Abstract
OBJECTIVES—To perform a pilot study on bacterial contamination in some dental surgeries (n=51) in a local health unit in Brescia (Lombardy Region, Italy) and to evaluate the procedures to control cross infection used by the personnel to reduce the risk of infection in dental practice. METHODS—A survey was carried out by interviewing 133 dental personnel with a questionnaire on the procedures used to control infection. The autoclaves, chemical baths (chemiclaves), and ovens present in the surgeries were tested for sterilisation efficiency with a spore test, and already packed and sterilised instruments were randomly sampled and tested for sterility. Microbial contamination of air, surface, and dental unit water samples were also studied. RESULTS—The dental personnel did not generally follow the principal procedures for infection control: 30% of personnel were not vaccinated against hepatitis B virus, infected instruments were often not decontaminated, periodic checks of autoclave efficiency were lacking, and the knowledge of disinfection mechanisms and procedures was incomplete. High bacteriological contamination of water at dental surgeries was often found and total bacteriological counts in air samples were high. Surface studies showed widespread bacterial contamination. CONCLUSIONS—On the basis of these results, an educational programme for the prevention of infective hazards has been prepared and carried out. The results of this pilot study will be used for planning a national survey. Keywords: dental surgeries; bacterial contamination; cross infection control procedures
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- Allsopp J., Basu M. K., Browne R. M., Burge P. S., Matthews J. B. Survey of the use of personal protective equipment and prevalence of work related symptoms among dental staff. Occup Environ Med. 1997 Feb;54(2):125–134. doi: 10.1136/oem.54.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Angelillo I. F., Villari P., D'Errico M. M., Grasso G. M., Ricciardi G., Pavia M. Dentists and AIDS: a survey of knowledge, attitudes, and behavior in Italy. J Public Health Dent. 1994 Summer;54(3):145–152. doi: 10.1111/j.1752-7325.1994.tb01206.x. [DOI] [PubMed] [Google Scholar]
- Atlas R. M., Williams J. F., Huntington M. K. Legionella contamination of dental-unit waters. Appl Environ Microbiol. 1995 Apr;61(4):1208–1213. doi: 10.1128/aem.61.4.1208-1213.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bentley E. M., Sarll D. W. Improvements in cross-infection control in general dental practice. Br Dent J. 1995 Jul 8;179(1):19–21. doi: 10.1038/sj.bdj.4808808. [DOI] [PubMed] [Google Scholar]
- Davies K. J., Herbert A. M., Westmoreland D., Bagg J. Seroepidemiological study of respiratory virus infections among dental surgeons. Br Dent J. 1994 Apr 9;176(7):262–265. doi: 10.1038/sj.bdj.4808430. [DOI] [PubMed] [Google Scholar]
- DiAngelis A. J., Martens L. V., Little J. W., Hastreiter R. J. Infection control practices of Minnesota dentists: changes during 1 year. J Am Dent Assoc. 1989 Mar;118(3):299–303. doi: 10.14219/jada.archive.1989.0106. [DOI] [PubMed] [Google Scholar]
- Gerbert B. AIDS and infection control in dental practice: dentists' attitudes, knowledge, and behavior. J Am Dent Assoc. 1987 Mar;114(3):311–314. doi: 10.14219/jada.archive.1987.0078. [DOI] [PubMed] [Google Scholar]
- Gershon R. R., Karkashian C., Vlahov D., Grimes M., Spannhake E. Correlates of infection control practices in dentistry. Am J Infect Control. 1998 Feb;26(1):29–34. doi: 10.1016/s0196-6553(98)70058-6. [DOI] [PubMed] [Google Scholar]
- Gibson G. B., Mathias R. G., Epstein J. B. Compliance to recommended infection control procedures: changes over six years among British Columbia dentists. J Can Dent Assoc. 1995 Jun;61(6):526–532. [PubMed] [Google Scholar]
- Grace E. G., Cohen L. A. Attitudes of dentists concerning hepatitis and hepatitis vaccination. Compendium. 1991 Mar;12(3):197–200. [PubMed] [Google Scholar]
- Grenier D. Quantitative analysis of bacterial aerosols in two different dental clinic environments. Appl Environ Microbiol. 1995 Aug;61(8):3165–3168. doi: 10.1128/aem.61.8.3165-3168.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- King T. B., Muzzin K. B., Berry C. W., Anders L. M. The effectiveness of an aerosol reduction device for ultrasonic scalers. J Periodontol. 1997 Jan;68(1):45–49. doi: 10.1902/jop.1997.68.1.45. [DOI] [PubMed] [Google Scholar]
- Klein R. S., Freeman K., Taylor P. E., Stevens C. E. Occupational risk for hepatitis C virus infection among New York City dentists. Lancet. 1991 Dec 21;338(8782-8783):1539–1542. doi: 10.1016/0140-6736(91)92369-d. [DOI] [PubMed] [Google Scholar]
- Legnani P., Checchi L., Pelliccioni G. A., D'Achille C. Atmospheric contamination during dental procedures. Quintessence Int. 1994 Jun;25(6):435–439. [PubMed] [Google Scholar]
- Martin M. V. The significance of the bacterial contamination of dental unit water systems. Br Dent J. 1987 Sep 5;163(5):152–154. doi: 10.1038/sj.bdj.4806220. [DOI] [PubMed] [Google Scholar]
- McCarthy G. M., MacDonald J. K. Improved compliance with recommended infection control practices in the dental office between 1994 and 1995. Am J Infect Control. 1998 Feb;26(1):24–28. doi: 10.1016/s0196-6553(98)70057-4. [DOI] [PubMed] [Google Scholar]
- McCarthy G. M., Mamandras A. H., MacDonald J. K. Infection control in the orthodontic office in Canada. Am J Orthod Dentofacial Orthop. 1997 Sep;112(3):275–281. doi: 10.1016/S0889-5406(97)70256-7. [DOI] [PubMed] [Google Scholar]
- Merchant V. A. Herpesviruses and other microorganisms of concern in dentistry. Dent Clin North Am. 1991 Apr;35(2):283–298. [PubMed] [Google Scholar]
- Mori M. Status of viral hepatitis in the world community: its incidence among dentists and other dental personnel. Int Dent J. 1984 Jun;34(2):115–121. [PubMed] [Google Scholar]
- Osorio R., Toledano M., Liébana J., Rosales J. I., Lozano J. A. Environmental microbial contamination. Pilot study in a dental surgery. Int Dent J. 1995 Dec;45(6):352–357. [PubMed] [Google Scholar]
- Panis B., Roumeliotou-Karayannis A., Papaevangelou G., Richardson S. C., Mitsis F. Hepatitis B virus infection in dentists and dental students in Greece. Oral Surg Oral Med Oral Pathol. 1986 Apr;61(4):343–345. doi: 10.1016/0030-4220(86)90416-0. [DOI] [PubMed] [Google Scholar]
- Pankhurst C. L., Philpott-Howard J. N. The microbiological quality of water in dental chair units. J Hosp Infect. 1993 Mar;23(3):167–174. doi: 10.1016/0195-6701(93)90022-r. [DOI] [PubMed] [Google Scholar]
- Piazza M., Borgia G., Picciotto L., Nappa S., Cicciarello S., Orlando R. Detection of hepatitis C virus-RNA by polymerase chain reaction in dental surgeries. J Med Virol. 1995 Jan;45(1):40–42. doi: 10.1002/jmv.1890450108. [DOI] [PubMed] [Google Scholar]
- Piazza M., Guadagnino V., Picciotto L., Borgia G., Nappa S. Contamination by hepatitis B surface antigen in dental surgeries. Br Med J (Clin Res Ed) 1987 Aug 22;295(6596):473–474. doi: 10.1136/bmj.295.6596.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reinthaler F. F., Mascher F., Stünzner D. Serological examinations for antibodies against Legionella species in dental personnel. J Dent Res. 1988 Jun;67(6):942–943. doi: 10.1177/00220345880670061001. [DOI] [PubMed] [Google Scholar]
- Shearer B. G. Biofilm and the dental office. J Am Dent Assoc. 1996 Feb;127(2):181–189. doi: 10.14219/jada.archive.1996.0166. [DOI] [PubMed] [Google Scholar]
- Soter N. A., Wasserman S. I., Austen K. F. Cold urticaria: release into the circulation of histamine and eosinophil chemotactic factor of anaphylaxis during cold challenge. N Engl J Med. 1976 Mar 25;294(13):687–690. doi: 10.1056/NEJM197603252941302. [DOI] [PubMed] [Google Scholar]
- Thomas D. L., Gruninger S. E., Siew C., Joy E. D., Quinn T. C. Occupational risk of hepatitis C infections among general dentists and oral surgeons in North America. Am J Med. 1996 Jan;100(1):41–45. doi: 10.1016/s0002-9343(96)90009-1. [DOI] [PubMed] [Google Scholar]
- Treasure P., Treasure E. T. Survey of infection control procedures in New Zealand dental practices. Int Dent J. 1994 Aug;44(4):342–348. [PubMed] [Google Scholar]
- Udasin I. G., Gochfeld M. Implications of the Occupational Safety and Health Administration's bloodborne pathogen standard for the occupational health professional. J Occup Med. 1994 May;36(5):548–555. [PubMed] [Google Scholar]
- Waddell C. Perception of HIV risk and reported compliance with universal precautions: a comparison of Australian dental hygienists and dentists. J Dent Hyg. 1997 Jan-Feb;71(1):17–21. [PubMed] [Google Scholar]
- Williams H. N., Baer M. L., Kelley J. I. Contribution of biofilm bacteria to the contamination of the dental unit water supply. J Am Dent Assoc. 1995 Sep;126(9):1255–1260. doi: 10.14219/jada.archive.1995.0360. [DOI] [PubMed] [Google Scholar]
- Williams J. F., Johnston A. M., Johnson B., Huntington M. K., Mackenzie C. D. Microbial contamination of dental unit waterlines: prevalence, intensity and microbiological characteristics. J Am Dent Assoc. 1993 Oct;124(10):59–65. doi: 10.14219/jada.archive.1993.0205. [DOI] [PubMed] [Google Scholar]
- Woo J., Anderson R., Maguire B., Gerbert B. Compliance with infection control procedures among California orthodontists. Am J Orthod Dentofacial Orthop. 1992 Jul;102(1):68–75. doi: 10.1016/0889-5406(92)70016-4. [DOI] [PubMed] [Google Scholar]