Female Dental Assistants Research Articles

Knowledge of Infection Control among Female Dental Assistants in Riyadh City, Saudi Arabia

Infection prevention must be a top concern in all dental settings, regardless of the level of care offered, and all settings must be set up to follow standard precautions and other infection prevention guidelines. This study's objective was to evaluate dental assistants' knowledge with infection control guidelines. In Riyadh, Saudi Arabia, a cross-sectional survey of female dental assistants was carried out. To collect information on knowledge of infection control, a 27-question survey was given out from January to March 2023. Comparisons that were both descriptive and statistical were made. The sample for the study included 125 female dental assistants. Among participants, correctly knew the essentials of infection control scored 88%. The percentage of correct responses for the understanding of personal protective equipment (PPE) was high (97%). The least amount of knowledge (82%) was possessed about sterilizing dental equipment. No statistically significant differences were found between any of the comparisons. With limitations, we concluded from the study that, with an overall score of 88%, the participants were knowledgeable on ways to decrease infection in dental clinics. Promoting infection control practices, risk awareness education, and initiatives that encourage the adoption of all precautions should be prioritized. Dental assistants need to have more information given how crucial infection control is to their field of work.

Prevalence of Muscular Skeletal Disorders among Qualified Dental Assistants.

The occupation of dental assistants (DAs) involves many health risks of the musculoskeletal system due to static and prolonged work, which can lead to musculoskeletal disorders (MSDs). The aim of the study was to investigate the prevalence of MSDs in DAs in Germany. Methods: For this purpose, an online questionnaire analyzed 406 (401 female participants and 5 male participants, 401w/5m) DAs. It was based on the Nordic Questionnaire (lifetime, 12-month, and seven-day MSDs’ prevalence separated into neck, shoulder, elbow, wrist, upper back, lower back, hip, knee, and ankle), and occupational and sociodemographic questions as well as questions about specific medical conditions. Results: 98.5% of the participants reported complaints of at least one body region in their lives, 97.5% reported at least one complaint in the last 12 months and 86.9% affirmed at least one complaint in the last seven days. For lifetime, 12-month and seven-day prevalence, the neck was the region that was most affected followed by the shoulder, the upper back and the lower back. Conclusion: The prevalence of MSDs among German (female) DAs was very high. The most affected area is the neck, followed by the shoulder, the lower back, and the upper back. It, therefore, seems necessary to devote more attention to ergonomics at the working practice of DAs as well in education and in dental work.

The Occurrence Of Delayed Adverse Health Effects In Dental Personnel After Exposure To Mercury

This paper gives some background information and sums up the results from research on possible late health effects in dental personnel after their occupational exposure to mercury from handling dental amalgam. We assessed that 0.5-2.8% of female dental assistants had possible delayed health injuries which mainly affected cognitive functions as a result of their occupational exposure to metallic mercury. Similar findings were not observed in dentists. When we followed all birth deliveries of 5,493 dental personnel compared to all other births in Norway from 1967 to 2006 in the National Birth Registry of Norway, we found no increase in the occurrence of malformations or other reproductive abnormalities in the dental personnel.

The Association Between Serotonin Transporter Gene Promotor Polymorphism (5-HTTLPR) and Elemental Mercury Exposure on Mood and Behavior in Humans

A functional polymorphism in the serotonin transporter (5-HTT) gene-linked polymorphic region (5-HTTLPR) is reported to affect mood and behavior in humans. In this study, the effects of 5-HTTLPR polymorphism on neurobehavioral and mood domains that are known to be affected by elemental mercury (Hg°) exposure in human subjects were examined. The Behavioral Evaluation for Epidemiologic Studies (BEES) test battery was administered concurrently with urine and buccal-cell collections for 164 male dentists (DD) and 101 female dental assistants (DA) with occupational exposure to Hg° for an average of 19 and 10 yr, respectively. Geometric mean urinary mercury (Hg) levels in DD and DA were 2.52 (2.22) μg/L and 1.98 (1.98) μg/L, respectively. Corresponding indices of chronic occupational Hg° exposure, weighted for historical exposure, were 1212 (1877) and 316 (429). 5-HTTLPR status was 40% and 20% wild type, 40% and 56% single allelic substitution, and 20% and 24% double allelic substitution for the two genders. DD and DA were evaluated separately. Regression analyses controlled for age, premorbid intelligence, frequency of alcohol per week, and education. 5-HTTLPR polymorphism was associated with 5 behavioral measures in DD and with 12 behavioral measures in DA. Mood scores were more consistently associated with the variant in both groups. The strongest evidence for an additive effect for urinary Hg and 5-HTTLPR polymorphism in both groups was for tests of Finger TapAlternate and Hand SteadinessFactor1. Other significant additive effects that were less consistent across groups were also observed. These results add to the growing evidence of genetic determinants of mood and behavior that potentially increase susceptibility to Hg toxicity in humans.

Occurrence of cognitive symptoms in dental assistants with previous occupational exposure to metallic mercury

Previous investigations have presented evidence for an increased prevalence of late cognitive effects in dental personnel exposed to metallic mercury. We wanted to examine if there was a correlation between mercury exposure and cognitive effects in a Norwegian population of dental workers, and if so, to quantify the occurrence. The study group consisted of 608 female dental assistants from central Norway and 425 female controls from the general population, all under the age of 70. They had responded to a standardized postal questionnaire (Euroquest) inquiring about seven symptoms in regard to neurology, psychosomatics, memory, concentration, mood, sleep disturbances, and fatigue. A score was calculated for each symptom based on 4–15 single questions graded on a scale from 1 (seldom or never) to 4 (very often). Dental assistants and controls had a participation rate of 56.4% and 42.9% respectively. Dental assistants reported more cognitive symptoms than the controls, but on average they reported having each of the symptoms “now and then” or less frequently. There were 4.4% of the dental assistants and 2.8% of the controls who reported having three or more of the seven symptoms “often” or more frequently. The corresponding figures for five or more of the seven symptoms were 1.0% and 0.5% respectively. The occurrence of cognitive malfunction may be moderately increased in dental assistants. For dental assistants there was a relative risk of 1.6 of having three or more symptoms “often” or more frequently, and a relative risk of 2.0 of having five or more symptoms as frequently. It can be assumed from our results that the prevalence of possibly work-related cognitive malfunction in dental assistants is between 0.4% and 2.8%, dependent on the applied severity.

Catechol O-Methyltransferase (COMT) VAL158MET Functional Polymorphism, Dental Mercury Exposure, and Self-Reported Symptoms and Mood

Associations were evaluated between a functional single nucleotide polymorphism (Val158Met) in the gene encoding the catecholamine catabolic enzyme catechol O-methyltransferase (COMT), dental mercury exposure, and self-reported symptoms and mood among 183 male dentists and 213 female dental assistants. Self-reported symptoms, mood, and detailed work histories were obtained by computerized questionnaire. Spot urine samples were collected and analyzed for mercury concentrations to evaluate recent exposures, whereas a chronic mercury exposure index for all subjects was created from the work histories. COMT polymorphism status was determined using a polymerase chain reaction (PCR)-based assay. Scores for current, recent, and chronic self-reported symptom groups and six self-reported mood factors were evaluated with respect to recent and chronic mercury exposure and COMT polymorphism status. Multiple regression analysis controlled for age, socioeconomic status, tobacco and alcohol use, self-reported health problems, and medications. Separate evaluations were conducted for dentists and dental assistants. No consistent patterns of association between either urinary mercury concentration or the chronic index of mercury exposure and any category of symptoms were observed. However, consistent and significant associations were found between increased symptoms and the COMT polymorphism involving the double allelic substitution (full mutation) compared to subjects with no substitutions. Associations with mood were limited to polymorphism status among female dental assistants, and were observed for four of six mood factors and overall mood score. These findings extend evidence of genetic factors potentially affecting human susceptibility to the toxic effects of mercury and other environmental chemicals.

The Association Between Serotonin Transporter Gene Promoter Polymorphism (5-HTTLPR), Self-Reported Symptoms, and Dental Mercury Exposure

The associations between a polymorphism of the serotonin transporter gene (5-HTTLPR), dental mercury exposure, and self-reported symptoms were evaluated among 157 male dentists and 84 female dental assistants. Self-reported symptoms and detailed work histories were obtained by computerized questionnaire. Spot urine samples were collected and analyzed for mercury concentrations to evaluate recent exposures, whereas a chronic mercury exposure index was created from the work histories. 5-HTTLPR polymorphism status was determined using a polymerase chain reaction (PCR)-based assay. Scores for current, recent, and chronic self-reported symptom groups were evaluated with respect to recent and chronic mercury exposure and 5-HTTLPR polymorphism status. Multiple regression analysis controlled for age, socioeconomic status, tobacco and alcohol use, self-reported health problems, and medications. Analyses were restricted to Caucasian subjects due to the highly skewed distribution of the 5-HTTLPR polymorphism. Separate evaluations were conducted for dentists and dental assistants. In contrast to previous reports, no consistent associations were found between either urinary mercury concentration or the chronic index of mercury exposure and any category of symptoms. However, both significant and consistent associations were observed between increased symptoms and the 5-HTTLPR polymorphism involving two copies of the short or “s” allele (full mutation), but not with the polymorphism involving only one copy (heterozygous), demonstrating a gene–dose relationship for symptom reporting. These findings suggest that within this restricted population increased symptoms of depression, anxiety, and memory are associated with the 5-HTTLPR polymorphism among both males and females.

Respiratory effects of exposure to methacrylates among dental assistants

Case reports of occupational asthma in dental personnel have been published, but there is little data on the risk of respiratory disorders related to occupational exposure to methacrylates in dental assistants. The objective of this study was to investigate the relation of exposure to methacrylates to occurrence of respiratory symptoms and diseases among dental assistants. A cross-sectional study of female dental assistants from the membership register of the Finnish Association of Dental Hygienists and Assistants was conducted in the Helsinki metropolitan area. A CATI was carried out to collect information on health and exposures. A total of 799 dental assistants participated (response rate 87%). Daily use of methacrylates was related to a significantly increased risk of adult-onset asthma (adjusted OR 2.65, 95% CI 1.14-7.24), nasal symptoms (1.37, 1.02-1.84), and work-related cough or phlegm (1.69, 1.08-2.71). Nasal symptoms showed a dose-response relation with increasing years of exposure to methacrylates, and those with >10 years of exposure had also increased risk of hoarseness, dyspnoea, and wheezing with dyspnoea. Dental assistants with a history of atopic diseases were particularly susceptible to exposure to methacrylates, the adjusted OR for adult asthma being in this group 4.18 (95% CI 1.02-28.55) and for nasal symptoms 2.11 (1.08-4.19). This study provides new evidence that the risk of adult-onset asthma, nasal symptoms and other respiratory symptoms increase significantly with daily use of methacrylates in dental assistants' work. The results suggest that exposure to methacrylates poses an important occupational hazard for dental assistants.

The association between a genetic polymorphism of coproporphyrinogen oxidase, dental mercury exposure and neurobehavioral response in humans

We previously described a polymorphism in exon 4 of the gene encoding the heme biosynthetic pathway enzyme, coproporphyrinogen oxidase (CPOX4), which significantly modifies the effect of mercury exposure on urinary porphyrin excretion in humans. Here, we examined potential consequences of this polymorphism (“CPOX4”) on performance within neurobehavioral domains, symptoms, and mood that are known to be affected by elemental mercury (Hg°) exposure in human subjects. A behavioral test battery was administered on the day of urine and buccal cell collections for 194 male dentists (DDs) and 233 female dental assistants (DAs) occupationally exposed to Hg° for an average of 19 and 10 years, respectively. Subjects had no history of health disorders and were employed for a minimum of 5 years in the dental profession. Respective mean urinary mercury (HgU) levels in DDs and DAs were 3.32 (4.87) μg/l and 1.98 (2.29) μg/l. Corresponding indices of chronic occupational Hg° exposure, weighted for historical exposure, were 27.1 (20.6) and 15.2 (12.3). The frequencies of the homogygous common (A/A), heterozygous (A/C), and homozygous polymorphic (C/C) genotypes were 75%, 23% and 2% for DDs and 73%, 25%, and 2% for DAs, respectively. DDs and DAs were evaluated separately. Regression analyses controlled for age, premorbid intelligence, alcohol consumption, and education. Statistically significant associations with HgU ( p < 0.05) were found for nine measures among DDs (BEES Digit Span Forward and Backward, WMS-R Visual Reproduction N Correct, BEES Symbol Digit Rate, BEES Finger Tapping Dom/Non-dom, and Alternate Partialed, Hand Steadiness Factor1, and BEES Tracking), and eight measures among DAs (BEES Digit Span Forward, BEES Symbol Digit Rate, BEES Pattern Discrimination Rate, BEES Trailmaking B, BEES Finger Tapping Dom/Non-dom, and Alternate Partialed, Hand Steadiness Factor1, and Vibration Sensitivity Hits). CPOX4 status was associated with four measures in DDs (BEES Spatial Span Forward, BEES Pattern Memory N Correct, BEES Symbol Digit Rate, and BEES Vigilance Hit) and five measures in DAs (BEES Digit Span Forward, WMS-R Visual Reproductions N Correct, BEES Symbol Digit Rate, BEES Simple and Choice Reaction Time Move. Both groups experienced an additive effect (no interaction term) for HgU and the CPOX4 polymorphisms on the Digit Rate whereas DAs also had additive effects for BEES Digit Span Forward and for Beck's Depression factor ‘Worthlessness’. These exploratory findings suggest that the CPOX4 polymorphism may affect susceptibility for specific neurobehavioral functions associated with mercury exposure in human subjects.

Chronic low-level mercury exposure, BDNF polymorphism, and associations with cognitive and motor function

Potential cognitive and motor effects from exposure to elemental mercury (Hg 0) were examined in the presence and absence of a polymorphism (Val66Met) in brain-derived neurotrophic factor (BDNF). A group of 194 male dentists (DDs) and 233 female dental assistants (DAs) were occupationally exposed to mercury and had no history of kidney or nervous system disorders. Acute exposure was measured using spot urinary Hg (HgU) concentrations (average 3.32 and 1.98 μg/l, respectively) and indices of chronic occupational exposure (26.3 and 14.9 years, respectively, weighted for historical exposures). The BDNF status was 68% and 66% wild type, 26% and 30% single substitution, and 5% and 4% full mutation for DDs and DAs, respectively. DDs and DAs were evaluated separately. Regression analyses controlled for age, premorbid intelligence, alcohol consumption, and education. Statistically significant adverse associations with HgU ( p < .05) were found for nine measures among DDs (Digit Span Forward, Digit and Spatial Span Backward, Visual Reproduction, Finger Tapping Dominant, Alternate, and Alternate Partialed, Hand Steadiness, and Tracking), and eight measures among DAs (Digit Span Forward, Visual Reproduction, Pattern Discrimination Rate, Symbol Digit Rate, Trailmaking B, Finger Tapping Dominant and Alternate Partialed, and Hand Steadiness). The BDNF status was associated with four measures in DDs and three measures in DAs. Joint effects were found for Finger Tapping Alternate and Alternate Partialed in DDs and Hand Steadiness and Trailmaking B in DAs. Joint effects were additive in all cases. Performance on verbal intelligence and reaction time were not associated with either HgU or BDNF status. A test of threshold effect for the association of Hand Steadiness with HgU demonstrated no lower boundary in both DDs and DAs. No associations were observed with estimates of chronic mercury exposure. Our findings are applicable to exposure levels of the general population and identify a potentially vulnerable group with a BDNF polymorphism.

Chronic low-level mercury exposure, BDNF polymorphism, and associations with self-reported symptoms and mood.

Recent reports have described neurobehavioral impairments in human subjects carrying a V66M polymorphism in the gene encoding brain-derived neurotrophic factor (BDNF). Inasmuch as ventral nervous system (CNS) deficits associated with this BDNF polymorphism are similar to those observed among subjects with chronic exposure to elemental mercury (Hg degrees ), we examined the potential effect of this BDNF polymorphism on symptoms and mood in an established cohort of dental practitioners with chronic low-level Hg degrees exposure. Self-reported symptoms and mood were obtained by computerized questionnaire from 193 male dentists (DTs) and 230 female dental assistants (DAs). Spot urine samples were analyzed for mercury concentrations to evaluate recent exposure. Detailed work histories were obtained to calculate chronic indices of Hg degrees exposure. Buccal cell samples were obtained to identify the V66M polymorphism of BDNF. Scores for 11 current and 12 recent and chronic symptom groups, along with six mood factors, were evaluated with respect to recent and chronic Hg degrees exposure and BDNF polymorphism. Multiple regression analysis controlled for age, race, socioeconomic status, tobacco and alcohol use, self-reported health problems, and medications. Separate evaluations were conducted for DTs and DAs. Twenty-three associations between recent or chronic Hg degrees exposure and BDNF status and self-reported symptoms were observed with p < 0.10. All but three were in the expected direction (symptom scores increasing with Hg degrees exposure or BDNF polymorphism), and all but six were among DAs. All eight correlations between chronic exposure indices and recent and chronic symptoms among DAs were in the expected direction. All seven associations between BDNF and symptoms were in the expected direction and split between DTs and DAs. All three associations with mood factors were among DAs and in the expected direction. These results indicate that among DAs very low levels of occupational Hg degrees exposure are associated with increased symptoms. The BDNF polymorphism is also associated with increased symptom and mood scores. Notably, Hg degrees and BDNF polymorphism were additive with respect to their associations with the same symptom group.

Exposure to N 2O During Anesthesia for Oocyte Pick-Up Was Not Shown to Have Any Adverse Effect on In-Vitro Fertilization Results

Objective: The effects of Nitrous oxide (N2O) on fertility in general and in-vitro fertilization (IVF) in particular are unclear as a result of conflicting evidence. One study has reported an increased risk of miscarriage among female dental assistants exposed to N2O for 3 or more hours per week, although another study failed to show such an effect on midwives. As for IVF, several authors have reported adverse effects on IVF outcome following anesthesia for oocyte pick-up (OPU) with N2O, although other authors failed to show such an effect, both in an animal model and in humans. The objectives of this study were to evaluate the effect of exposure to N2O during OPU on IVF results.

Nitrous oxide and spontaneous abortion in female dental assistants.

The relation between anesthetic gas exposure and spontaneous abortion remains unresolved. We examined the effect of nitrous oxide on spontaneous abortion among female dental assistants. Questionnaires were sent to 7,000 dental assistants aged 18-39 years who were registered in California in 1987; 4,856 (69%) responded. Analysis was based on 1,465 respondents whose most recent pregnancy was conceived while working full time. Women were asked how many hours a week they worked with nitrous oxide during this pregnancy and whether the excess gas was scavenged (vented). Relative risk of spontaneous abortion (through week 20) was calculated using a person-week model. This allowed women with current pregnancies (13%) or induced abortions (10%) to be included for appropriate time periods of risk. A total of 101 pregnancies (7%) ended as spontaneous abortions. An elevation in risk of spontaneous abortion was seen among women who worked with nitrous oxide for 3 or more hours per week in offices not using scavenging equipment (relative risk = 2.6, 95% confidence interval 1.3-5.0, adjusted for age, smoking, and number of amalgams prepared per week), but not among those using nitrous oxide in offices with scavenging equipment. This relation changed little when analyses were restricted to confirmed pregnancies or examined for several types of potential bias. Scavenging equipment appears to be important in protecting the reproductive health of women working with nitrous oxide.

The effect of occupational exposure to mercury vapour on the fertility of female dental assistants.

Exposure to mercury vapour or inorganic mercury compounds can impair fertility in laboratory animals. To study the effects of mercury vapour on fertility in women, eligibility questionnaires were sent to 7000 registered dental assistants in California. The final eligible sample of 418 women, who had become pregnant during the previous four years, were interviewed by telephone. Detailed information was collected on mercury handling practices and the number of menstrual cycles without contraception it had taken them to become pregnant. Dental assistants not working with amalgam served as unexposed controls. Women with high occupational exposure to mercury were less fertile than unexposed controls. The fecundability (probability of conception each menstrual cycle) of women who prepared 30 or more amalgams per week and who had five or more poor mercury hygiene factors was only 63% of that for unexposed women (95% CI 42%-96%) after controlling for covariates. Women with low exposure were more fertile, however, than unexposed controls. Possible explanations for the U shaped dose response and limitations of the exposure measure are discussed. Further investigation is needed that uses biological measures of mercury exposure.

Reduced fertility among women employed as dental assistants exposed to high levels of Nitrous Oxide

Abstract Background. Fertility is reduced in female rats exposed to levels of nitrous oxide similar to those found in some dental offices. Epidemiologic studies have suggested an association between exposure to mixed anesthetic gases and impaired fertility. We investigated the effects of occupational exposure to nitrous oxide on the fertility of female dental assistants. Methods. Screening questionnaires were mailed to 7000 female dental assistants, ages 18 to 39, registered by the California Department of Consumer Affairs. Sixty-nine percent responded. Four hundred fifty-nine women were determined to be eligible, having become pregnant during the previous four years for reasons unrelated to the failure of birth control, and 91 percent of these women completed telephone interviews. Detailed information was collected on exposure to nitrous oxide and fertility (measured by the number of menstrual cycles without contraception that the women required to become pregnant). Results. After controlling for covaria...

Reduced Fertility Among Women Employed as Dental Assistants Exposed to High Levels of Nitrous Oxide

ROWLAND, ANDREW S.; BAIRD, DONNA DAY; WEINBERG, CLARICE R.; SHORE, DAVID L.; SHY, CARL M.; WILCOX, ALLEN J. Author Information

Reduced fertility among women employed as dental assistants exposed to high levels of nitrous oxide.

Fertility is reduced in female rats exposed to levels of nitrous oxide similar to those found in some dental offices. Epidemiologic studies have suggested an association between exposure to mixed anesthetic gases and impaired fertility. We investigated the effects of occupational exposure to nitrous oxide on the fertility of female dental assistants. Screening questionnaires were mailed to 7000 female dental assistants, ages 18 to 39, registered by the California Department of Consumer Affairs. Sixty-nine percent responded. Four hundred fifty-nine women were determined to be eligible, having become pregnant during the previous four years for reasons unrelated to the failure of birth control, and 91 percent of these women completed telephone interviews. Detailed information was collected on exposure to nitrous oxide and fertility (measured by the number of menstrual cycles without contraception that the women required to become pregnant). After controlling for covariates, we found that women exposed to high levels of nitrous oxide were significantly less fertile than women who were unexposed or exposed to lower levels of nitrous oxide. The effect was evident only in the 19 women with five or more hours of exposure per week. These women were only 41 percent (95 percent confidence interval, 23 to 74 percent; P less than 0.003) as likely as unexposed women to conceive during each menstrual cycle. Occupational exposure to high levels of nitrous oxide may adversely affect women's ability to become pregnant.