentistry was 12.1 times higher than that in Oral Surgery (OR 12.1, 95% CI: 1.4-101.4). Appropriately 64.9% NSIs occurred when chairside assistants were absent. Compared to working alone, the risk of peer-inflicted NSIs was 32.3 times higher when providing chairside assistance (OR 32.3, 95% CI: 7.2-145.4). The left-hand index finger was the most commonly injured site. About 71.4% of exposures were reported in paperwork.

CONCLUSIONS

Dental interns are susceptible to NSIs during their first-year clinical training. Extra attention should be paid to syringe needles, dental burs, suture needles, and ultrasonic chips. The lack of chairside assistance is hazardous regarding NSIs. The training of chairside assistance of the first-year dental interns should be enhanced. First-year dental interns are required to increase their awareness of ignored behaviors related to NSI exposures.

A Cross-Sectional Questionnaire-Based Survey on Blood-Borne Infection Control among Romanian Dental Students

Background and Objectives: According to the CDC estimates, 5.6 million healthcare workers worldwide are exposed to the risk of occupationally contracting blood-borne pathogens, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and others. The aim of the present study was to assess the knowledge level on blood-borne infection control (IC) among Romanian undergraduate dental students. Materials and Methods: A cross-sectional, questionnaire-based survey with 21 items was conducted from May 2022 to June 2022. The study had α = 0.620 and Cronbach’s Alpha = 0.660. The Chi-square test was used for data comparison. The data were analyzed using IBM SPSS version 26 (IBM, Armonk, NY, USA), and p ≤ 0.05 was considered statistically significant. Results: The study sample included 207 subjects with a mean age of 21.38 (±1.9) years, 59.9% F (female), 40.1% M (male), 38.2% students from year II and 61.8% from year III. Most of the subjects did not have knowledge on the indirect mode of IC, the persistence of HBV, HCV, or HIV, or the existence of rapid tests (p < 0.05). PEP (post-exposure prophylaxis) was known as follows: HBV, 32.36% (67); HCV, 25.60% (53); and HIV, 36.71% (76); p < 0.05. Only 50.24% (104) had knowledge on the recommended testing moments (p = 0.019 by gender, p = 0.752 by year of study). The optimal time to access PEP was considered by 28.01% (58), p ˃ 0.05. Only 37.68% (78) strongly agreed that the one-hand covering technique of the needle was efficient in IC (p < 0.05). Conclusions: The evaluation of the knowledge regarding IC highlighted major gaps in the perception of the subjects, which underlined the need to implement sustained forms of continuing medical education on this topic.

Global prevalence, risk factors and reporting practice of needlestick and sharps injuries among dental students: A systematic review and Meta-analysis

BACKGROUND

Dental students are vulnerable to needlestick injuries (NSI) due to their inadequate training. However, the global prevalence of NSI among dental students is unknown.

AIM

To determine the pooled prevalence among dental students, epidemiological profile, and risk factors for NSI.

METHODS

A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The review protocol was registered at the International Prospective Register of Systematic Reviews (CRD 42022312778). Eligible studies were identified from PubMed, Scopus, Web of Science, Embase, OVID, and EBSCO databases. A meta-analysis with a random effects model was performed to estimate the pooled prevalence, and meta-regression was conducted to explore heterogeneity among studies.

FINDINGS

A total of 25 studies from 15 countries met the inclusion criteria. The estimated pooled prevalence of NSI among dental students was 44% (95% CI: 38-51%). Local anesthesia, tooth cleaning or scaling, and waste disposal were associated with highest risk for NSI. Most studies observed under-reporting of NSI. Dental students had inadequate knowledge regarding post-exposure management.

CONCLUSION

Dental students had a high prevalence and low reporting rate of NSI exposure. Inadequate knowledge might increase the probability of NSI exposure.

Percutaneous exposure injuries amongst dental staff and students at a university dental clinic in Australia: A 6-year retrospective study

PURPOSE/OBJECTIVES

Dental care providers are at risk of percutaneous exposure injuries (PEIs) due to the intimate nature of the patient-dentist environment and the routine use of sharp instruments. They are the most vulnerable to accidental exposure of blood-borne viruses. The aim of this study was to determine the types of PEIs sustained by staff and students at the Griffith University Dental Clinic over a 6-year period.

METHODS

Data were collected regarding PEIs sustained amongst dental staff and students between 2014 and 2019. Data were obtained from the risk incident reporting system (GSafe) and the patient management Software (Titanium), and then analysed using IBM SPSS. The chi-squared tests and multinomial logistic regressions were performed with significance set at <.05.

RESULTS

Over the 6-year period, there were 308 PEIs with an incidence rate of 0.109%, with 67 being needle stick injuries (0.023%). These injuries happened more often in restorative procedures, followed by local anaesthesia and oral surgery. Dental students were at a greater risk of sustaining PEIs (65.6%) when compared with professional staff (34.4%). Most common instruments included needles (21.8%), probes (20.5%) and burs (18.2%).

CONCLUSION

Overall, the incidence of percutaneous injuries at the Griffith University Dental Clinic was low. The most common instruments were needles, probes and burs, and dental students were at greatest risk of sustaining injuries. Prevention of injuries by not recapping needles, immediate removal of burs from handpieces, the use of cassettes and single-use instruments has effectively decreased PEIs experienced by dental students and staff.

Epidemiology of needlestick injury exposures among dental students during clinical training in a major teaching institution of China: A cross-sectional study

Background/purpose

Dental students are particularly vulnerable for needlestick injuries (NSI). However, the epidemiology of NSI exposures among Chinese dental students was rarely reported. The objectives of this study were to determine the prevalence of NSI among dental students in a major teaching institution of China, and to identify associated factors.

Materials and methods

A self-administrated online questionnaire was developed based on previously published studies, and distributed to dental students of Class 2011–2015 recruited from Peking University School and Hospital of Stomatology.

Results

Two hundred and sixty-eight dental students including 38.8% of males and 61.2% of females (response rate of 90.0%) completed the survey. Approximately 36.2% of the respondents had sustained at least one NSI. A total of 112 NSI cases were reported. The majority of NSIs were related to the procedures of local anesthesia administration (15.2%) and tooth cleaning or scaling (15.2%). Syringe needles, dental burs and ultrasonic chips were the most notorious devices. Statistical analysis showed significant distribution in NSI occurrence between July–September and October–December. The main cause was lapse in concentration (67.9%), followed by fatigue (22.3%). Up to 66.1% of the exposures occurred when the student was working alone, while only 10.7% with assisting. Unfortunately, 26.8% of the incidents were under-reported.

Conclusion

Dental students are prone to needlestick injuries. The present study clearly reveals a need for increased awareness of NSI prevention among dental students. The quality of infection control education at dental teaching institutions is crucial and indispensable for reducing NSI exposures.

Knowledge, Perceptions, and Attitudes Regarding COVID-19 and Infection Control Measures Against it among Dental Students in Saudi Arabia

Background

Coronavirus disease (COVID-19) is a highly infectious disease caused by an RNA virus named SARS CoV2. The increased risk of infection by this virus among dental students necessitates updated knowledge and highlights their important role in preventing and controlling its transmission.

Objective:

This study aims to assess knowledge, perceptions, and attitudes regarding COVID-19 and infection control measures among dental students in Saudi Arabia.

Methods:

A cross-sectional study was conducted among dental students in different Saudi universities using an online self-administered questionnaire. It gathered data on students’ demographic information, knowledge of COVID-19 and infection control measures, risk perception and attitudes toward the disease, and their preparedness for treating infected patients.

Results:

A total of 327 dental students responded to the questionnaire. Of these students, 92.4% had received training in infection control in dental practice, but only 24.2% had attended training regarding COVID-19. The majority of students had adequate knowledge regarding the modes of transmission and the common symptoms of COVID-19, with statistically significant total mean knowledge scores among students in different academic years (p<0.05). A large percentage of the students (92.7%) agreed that the use of rubber dams or high-volume saliva ejectors could reduce the possibility of transmitting infection. However, 58.4% of the students disagreed that intraoral dental radiographs should be avoided to reduce the possibility of transmitting infection.

Conclusion:

Although knowledge of and risk perception concerning COVID-19 among students is good, additional training sessions integrating recent international guidelines for infection control are required to update their knowledge and achieve safe dental practice.

Occupational exposures to bloodborne pathogens and its underreporting in dental teaching environment in an Indian dental school

Introduction

The aims of this study were 1) to find out the prevalence of occupational exposures to contaminated biological material among undergraduate students and interns; 2) to find out how many cases of occupational exposures to bloodborne pathogens are reported; and 3) to know the reasons for non-reporting of occupational exposures.

Materials and Methods

The study was conducted in a Dental School in Navi-Mumbai, India. An anonymous self-administered questionnaire was formulated. 210 dental students were given a questionnaire out of which 150 students attending clinical postings in their third year, final year, and internship responded. Approval was obtained from the Institutional Ethical Committee.

Results

The study revealed a very high prevalence (66.7%) of exposures among the students. Only 12% of the students reported the exposures to the staff. Students from III year and final year BDS (Bachelor of Dental Surgery) had mean exposure of 2.40 as compared to 1.94 among interns. 46% of the students stated that they did not report about the exposure because they thought that injury was of minor nature.

Conclusion

There is a very high prevalence of occupational exposures among students which are not reported. There is a need for the development of a post exposure protocol which has to be strictly implemented. The principle of infection control has to be emphasised to the students periodically and they should be encouraged to report incidences of exposures to biological material.

Occupational percutaneous injuries and exposures in a dental teaching environment: A 10-year report

PURPOSE

Percutaneous injuries (PIs) are woefully underreported and the risk at dental academic institutions is higher due to lack of knowledge and experience of students. The aims of this study are to (1) present data on the prevalence of PIs and exposures over a 10-year period in a dental teaching institution; (2) provide information on areas with increased risk as it relates to personnel and instruments; and (3) improve the awareness of the risk of occupational PIs and exposures in dentistry.

METHODS

Data presented were collected as a part of an infection control program. A description of the incident reporting and collecting methodology is provided. Distribution tables and confidence intervals for injuries by year were calculated. Overall associations were produced using either Fisher's exact or Chi-square test.

RESULTS

Between 2009 and 2019, a total of 342 PIs (338) and mucosal exposures (4) were reported. A significant number of injuries occurred while reaching for an instrument (15.2%), injecting local anesthetic (13.2%), and cleaning an instrument (11.7%). About 31% of the injuries were caused by needlesticks followed by burs (22.8%). There was a statistically significant association between work practice controls and activity type (p < 0.001) and position (p = 0.01). PIs and compliance issues were higher among the third-year dental students.

CONCLUSIONS

There was a declining trend in incidents over the years, which could be attributed to the extra-protective measures that were implemented. Uncovered dental burs and needlesticks continue to be the predominant cause of PIs in academia. We found that collection of data on such occupation-related injuries to be useful in observing any trends and implementation of corrective actions.

Identifying Trends of Percutaneous Injuries at an Australian Dental School

Objectives

The aim of this study was to retrospectively examine trends in percutaneous exposure incidences (PEIs) at the School of Dentistry (SoD) from 2009 to 2019 and to report on the underreporting rate of PEIs, current attitudes, and awareness of PEI safety protocols from clinical staff and students at the SoD in 2019.

Methods

Retrospective data were collected from deidentified archival incident reports from 2009 to 2019 from the SoD's incident reporting system (UQSafe and Legacy Database). Additionally, cross-sectional data were collected via the validated Percutaneous Exposure Incident Questionnaires (PEIQ) completed by clinical staff and students of the SoD in 2019.

Results

From the archival data, the majority (79.9%) of the 618 reported PEIs involved students. Local anaesthetic-related procedures were the most common cause in the archival (31.5%) and survey data (23.7%), whereas the needle-prick was the most common causative instrument in both data sets. Additionally, the finger was the most common site of injury found in the archival (53.0%) and survey data (52.8%). From 345 responses to the survey, 42.1% of PEIs sustained were not reported.

Conclusions

Students were at a higher risk of sustaining a PEI than staff members between 2009 and 2019. The reported knowledge on PEI classification and preventative measures is inadequate, suggesting that further PEI education is necessary. The study provides evidence of the trends in PEIs as well as data on the attitudes and awareness of student and staff at a dental teaching faculty to support the development of PEI safety management protocols.

Infection Control Knowledge, Attitudes, and Practices among Students of Public Dental Schools in Egypt

In developing countries such as Egypt, the risk of blood-borne diseases such as human immunodeficiency virus, hepatitis B virus, and hepatitis C virus is high for healthcare workers. To evaluate infection control knowledge, attitudes and practices, as well as the associated risk of percutaneous infection among dental students, a cross-sectional study was conducted in four Egyptian public dental schools in 2016. A total of 1776 students received an anonymous questionnaire on infection control knowledge, attitudes, and practices and the occurrence of needle and sharps injuries; 1067 (60.1%) completed the questionnaire. Third- (pre-clinical), fourth- (junior-clinical), and fifth-year (senior-clinical) students comprised 44.2%, 15.6%, and 40.2%, respectively. Although the majority of the students reported good attitudes and practices for infection control, knowledge scores were generally low. Female students scored higher on self-protection and sterilization practices than did male students, and the fourth-year students showed significantly higher scores for infection control practice than did the fifth-year students. In multivariate analysis, higher scores for all infection control practices were associated with higher scores for attitudes towards infection control and fewer (1–3) needle injury experiences. Although an alarming proportion had experienced needle or sharps injuries during clinical training, around 30% of the students had not received a complete hepatitis B vaccination. Future infection control education should introduce refresher training before graduation that focuses on injury prevention and post-exposure protocols. Additionally, introducing safer products and clinical procedures is highly recommended to minimize the risk of injuries during clinical practice for dental students in Egypt.

Development and validation of an instrument to assess adherence to occupational health protocols in dentistry

OBJECTIVES

The purpose of this study was the creation and validation of an instrument to evaluate adherence to occupational health protocols used in dentistry that arise from official regulations and international recommendations on infection control, biosafety, and occupational health in dentistry. Additionally, in May 2017 the effectiveness of the instrument was documented within the dental care clinics in the postgraduate area.

METHODS

The instrument was developed based on constructs of occupational health, infection control, and biosafety in dentistry, made up of 21 indicators of 5 dimensions called protocols. Using direct observation through 35 measurements during 1 week, adherence to occupational health protocols was evaluated in postgraduate residents within the clinical sections of endodontics/pediatric dentistry, periodontics, prosthodontics, and orthodontics.

RESULTS

The instrument presents an index of 0.88 in Cronbach's alpha analysis. There is a 34.4% adherence within the postgraduate dental clinic to the proposed occupational health protocols. The protocol with the highest adherence at 41.1% was the personal protection protocol. The periodontics section had a 52.9% observance of the proposed protocols and had the highest adherence to occupational health protocols.

CONCLUSIONS

The proposed instrument is valid and reliable to evaluate adherence to the proposed occupational health protocols within dental care clinics. Dental clinics must be inspected and evaluated to ensure adherence to infection control, biosafety, and occupational health protocols within routine dental practice.

Self-reported percutaneous injuries of students and interns at the School of Dentistry in Trinidad: A follow up study of an updated sharps protocol

Objective To report the results of a survey of all percutaneous injuries that occurred between 2009 – 2014 among students and interns at the dental school in Trinidad and to evaluate compliance with the protocol for the management of percutaneous injuries. Methods Data was collected via questionnaires administered to 186 clinical students and interns in 2012 and 2014. Data were analysed using SPSS® 17.0 Statistical software. Results A 90% response rate was obtained. Forty-eight persons (29%) reported one or more sharps injuries at the dental school. Of the 76 sharps injuries reported, 55 were percutaneous. Needle sticks and burs accounted for the majority of injuries and mostly occurred while working on patients. There were no significant relationships (p>0.05) between sex nor student year with the occurrence of injuries. 76% of the respondents described their concern for contracting blood borne injuries from sharps injuries as “high.” After injury, 41% of the respondents followed the school’s protocol for sharps injuries. Conclusion The prevalence of percutaneous injuries among students and interns at the UWI dental school in Trinidad is 23% and occur most commonly while working on patients. Compliance with the protocol for percutaneous injuries needs to be improved. The protocol needs to be audited to improve efficiency and reinforced to the students, interns and clinical supervisors during their clinical years.

Evaluation of knowledge, attitudes, and clinical education of dental students about COVID-19 pandemic

BACKGROUND

The novel coronavirus disease (COVID-19) is a new viral respiratory illness, first identified in Wuhan province, China. Dental professionals and dental students are at an increased risk for these viruses from dental patients, as dental practice involves face-to-face communication with the patients and frequent exposure to saliva, blood, and other body fluids. Dental education can play an important role in the training of dental students, adequate knowledge and adopting attitudes regarding infection control measures. The aim of this study was to evaluate knowledge, attitudes, and clinical education of dental students about COVID-19 pandemic.

METHODS

A total of 355 pre-clinical and clinical dental students (242 and 113, respectively, comprising 190 females and 165 males) at Fırat University Dentistry Faculty, in Elazığ, Turkey answered an online questionnaire about the biosafety procedures for and their attitudes to and knowledge of COVID-19. The study was conducted in March 2020, Turkey. The data gained were analyzed using descriptive statistical methods and chi-square test.

RESULTS

Both the clinical and preclinical students were found to be afraid of infecting themselves and their environment with COVID-19, and the difference between them was statistically significant. Three quarters (74.9%) of the participants responded yes to the question of whether they thought that experiences related to COVID-19 affected them psychologically, with the differences between gender and clinical status were statistically significant. Responses to the question of which clinical rotation worried them more were 29.9% endodontics, 25.1% oral and maxillofacial surgery, 16.3% prosthesis, 15.2% periodontology, 6.8% restorative dentistry, 3.9% oral diagnosis and radiology, 1.7% pedodontics, and 1.1% orthodontics, with a significant difference between the preclinical and clinical students. Regarding the measures applied by the clinical students in their clinical rotation, the responses were 100% gloves and 100% mask (with 11.5% FFP3/N95 mask), 73.6% face protective shield and 37.1% safety glasses, and 49% bonnet and 16.8% disposable box, with 90.2% frequent hand washing, and 86.7% frequent hand antiseptic usage.

CONCLUSIONS

While students gave good responses regarding the standard measures they take to protect against transmission of COVID-19, their knowledge and attitudes about the extra measures they can take should be improved. For students to be least affected by fears associated with the disease, dental faculties should be ready to provide psychological services to those in need.

Analysis of factors related to needle-stick and sharps injuries at a dental specialty university hospital and possible prevention methods

Needle-stick and sharps injuries (NSIs) can happen even when dental health care workers (DHCWs) act in compliance with standard precautions to prevent transmitting blood-borne infections. The objective of this study was to investigate causes of NSIs that had occurred at a dental specialty university hospital during the past 12 academic years. A total of 215 NSIs were reported during the investigation period, and NSIs ascribed to female DHCWs (n = 148; 68.8%) were significantly (P < 0.05) more common than those ascribed to male DHCWs (n = 67; 31.2%). One hundred twenty-six NSIs (58.6%) were caused by DHCWs with little experience (P < 0.05), and 37 of those (17.2% of the total) were ascribed to undergraduate students during clinical training (P < 0.05). The NSIs occurred both during treatment (n = 119; 55.3%) and during cleaning up used devices (n = 89; 41.4%). The NSIs at the dental hospital occurred with a probability of 0.004% of total therapeutic opportunities. Prevention of NSIs should be the responsibility of dental students and DHCWs, and should be a part of education about infection control to prevent the nosocomial transmission of blood-borne pathogens.

The impact of educational intervention based on the health belief model on observing standard precautions among emergency center nurses in Sirjan, Iran

Providing health care services has always been considered as a hazardous job due to a number of reasons. The risk of blood-borne viruses and the importance of their prevention has led to the formulation of principles called standard precautions (SPs). The goal of this study was to investigate the impact of an educational intervention based on the Health Belief Model constructs on the behavior of nurses in emergency centers regarding observing SPs in Sirjan, Iran. This was a quasi-experimental study. The study population included 100 emergency personnel working in health centers in Sirjan city (of Iran), who were randomly divided into two intervention (n = 50) and control (n = 50) groups. The educational intervention was conducted over two sessions each lasting for 60 min. Information was collected by a questionnaire (with 64 questions), completed in an interview conducted directly before the intervention and 3 months later. Data were analyzed using the χ2 test, t-test and paired t-test.The results showed nurses did not have enough information about SPs, but after the intervention, knowledge scores increased in both groups. In the Health Belief Model (HBM) constructs, significant differences were observed in perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action and self-efficacy, after the intervention, in the intervention group (P < 0.001), but not in the control group (P > 0.05). HBM was effective in educating SPs among emergency personnel.

Observed infection control compliance in a dental school: A natural experiment

OBJECTIVE

The objective of this study was to determine student adherence to infection control policies at 1 dental school. A secondary objective was to determine the influence of Ebola virus disease (EVD)-related training on student infection control behaviors.

METHODS

An instrument to assess and record infection control behaviors was developed to reflect Centers for Disease Control and Prevention guidelines as well as current teaching. Third- and fourth-year dental students were observed during patient-care appointments and behaviors were recorded and analyzed. Behaviors observed before the EVD outbreak and subsequent mandatory in-service training were compared with behaviors observed after completion of the training.

RESULTS

Use of personal protective equipment was nearly universal. Overall compliance with infection control parameters was 88%. However, only a minority of students demonstrated no breaches of protocol. Most violations involved improper mask use and improper glove use during the intraoperative phase of an appointment and failure to wash hands after removing gloves. There were no significant overall differences in observed behavior pre- and post-EVD training.

CONCLUSION

Overall compliance with recommendations was high but some areas showed room for improvement. Future training in infection control should focus on these areas. Training related to EVD had no influence on student behavior.

Knowledge, attitudes and practices surrounding occupational blood-borne pathogen exposure amongst students in two Chinese dental schools

OBJECTIVE

To investigate the knowledge, attitudes and practices surrounding occupational blood-borne pathogen exposure amongst dental students at two Chinese dental schools, as well as important factors that are associated with their career choice and attitudes towards infected patients.

SUBJECT AND METHODS

The study was conducted using a student self-administered questionnaire from March to June 2013 at two Chinese dental schools. Chi-square tests and multivariable logistic regression were used to compare the categorical variables and identify the variables related to attitudes.

RESULTS

One hundred and seventy-one students answered the questionnaire (response rate 83%). Most participants had incomplete knowledge about occupational exposure and participants' compliance with the infection control programme during routine clinical work was low. Fifty-six participants (34%) experienced at least one occupational exposure, but only one reported the incident. Percutaneous injuries and mucous membrane exposures were the main causes for exposure. Protection of the eyes and post-exposure management were inadequate. According to most participants, they had received insufficient education. Their concerns about the risk of infectious professional exposure would influence their career choice and approach to patients. Only 14% and 26% of the participants were willing to treat human immunodeficiency virus- and hepatitis B virus-infected patients, respectively.

CONCLUSIONS

More effective education on prevention and management is required for dental students to reduce the harm caused by occupational exposure. It is important to ensure dental students' knowledge and understanding before allowing them to enter clinical training.

Compliance with infection prevention and control in oral health-care facilities: a global perspective

Many publications are available on the topic of compliance with infection prevention and control in oral health-care facilities all over the world. The approaches of developing and developed countries show wide variation, but the principles of infection prevention and control are the same globally. This study is a systematic review and global perspective of the available literature on infection prevention and control in oral health-care facilities. Nine focus areas on compliance with infection-control measures were investigated: knowledge of infectious occupational hazards; personal hygiene and care of hands; correct application of personal protective equipment; use of environmental barriers and disposable items; sterilisation (recirculation) of instruments and handpieces; disinfection (surfaces) and housekeeping; management of waste disposal; quality control of dental unit waterlines, biofilms and water; and some special considerations. Various international studies from developed countries have reported highly scientific evidence-based information. In developed countries, the resources for infection prevention and control are freely available, which is not the case in developing countries. The studies in developing countries also indicate serious shortcomings with regard to infection prevention and control knowledge and education in oral health-care facilities. This review highlights the fact that availability of resources will always be a challenge, but more so in developing countries. This presents unique challenges and the opportunity for innovative thinking to promote infection prevention and control.