Very often, dentistry focuses on the health of one person: the patient. In practices, dentists work to absolve them of infection and pain, and in the laboratory, technicians endlessly craft the most comfortable and effective restorations available.
But there is another group that must be looked after every day – the professionals themselves. In the dental laboratory in particular, there are a variety of specific risks that can affect technicians immediately and in the long-term. Taking the appropriate steps to both familiarise yourself with these, and work to actively minimise them, is essential.
First steps
Despite in-depth guidance on the topic of infection control in the laboratory being made available, the infection of technicians working with contaminated prosthetics is still possible. Putting in place effective measures to prevent this is fundamental. If you find that your currently laboratory has insufficient standards that put you and your colleagues at risk, the General Dental Council (GDC) states that you must act promptly to amend this.[i]
Risks to health can also originate from outside of the laboratory. A physical impression may be contaminated with blood, saliva or gingival tissue from the patient. In fact, approximately 25% of dental impressions are visibly contaminated with blood upon arrival from a commercial clinic.ii One study of GDC registered professionals found 95% of technicians had received blood-contaminated impressions, and 24.7% of dentists did not communicate their disinfection procedures to the dental laboratory that would receive them.[ii]
Disinfecting every impression that you receive from a dental practice may feel redundant at times, but will ensure that members of the team are not subject to any unnecessary infection risks. It also means other equipment in the laboratory does not become contaminated.
It is just as important to establish a confident line of communication with the practices you work with, ensuring the dentists themselves always disinfect their impressions before they are sent to the laboratory. This avoids repeat disinfections, which risks the surface detail and accuracy of the material.ii
Up in the air
The risk of infection or ill-health may not just be generated from the contamination of physical surfaces in the dental laboratory, but also the air itself. A variety of daily tasks performed within the laboratory create dust or expel foreign nanoparticles into the air. This includes the abrasion of composites or the polishing of a prosthetic with pumice.
Here, dental technicians are at risk for multiple reasons. Firstly, the inhalation of dust itself can be incredibly damaging. Pneumoconiosis, chronic bronchitis, emphysema, dust related diffuse pulmonary fibrosis, systemic connective tissue disease, and renal dysfunction have all been described as a potential result of dust inhalation.[iii]
Dust in the working environment may not only harm respiratory functions, but can cause pain to the eyes too. It is a common complaint that affects anywhere between 5-30% of dental technicians.[iv]
Combating the basic risks of dust exposure in the dental laboratory is possible. Individuals should always seek out personal protective equipment (PPE) that reduces the chance of dust inhalation and damage. Masks like an N95/FFP2 respirator can help to keep out small particles that put technicians at risk, and they provide an effective 95% filtering capacity for particles with a diameter of 0.3 μm., where dust is typically defined as airborne solid particles between 1 and 100 μm. Goggles should be worn to prevent ocular damage, alongside the regular use of gloves where it is appropriate.iii
Effective ventilation is also necessary, both where a technician is operating, and throughout the entire laboratory.
Making polishing safer
Dental technicians could be at further risk if the airborne particles themselves are contaminated. Take pumice, for example. Used in the polishing of dental prosthetics, previous studies found this to be the most heavily contaminated stage of laboratory appliance construction.[v]
The pathogens may have both oral and non-oral sources, but when a prosthesis is polished with pumice, contaminated aerosol particles are expelled into the surrounding area.[vi] This includes gram-negative bacteria and fungi which can cause ocular and respiratory infections, especially in those with a predisposed chronic respiratory disordervi – this is important when we consider the aforementioned risk of developing this from dust inhalation.
Effective health and safety measures in your dental laboratory keep you and your colleagues safe over time. This requires the establishment of defined workflows, the implementation of high-quality PPE, and the use of brilliant cleaning materials like PumiceSafe from Kemdent. As a non-foamy, alcohol-free universal cleaner, PumiceSafe is an ideal algicidal and fungicidal product to make up a pumice slurry, reducing the presence of dust within the laboratory environment. It is kind to skin, avoiding the irritation caused by some other chemicals, and can even double as a powerful tabletop surface cleaner.
Keeping on top of your disinfection and safety measures is essential in the dental laboratory. It’s important to first recognise the occupational health hazards posed specifically to dental technicians, and then have an open conversation with those around you about the steps taken to minimise their effect.
For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256
[i] General Dental Council, (2019). Standards for the dental team. (Online) Available at: https://www.gdc-uk.org/standards-guidance/standards-and-guidance/standards-for-the-dental-team [Accessed March 2024]
[ii] Almortadi, N., & Chadwick, R. G. (2010). Disinfection of dental impressions–compliance to accepted standards. British dental journal, 209(12), 607-611.
[iii] Ding, J., Li, J., Qi, J., & Fu, L. (2023). Characterization of dental dust particles and their pathogenicity to respiratory system: a narrative review. Clinical Oral Investigations, 1-15.
[iv] Yurdasal, B., Bozkurt, N., Bozkurt, A. İ., & Yilmaz, Ö. (2015). The evaluation of the dust-related occupational respiratory disorders of dental laboratory technicians working in Denizli Province. Annals of Thoracic Medicine, 10(4), 249.
[v] Haworth, J., Sandy, J., & Ireland, A. J. (2021). Infection control: current status. risks, research, rules and recycling. Orthodontic Update, 14(2), 59-66.
[vi] Firoozeh, F., Zibaei, M., Zendedel, A., Rashidipour, H., & Kamran, A. (2013). Microbial contamination of pumice used in dental laboratories. Healthcare in Low-resource Settings, 1(1), e5-e5.
