National survey of endodontists and selected patient samples: infectious diseases and attitudes toward infection control

Application of forensic luminol for blood detection in endodontic files

Abstract Introduction Blood is a biological material with high potential of infectious transmission in dental environments, including herpes simplex, hepatitis and AIDS. Aim To investigate the efficacy of luminol in detecting blood in endodontic files before and after the sterilization process. Material and method Luminol was used to investigate the presence or absence of traces of blood tissue in 50 endodontic files, visible to naked eye or not, after performing endodontic treatment and after the cleaning/sterilization process. The results obtained were tabulated and statistically analyzed by using the Friedman’s test at a significance level of 5% (p<0.05). Result By naked eye, it was found that 31/50 files showed no trace of blood, 8/50 showed a slight presence of blood and 11/50 showed a considerable presence of blood after endodontic treatment. After the use of luminol, however, 16/50 endodontic files showed no trace of blood, 19/50 showed a slight presence of blood and 15/50 showed a considerable presence of blood. After the cleaning and sterilization process, no blood was detected in the files. Conclusion It was concluded that the luminol solution is effective in detecting blood tissue in endodontic files as well as in validating the cleaning/sterilization process.

A survey of cross-infection control procedures: knowledge and attitudes of Turkish dentists

Objectives:

The objective of this study was to investigate the knowledge, attitudes and behavior of Turkish dentists in Samsun City regarding cross-infection control.

Material and methods:

A questionnaire was designed to obtain information about procedures used for the prevention of cross-infection in dental practices and determine the attitudes and perceptions of respondent dental practitioners to their procedures. The study population included all dentists in the city of Samsun, Turkey, in April 2005 (n=184). The questionnaire collected data on sociodemographic characteristics, knowledge and practice of infection control procedures, sterilization, wearing of gloves, mask, use of rubber dam, method of storing instruments and disposal methods of contaminated material, etc. Questionnaire data was entered into a computer and analyzed by SPSS statistical software.

Results:

From the 184 dentists to whom the questionnaires were submitted, 135 participated in the study (overall response rate of 73.36%). As much as 74.10% dentists expressed concern about the risk of cross-infection from patients to themselves and their dental assistants. Forty-three percent of the participants were able to define "cross-infection" correctly. The greatest majority of the respondents (95.60%) stated that all patients have to be considered as infectious and universal precautions must apply to all of them. The overall responses to the questionnaire showed that the dentists had moderate knowledge of infection control procedures.

Conclusions:

Improved compliance with recommended infection control procedures is required for all dentists evaluated in the present survey. Continuing education programs and short-time courses about cross-infection and infection control procedures are suitable to improve the knowledge of dentists.

Characteristics of infection control programs in U.S. Air Force dental clinics

BACKGROUND

National organizations and regulatory agencies have issued a number of guidelines on proper infection control procedures in dentistry. The objective of the authors' research was to gather information about current infection control practices in U.S. Air Force (USAF) Dental Corps clinics for the purpose of updating previously issued guidelines and developing infection control training programs.

METHODS

The authors mailed a 60-item self-administered survey to the commanders of all USAF dental clinics located in the United States and overseas (n=82). The survey used primarily fixed-response questions to gather information about aspects of the clinics' infection control programs. The authors obtained descriptive statistics of the returned data by means of a statistical software package.

RESULTS

The results indicated a high degree of compliance with existing USAF dental infection control guidelines. All clinics had personnel assigned to manage their programs, had a written exposure control plan and took measures to improve dental unit water quality. Facilities used a number of approaches to achieve and monitor compliance and exhibited a considerable amount of variation in infection control procedures when specific guidelines did not exist.

CONCLUSIONS

In general, USAF dental clinics reported high levels of compliance with current infection control policies and procedures. Recurrent training, continual oversight, a highly motivated staff and teamwork are essential for reaching and maintaining these levels. Clinical Implications. Although compliance with recommended infection control guidelines is challenging, the results of this survey indicate that compliance is achievable, even in large group practices.

Infection control in the private dental sector in Riyadh

BACKGROUND

With the global rise in the number of people infected with hepatitis B and C and HIV viruses, cross infection has become of paramount concern to dental health care workers and their patients. The objective of this study was to assess the infection control practice in the private dental sector in Riyadh, Saudi Arabia.

SUBJECTS AND METHODS

The study was conducted through a cross-sectional survey of private dental practices in the city of Riyadh. A total sample size of 132 dental units was chosen using the proportional allocation method. Three hospitals, 45 clinics and 39 centers were selected randomly. A self-administered questionnaire was completed by dentists working in the selected settings.

RESULTS

Of the 206 questionnaires sent, 203 (98.5%) were completed. The mean age of the responding dentists was 36.8+/-6.7 years. A total of 139 dentists (68.5%) were general practitioners and 64 (31.5%) were specialists. A total of 129 (63.5%) stated that they had been vaccinated against hepatitis B virus and 189 (93.1%) stated that they always took a medical history of each patient before treatment. All the studied dentists reported that they always used gloves for every patient during dental treatment, and 90.6% stated that they always wore a face mask during dental treatment. The primary source of infection control information for the studied dentists was from the colleges (78.3%). Only 37.9% of the dentists sterilized their handpieces by autoclaving, while the other 53.7% used disinfectant. About 56% disposed of used needles and sharp instruments in special safety containers. Multivariate logistic regression analysis revealed that working in clinics, age >40 years and knowledge of correct sterilization steps were independent promoting factors for adherence to infection control practice (OR=3.8, CI=1.2-12.1; OR=10.2, CI=1.61-64.8; OR=5.6, CI=1.04-29.9, respectively).

CONCLUSION

The development of infection control manual for dental practices, in addition to a campaign of health education for dentists in the private sector, is recommended.

Systematic review of adherence to infection control guidelines in dentistry

OBJECTIVES

The purpose of this study was to determine the knowledge and attitudes of dental health care workers (DHCWs) towards infection control procedures, to examine DHCWs' practising behaviour in respect of infection control, and to determine whether a relationship exists between knowledge, attitudes and behaviour.

METHODS

Within this systematic review, study quality was assessed in line with selection criteria relating to study design, participants, interventions and outcome measures. Following data extraction, the heterogeneity of study design, targeted participants, sample size and outcome measures precluded a quantitative analysis. Qualitative data synthesis followed.

RESULTS

Overall, the quality of the studies reviewed was poor. Only 71 studies meeting the selection criteria were identified. Data indicated that over the period of the review there have been substantial improvements with compliance in some areas of infection control in dentistry, for example glove wearing. However, other aspects, such as the effective management of needlestick injuries, remain problematic.

CONCLUSIONS

More rigorously designed studies are required to assess accurately dental team members' adherence to infection control guidelines.

Factors associated with Mexico City dentists' willingness to treat AIDS/HIV-positive patients

OBJECTIVE

The purpose of this study was to investigate the characteristics and infection control practices of dentists in Mexico City in relation to their willingness to treat AIDS/HIV-positive patients.

STUDY DESIGN

The population study encompassed Mexico City dentists who were selected according to a geographic criterion. A questionnaire was delivered personally to each participant, and multiple logistic regression was used for data analysis.

RESULTS

A total of 598 dentists participated in the study. The response rate was 99.3% (598/602). Seventy-four percent (444) of the dentists said they would be willing to treat AIDS/HIV-positive patients. Among the variables associated with the prediction of willingness to treat these patients were glove-wearing patterns (odds ratio, 2.39; confidence interval, 1.4-4.2), types of available sterilization equipment (odds ratio = 2.42; confidence interval, 1.4-4.1), fear of losing non-AIDS/HIV-positive patients (odds ratio = 4.28; confidence interval, 2.3-8.4), and risk perception of HIV transmission (odds ratio = 2.66; confidence interval, 1.5-4.9). An interaction was found between perception of risk of HIV transmission and increase in costs (odds ratio = 3.35; confidence interval, 1.3-8.9).

CONCLUSIONS

Approximately 26% of the Mexico City dentists included in the study were not willing to treat AIDS/HIV-positive patients. Educational programs aimed at misperceptions appear to be warranted.

A comparison of infection control practices of different groups of oral specialists and general dental practitioners

OBJECTIVE

The purpose of this study was to compare the infection control practices of general dentists and dental specialty groups.

METHODS

A survey was mailed to 5997 dentists in 1994; the response rate was 70%. The data were analyzed with multiple logistic regression (reference group: general dentists).

RESULTS

When sociodemographic influences were taken into consideration, significant predictors of routine infection control practices included all of the following characteristics (odds ratios are in parentheses): 1. Gloves: being younger than 40 years of age (4.5) and being female (5.9). 2. Using gloves and changing gloves after each patient: being younger than 40 years of age (4.0), being female (3.0), being an oral surgeon (3.6), and being an orthodontist (0.2). 3. Using gloves, masks, and protective eyewear: being younger than 40 years of age (2.5), being female (2.3), and being an orthodontist, oral physician, or oral pathologist (0.2). 4. Hepatitis B vaccination for the practitioner: being younger than 40 years of age (5.1). 5. Hepatitis B vaccination for all clinical staff members: being younger than 40 years of age (1.2), being an oral surgeon (1.7), and being an orthodontist (0.6). 6. Heat sterilization of handpieces: being younger than 40 years of age (1.5), being an oral surgeon (5.4), and being an orthodontist (0.2). 7. Taking no additional precautions for patients with HIV: being younger than 40 years of age (1.7), being a periodontist (2.6), being a pedodontist (2.3), and being an oral physician/oral pathologist (4.3).

CONCLUSION

Improved compliance with recommended infection control procedures is required for all groups and is particularly necessary for orthodontists.