Controlling Anesthesia Exposures in Dentistry
A recent study of survey data from dental anesthesia providers found a lack of adherence to many recommended precautionary practices during dental procedures. The study, published in the June 2017 Journal of Occupational and Environmental Hygiene (JOEH), examines data from NIOSH’s Health and Safety Practices Survey of Healthcare Workers, which was conducted in 2011.
Nitrous oxide is the most common inhaled anesthetic used in dentistry in the United States, and several engineering, administrative, and work practice controls exist to limit exposure. While scavenging systems, which prevent nitrous oxide gas from escaping into dental operatories, are widely used, the survey results indicate that many dentists, dental hygienists, and dental assistants fail to consistently use other precautions such as checking for leaks in equipment. Exposure to nitrous oxide can cause lightheadedness, eye and upper airway irritation, cough, shortness of breath, and decreased mental performance, and has been linked to increased risk of neurologic, renal, and liver disease.
Information from the survey appears below.
From “Exposure Control Practices for Administering Nitrous Oxide: A Survey of Dentists, Dental Hygienists, and Dental Assistants”: “Successful management of nitrous oxide emissions should include properly fitted nasal scavenging masks, supplementary LEV (when nitrous oxide levels cannot be adequately controlled using nasal masks alone), adequate general ventilation, regular inspection of nitrous oxide delivery and scavenging equipment for leaks, availability of standard procedures to minimize exposure, periodic training, ambient air and exposure monitoring, and medical surveillance.”
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