Dental Health And Safety

Introduction:

For dental laboratory and clinical environment, health and safety practices as well as infection control process are paramount to provide safe and healthy treatment to patients. In dental environment, practitioners need to maintain proper risk assessment framework that will avoid the development of infections and disease. This essay is going to identify the health and safety requirement in the laboratory and clinical dental environment. Moreover, the essay would emphasize on routes of infections transmission in the dental practices and on the measures that are taken by dental professionals and technicians for preventing infection development. This essay would identify the risks associated with working in the dental laboratory and the processes that will assist the health professionals to promote safe patient care. By mentioning the national and local clinical governance as well as health and safety legislation, this essay is going to highlights the roles of implementation of these legislations into dental practices to provide proper clinical support to the patient.

Discussion:

On describing the prudent principles of primary dental care Yurdasalet al. (2015) mentioned that dental care professionals need to develop own understanding about Standard Operating Procedures in dental environments for providing the best clinical support. Purpose of the Standard Operating Procedure (SOP) is describing the process in which dentists pour dental impression by using Artimax Quadrant articulator tray. SOP sets standards for dieticians in order to maintain the correct process of decontamination as well as sterilisation in order to eliminate the risk of transmission of the blood borne pathogens. SOP provides the form of proper documented instructions or protocol developed by eth organisation itself. Through implementing the guidelines of SOP, dental practitioners can maintain and maximise the safety in their workplace. This protocol also assists the dental practitioners aas well as organisations in order to maintain perfect compliance with the regulations thereby maintaining the quality standard (nhsggc.org.uk, 2018).

Dental professionals are responsible for providing the proper dental treatment to the patient by considering the influence of diverse community based behavioural, sociological and economic factors affecting the oral health and illness. As stated by Ilićet al. (2015), based on the guidelines of Health and Safety at Work Act (1974), dental practitioners need to emphasize on oral health promotion by assessing the determinants as well as cause of dental; issues and take complementary approaches for resolving the issues.

Health and Safety requirements are associated with the dental practice, which ensures proper oral health and wellbeing of people. According to Hatrick and Eakle (2015), dental care professional needs to focus on Safe Working Practice in dental environment, safe storage as well as disposal of materials and proper risk assessment framework under the guidelines of The Management of Health & Safety at Work Regulations 1992. For meeting the health and safety requirement of patient in order to recover the dental issues, professionals need to follow the guidelines of Standard Operating Procedure set by General Dental Council, 2013. Based on the standard, dental professionals need to focus on three main criteria including:

Safe working practices in the dental environment COSHH assessment as well as risk assessment process Safe storage, use and disposal of the materials Safe working practices is based on the guidelines of Health and Safety at Work (1999), which assist dental professional to make the suitable arrangement in order to maintain healthy as well as hygienic treatment process as well as clinical framework for patient with dental issues. For example, Health Technical Memorandum 01-05 focuses on the fact that primary dental care practitioners would provides safe as well as hygienic clinical environment to patients that will incorporate separate ventilation, non-interruption policy and no eating or drinking process after the dental surgery (Sollecito, et al. 2015). Dental care practitioners would follow the guidelines of Control of Substances Hazardous to health Regulations 2002 (COSHH), that assist them to safe handling of substances that can cause potential harm to health. For example, in dental laboratory, dental care practitioners use gloves, face musk and spectacles to avoid contamination of harmful chemicals. Moreover, dental care staffs use proper equipments to hold bottles of different explosive chemicals and liquids that lead to development of microbial contaminants (hse.gov.uk, 2018).
Risk assessment process assists dental practitioner to determine, evaluate and analyse the possible risk associated with dental care process. There are different types of hazards associated with the dental healthcare process such as electrical hazards, diseases contamination, hazards due to improper use of portable instruments. For example, before conducting any dental surgery, dental professionals need to conduct PAT testing (Portable Appliance Testing) which assure that all equipments as well as appliance that are going to be

used in dental surgery are in fully usable and appropriate to the care process. Based on the Health and Safety at Work Act (1974), dental professional need to ensure that all electrical devices in the laboratory as well as in entire healthcare area. For example, Health Technical Memorandum 01-05: focuses on obligation of dental care professionals to set proper decontamination and infection control process for avoiding future infection or injuries in dental area (GOV, 2018).

Safeguarding is paramount in dental care process in which, dental team members as well as patient are provided with proper safety framework for fulfilling their health and safety requirements. According to Lang and Lindhe (2015), health and safety requirement in dental clinical environment is not just avoid injuries or providing hygienic treatment process to patients, but to create well-organised medical procedures in which entire treatment process is under proper supervision for avoiding the sudden risk. All the dental staffs are well-trained to mention proper hygiene and safety in workplace during their work for implementing the guidelines of The Workplace (Health, Safety and Welfare) Regulations (1992). Dental healthcare organisation put the legal obligation on practitioners as well as staffs to place the suitable arrangements regarding the dental treatment for managing the oral health and wellbeing. Health and Safety Executes (HSE) are also appointed in each local dental care clinic that ensures the all the health and safety requirement are met by the professionals staffs for providing appropriate treatment process to each patient. As stead by Cleveland et al. (2016) dental laboratory staffs need to follow the H&S guidelines of Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), in which laboratory staffs are in charge of reporting work-related accidents and sudden injuries to the upper hierarchy staffs in order to offer immediate treatment to victims. As dental staffs are predisposed into ranges of occupational hazards, there are requirement to maintain quality of individual responsibility in order to manage safety and wellbeing in the laboratory. Dental practitioners needs to have proper knowledge on different types of hazards during working in laboratory such as infectious hazards, allergic reaction, psychological hazards, mercury health hazards and physical hazards. They should have proper expertise in dealing with ionising and non-ionising radiation to maintain proper workplace safety and healthy environment in the laboratory. All laboratory assistants needs to have proper expertise in handling different chemicals and gases during the process of dental impression, decontamination and sterilisation. NHS nurses in the dental clinic would be high skill and professional to maintain compliance with the laboratory guidelines and SOP standards in order to assist dental practitioner in different work. Dental laboratory assistants would also assure that all equipments and machines and in workable condition. Moreover, dental practitioners would clean and sterilise each instruments before using them in the laboratory for maintaining the health and safety in the workplace (GOV, 2018).

In this context Hatrick and Eakle (2015), mentioned that, cross infection is one of eth major health risk in dental patient. Cross infection is transmission of the pathogenic substances or bacteria from one person to another. There are three processes in which the cross contamination happens such as: Direct or indirect transmission Through blood stream (parental or hereditary) Through the air Based on the guidelines set by General Dental Council, 2013, dental team need to be concern about different contagious disease such as Hepatitis A, B, C, AIDS, vCID (variant Creutzfeldt Jakobs disease), Herpes and TB (Tuberculosis). Based on the Health Technical Memorandum (01-05), dental professionals has the responsibility to conduct proper infection control process by applying the processes, protocols and practices for reducing or preventing the transmission risk of the potentially harmful things. As stated by Scannapieco and Cantos (2016) Blood borne transmission is one type of direct transmission that transmit the infections through contact with blood as well as body fluids. Infection control procedure involves hand hygiene, disinfection, sterilisation, instrument cleaning, storage, transportation and packaging, waste disposal and decontamination and spillage management. Cross infection control process is important in dental framework to assure healthy as well as hygienic treatment process that protect patient with dental issues from any further infection or disease. According to Sollecito, et al. (2015), there are some limitations of this process such as poor risk management framework, carriage of the dangerous goods and contaminants, poor bio safety in the healthcare homes, outdated, irrelevant medical device, unhygienic treatment process that leads to transmissions of infection through blood or body fluids. Based on the guidelines of Standard Operating procedure (SOP), dental professionals need to implement different infections control process such as decontamination, Aseptic techniques, disinfection and sterilisation. Moreover, dental practitioners consider different types of contaminants such as physical contaminants, microbial contaminants and chemical contaminants. Physical contaminants are anything that

can be easily visible. Chemical contaminants are the chemical substances that may be used in dental laboratory (Abdouchakour et al. 2015). Chemical contaminates are associated with infections and allergies. Microbial contaminants are disease or infection that develops bacteria, fungus, mould, yeast and virus. All these pathogens lead to cause allergic reaction. According to Rutala and Weber, (2016), decontamination is most effective infection control process in dental care framework; in which professional prevent the transmission of infection and disease through contaminants, blood and body fluids. The decontamination process is based three aspects including, breakage of infection chain, and development of barriers to infections and deny the porter on entre. Decontamination process is divided into two methods such as disinfection and sterilisation. Sterilisation is the process of killing microbes that are whether harmful or not. Disinfection process is elimination of harmful microorganism that spread infection or disease in-patient with dental issues. In case of disinfection method, dental practitioners use chemical substances such as aldehydes, Phenolic disinfectants, oxidizing agents, halogens and alcohol. Other processes that the dental professionals also use are pasteurization and Heating. For sterilisation, dental staffs use chemicals, heat, steam, filtration, radiation and gases.
Based on the guidelines of section 7 of HTM01- 05, Impression disinfection process is based on instruction on managing dental impression, appliances and prosthesis. According to Kamimura et al. (2017), decontamination involves multistep procedure. The impression disinfection process is based on the following aspects: After the immediate removal of any device from mouth, it needs to rinse well under running water. This process would continue until the device is properly clean.
All the devices would receive the disinfection based on the manufacturer’s instructions. This process will include the specific cleaning of all materials that are used in impression. After the disinfection process, all the devices would again be washed in proper way until it looks clean from all sides Before returning these devices to the suppliers or laboratory, practitioners would use label on each device to indicate that decontamination process has been completed (GOV, 2018)

As stated by Hatrick and Eakle (2015), there processes of sterilisation such as chemical, physical and physiochemical process. In the case of physical sterilization, the dental instruments and devices are sterilised with high pressure, radiation, steam and filtration (GOV, 2018). For chemical sterilisation, practitioners use gaseous chemicals and liquids and for the physiochemical process, they use combination of both chemical and physical method to sterilize the dental instruments. Spray technique is another important disinfectant process in dental clinic, in which disinfectants are sprayed onto the surface of the impression material. Labelling, packaging and transportation are important for maintaining hygiene as well as disinfectant environment in the dental laboratory. All the dental devices need to be labelled, packaged and transported in well-organised manner. All the devices are labelled as per the B biological substance UN3373 category and P650 regulation (hse.gov.uk, 2018). For avoiding the contamination of disease and infection, dental practitioners need to use the correct protocol and techniques that are associated with maintaining hygienic environment within the dental laboratory. Moreover, dental practitioners and laboratory assistants would follow the guidelines of Health Technical Memorandum 07-10: Safe Management of Healthcare waste to segregate the waste product in proper manner to avoid the germ development.

According to Miller and Palenik (2014), dental practitioners need to implement proper infection control process in surgery as well as in laboratory. Based on the Standard Operating procedure (SOP) dental professionals would maximise the safety and hygiene within the laboratory environment by using an appropriate protocol that is associated with maintaining the infection-free framework. Universal Precautions set the minimum standard for hygiene that needed to be applied while there are chances of contact with blood or the body fluids from any parts of the body. As stated by, Berríos-Torres et al. (2017) SOP are associated with precautions that are important for avoiding nosocomial infections. Dental practitioners would emphasize maintaining the laboratory asepsis (Health and Safety Executive, 2018).

During infection control, process dental professionals would work under the guidelines of Medicines and Healthcare products Regulatory Agency (MHRA), in which they need to ensure that all the medical devices and medicines are in workable, condition. MHRA in association with Medical Devices Agency (MDA), emphasize on sterilization of all dental instruments before using them in practical field. Audit operation in the dental practices increases to check the accountability as well as credibility if dental practitioners in order to deal with laboratory work. Duties of the audit staffs are to investigate the healthcare framework in dental clinic and laboratory to ensure that there are no fraudulent healthcare cases of violation of SOP guidelines.

Conclusion:

From the above discussion, it can be concluded that the dental laboratory environment needs disinfecting methods to offer hygiene as well as highly effective treatment process. Dental practitioners need to meet all health and safety requirement by following the national and local legislative guidelines. Moreover, clinicians need to focus on disinfecting methods such as sterilisation, which maintains proper hygiene and safety in the health framework. Moreover, this essay concludes that dental professionals would identify the associated hazards in the laboratory for taking proper steps to control and eliminate the hazards.

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