Shuchi Tripathi1*, Raghuwar Dayal Singh1, Rameshwari Singha2, Richa Khanna3, Deeksha Arya1 and Swapnil Parlani4
1Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
2Department of Periodontics, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
3Department of Pedodontics, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
4Department of Prosthodontics, People’s Dental College, Bhopal, Madhya Pradesh, India
Received: 17 February, 2017; Accepted: 14 March, 2017; Published: 15 March, 2017
Shuchi Tripathi, Associate Professor, Department of Prosthodontics, Faculty of Dental Sciences, King George’s Medical University, India, E-mail:
Tripathi S, Singh RD, Singhal R, Khanna R, Arya R, et al. (2017) Sharps Safety and Management among Dental Practitioners. J Dent Probl Solut 4(2): 015-018.10.17352/2394-8418.000041
© 2017 Tripathi S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Blood borne infections; Infection control; Needlestick injury; Waste management
Background: The potential for transmission of blood borne infections is highest during handling of needles and sharps. The factors which relate commonly to sharps injuries include the inadequate design or inappropriate placement of sharps disposal container, overfilling of sharps disposal container and inappropriate sharps disposal practices by the care provider during patient treatment. The present study was undertaken to assess the knowledge and practice of sharps use and disposal in dentists practising in government and private sectors and also to provide correct methods and procedure regarding sharp use and disposal to increase awareness.
Methods: A questionnaire comprising of 20 self-administered questions regarding knowledge, use and disposal methods of sharps in dentistry was prepared. The questionnaire was sent to 220 dentists practising in Lucknow and nearby area. Out of them 86 dentists in government teaching institute and hospitals, 45 dentists in private teaching institute and hospitals and 29 dentists of private clinic had answered back. The resulting data was compared and statistically analyzed.
Results: Only 11% dentists were fully aware about the type of sharps used in the dentistry. 79% of dentists prefer to use gloves always at the time of injection. 81% of the dentists were agreed with use of mechanical needle cutter and electrical needle destroyer to destroy the needle tips, however only 37% were actually using these methods. 66% answered that incineration is best method of final disposal of sharps.
Conclusion: There is somewhat lack of motivation and awareness regarding the sharps use and their maintenance among dentists, which needs special attention.
Accidental percutaneous injury is commonly seen as the primary route of occupational exposure to blood borne pathogens. During dental practice, sharp devices and equipments such as needles, scalpels, root canal reamers, stitch cutters, glass ampoules, sharp instruments and broken crockeries and glasses are used and accidental injury may occur during the time of use or disposal. A recent study done on needle stick injuries have shown that these injuries leads to one fourth of the occupational injuries . Dental staff working in clinics, may be exposed to blood-borne viruses (BBV) carried in blood, oral fluids and tissues. Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are the principal pathogens of concern to dental staff which spread though sharp injuries . HBV is the most infectious of the three viruses with a 30% risk of seroconversion following a sharps injury involving a high risk carrier to a susceptible individual [3,4]. HBV has frequently been transmitted in dental practice, although infection rates have declined considerably in dental staff as a consequence of immunization and improvements in infection control practices. However, there are evidences in the recent literature that significant groups of healthcare workers worldwide do not receive appropriate hepatitis B vaccination [5,6]. Hepatitis C virus (HCV) found in saliva, is most frequently acquired by direct blood to blood contact. The estimated risk of HCV transmission after needle sticks is 1.8% .The risk of HIV infection following a dental sharps injury is comparatively low with 0.3% risk of transmission .
Use of sharps is inherent in practice of dentistry and now it is established fact that occupational blood exposures carry a certain risk of transmission for blood borne infections. The present study was therefore undertaken to assess the knowledge and practice of sharps use and disposal among dentists practising in Lucknow and nearby area. The correct method for use and disposal of sharps was sent to the practicing dentists after getting the answers of survey questionnaire to increase their knowledge and awareness.
An epidemiological survey was conducted in dental practitioners practicing in government and private sectors. A closed ended questionnaire of 20 self-administered objective questions was made consisting of questions related to the knowledge of sharps used in dental clinics, attitude towards use and practice of sharps disposal technique. Ethical approval was taken from the institutional ethical committee. 220 dental practitioners working in government and private teaching institutes and hospitals and private dental clinics were selected by convenience sampling, contacted and questionnaire form was e-mailed to them. Participants were assured of the confidentiality of the project and were requested to provide appropriate answers. Among them 86 dentists in government teaching institute and hospitals, 45 dentists in private teaching institute and hospitals and 29 dentists of private clinic had answered back. Reminder was sent to the rest of dentists and after two reminders they were excluded from the study. The answers obtained were then compared and statistical analysis was done SPSS (Statistical Package for Social Sciences) software version 17.0.
Figure 1 shows the percentage of dentists answered the questionnaire. Only 11% dentists were fully aware about the type of sharps used in the dentistry. 4% of the dentists consider that gloves not necessary during the time of injection, though gloves are necessary as they provide primary barrier. 79% of the dentists always prefer to wear gloves during the time of injection. Figure 2 shows the percentage of dentist and staff exposed to needlestick injuries/sharp instrument injury. Most of the dentist and staff were exposed to needlestick injuries approximately 10% or less than 10% incidental rate.
- Adell R, Lekholm U, Rockler B, Brånemark PI (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 10: 387-416. Link: https://goo.gl/7FrR67
- Albrektsson T (1988) A multicenter report on osseointegrated oral implants. J Prosthet Dent 60: 75-84. Link: https://goo.gl/NrHgaI
- Andersson B, Odman P, Lindvall AM, Brånemark PI (1998) Five-year prospective study of prosthodontic and surgical single-tooth implant treatment in general practices and at a specialist clinic. Int J Prosthodont 11: 351-355. Link: https://goo.gl/sDTFn1
- Engelman MJ, Sorensen JA, Moy P (1988) Optimum placement of osseointegrated implants. J Prosthet Dent 59: 467-473 Link: https://goo.gl/q1FRPI
- Stella JP, Tharanon W (1990) A precise radiographic method to determine the location of the inferior alveolar canal in the posterior edentulous mandible: Implications for dental implants. Part 1: Technique. Int J Oral Maxillo fac Implants 5: 15-22. Link: https://goo.gl/XNTmdm
- Klinge B, Petersson A, Maly P (1989) Location of the mandibular canal: Comparison of macroscopic findings, conventional radiography, and computed tomography. Int J Oral Maxillo fac Implants 4: 327-332. Link: https://goo.gl/ArqDC4
- Lindh C, Petersson A (1989) Radiologic examination for location of the mandibular canal: A comparison between panoramic radiography and conventional tomography. Int J Oral Maxillo fac Implants 4: 249-253. Link: https://goo.gl/jiKobj
- Tyndall DA, Brooks SL (2000) Selection criteria for dental implant site imaging: A position paper of the American Academy of Oral and Maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89: 630-637. Link: https://goo.gl/Ptdl2Z
- Scaf G, Lurie AG, Mosier KM, Kantor ML, Ramsby GR, et al. (1997) Dosimetry and cost of imaging osseointegrated implants with film-based and computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83: 41-48. Link: https://goo.gl/vRCm1d
- Monsour PA, Dudhia R (2008) Implant Radiography and Radiology. Aust Dent J 53: S11-S25. Link: https://goo.gl/tEP7gY
- Sarik Gupta, Neelkant Patil, Jitender Solanki, Ravinder Singh, Sanjeev Laller (2015) Oral Implant Imaging: A Review. Malays J Med Sci 22: 7-17. Link: https://goo.gl/I0m8Jf
- SJJ McCrea (2008) Pre-Operative radiographs for dental implants-are selection criteria being followed? Bri Dent J 204: 675-682. Link: https://goo.gl/ZGHB2d
- Beason RC, Brooks SL (2001) Preoperative implant site assessment in southeast Michigan. J Dent Res 80: 137. Link: https://goo.gl/NiVqF3
- Sakakura CE, Morais JA, Loffredo LC, Scaf G (2003) A survey of radiographic prescription in dental implant assessment. Dentomaxillo fac Radiol 32: 397-400. Link: https://goo.gl/lXHDBa
- deMorais JA, Sakakura CE, LoffredoLde C, Scaf G (2007) A survey of radiographic measurement estimation in assessment of dental implant length. J Oral Implantol 33: 186-190. Link: https://goo.gl/W19Xwg
- Majid IA, Mukithur Rahaman S, Kumar H, Sowbhagya MB, Alikutty FK (2014) Radiographic prescription trends in dental implant site. J Dent Implant 4: 140-143. Link: https://goo.gl/EZUDF4
- Aishwarya Nagarajan, Rajapriya Perumalsamy, Ramakrishnan Thyagarajan, Ambalavanan Namasivayam (2014) Diagnostic Imaging for Dental Implant Therapy. J Clin Imaging Sci 4: 4. Link: https://goo.gl/Gkl60p
- Naseem Shah, Nikhil Bansal, Ajay Logani (2014) Recent Advances in imaging technologies in dentistry. World J Radiol 6: 794-807. Link: https://goo.gl/4i4Ycm
- Reddy MS, Mayfield Donahoo T, Vanderven FJ, Jeffcoat MK (1994) A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 5: 229-238. Link: https://goo.gl/k63G3x
- Bolin A, Eliasson S, von Beetzen M, Jansson L (1996) Radiographic evaluation of mandibular posterior implant sites: Correlation between panoramic and tomographic determinations. Clin Oral Implants Res 7: 354-359. Link: https://goo.gl/UeD4CY
- Peñarrocha M, Palomar M, Sanchis JM, Guarinos J, Balaguer J (2004) Radiologic study of marginal bone loss around 108 dental implants and its relationship to smoking, implant location, and morphology. Int J Oral Maxillofac Implants 19: 861-867. Link: https://goo.gl/hQVRE7