12-year data on skin diseases in the Finnish Register of Occupational Diseases II: Risk occupations with special reference to allergic contact dermatitis.

BACKGROUND: Detailed epidemiological studies on occupational skin diseases (OSDs) are scarce. OBJECTIVES: To analyze risk occupations for OSDs in the Finnish Register of Occupational Diseases (FROD). METHODS: We retrieved numbers of OSD cases (excluding skin infections) for different occupations from the FROD in 2005-2016. In the FROD, Finnish ISCO-08-based classification of occupations was used since 2011, and the preceding ISCO-88-based version until 2010. We combined cases from the earlier and the later period using conversion tables provided by Statistics Finland. We included occupations with at least five cases and analyzed them in detail. We calculated incidence rates for OSDs and separately for allergic contact dermatitis (ACD) in different risk occupations using national labor force statistics. We also studied causes of ACD in these occupations. RESULTS: Risk occupations with the largest number of OSD cases included farmers, hairdressers, assistant nurses, cooks, cleaners, machinists, and nurses. Occupations with the highest incidences of OSDs comprised spray painters (23.8/10 000 person years), bakers (20.4), and dental technicians (19.0). Epoxy compounds and acrylates were prominent causes of ACD in occupations with the highest incidences of ACD. CONCLUSIONS: Uniform use of International Standard Classification of Occupations (ISCO) would facilitate comparisons of OSD figures in different countries.

An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland.

OBJECTIVE: Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland. MATERIALS AND METHODS: The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases. RESULTS: Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications. CONCLUSIONS: Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.

The relation between the extent of radiological findings and respiratory functions in pneumoconiosis cases of dental technicians who are working in Ankara.

INTRODUCTION: In dental technicians, parenchymal changes caused by dust affect pulmonary functions. The evaluation of the relation between radiological scores (chest X-Ray/HRCT) indicating the extent of pulmonary involvement and the severity of functional findings in dental technicians. MATERIALS AND METHODS: 440 dental technicians were evaluated with chest X-Ray, pulmonary function tests (PFTs) and high resolution computed tomography (HRCT). The degree of pulmonary involvement in radiological images was categorized based upon emphysema, the profusion of opacities, ground-glass opacity, honey combing and extent of pleural abnormalities. RESULT: Mean age of the study population was 34.7 ± 8.5 and mean duration of work was 16.5 ± 7.9 years. The prevalance of Dental technicians' pneumoconiosis (DTP) was 11.1%. The most common opacity in HRCT was round opacity with a rate of 89.7%. The rate of large opacity was %14.3. There was positive correlation between ILO score and HRCT score. Negative correlation was found between ILO and HRCT scores and all pulmonary function tests (except for FEV1/FVC), while no relation was found with age, overall duration of exposure, smoking and the age ofwork onset. In Multiple regression analysis, the extent of pulmonary involvement (HRCT scores) was found to be an independent predictor of functional impairment. Functional parameter reflecting the extent of pulmonary involvement most accurately was (FEV1%). CONCLUSIONS: It is our suggestion that radiological measurement should be used along with functional measurements in the evaluation of functional impairment in mixed dust exposed dental technicians.

Disparity in perception of the working condition of dental hygienists between dentists and dental hygiene students in Japan.

OBJECTIVES: In Japan, there continues to be a shortage of active dental hygienists. The scope of dental hygienists' practice is also considered to be unclear. One of the reasons for this is that dental hygienists find the working conditions during dental hygiene education different from those in reality. The purpose of this study was to clarify the actual working condition of dental hygienists in dental clinics, as well as evaluate the awareness of dental hygiene students and dentists regarding the working condition of dental hygienists. METHODS: Questionnaires were sent by post to 481 dentists and were distributed to 89 dental hygiene students. The awareness about the working condition of dental hygienists was compared between dentists and dental hygiene students. RESULTS: Two hundred twenty-two dentists and 89 dental hygiene students responded to questionnaires. Dental hygiene students considered the team of 'dental hygienist, dental technician and clerk' to be more effective in providing dental care than dentists (P < 0.001). Among the dentists, 37.1% did not find any clear distinction between hygienists and assistants in their clinics. However, 97.4% of dental hygiene students answered that dental team members should clearly inform patients of the distinction between hygienists and assistants. CONCLUSIONS: This study indicated that there was disparity between dentists' and dental hygiene students' perception of dental hygienists' working conditions, and dental team work was not always effective. For training high quality dental hygienists, all educational institutions related to dentistry must educate students regarding the more realistic dental hygienists' working condition, as well as benefits.

Pneumoconiosis in dental technicians: HRCT and pulmonary function findings.

BACKGROUND: Pneumoconiosis is a form of diffuse interstitial lung disease, often resulting from occupational exposures. As dental prosthetic technicians (DPTs) build prostheses, they are exposed to many chemical materials that increase their risk of developing pneumoconiosis. AIMS: To document pulmonary function and prevalence of pneumoconiosis in DPTs. METHODS: A cross-sectional study of DPTs working in prosthetic laboratories who underwent pulmonary function test and high-resolution chest computed tomography (HRCT) scanning. RESULTS: There were 76 participants and pneumoconiosis was diagnosed in 46%. The most commonly seen radiological finding was round opacities, present in 38%. Agreement among HRCT readers was moderate to good. As defined by HRCT, emphysema was diagnosed more often in those with a longer occupational history or a history of smoking, and low carbon monoxide diffusion capacity (DLCO), but not in those with pneumoconiosis. Forced expiratory rate and DLCO were significantly lower in those who had worked 16 years or more (all P < 0.05). DLCO values were significantly lower in technicians with emphysema and in current smokers (all P < 0.01). Round opacities were also present in a substantial proportion of DPTs who had 15 years or less exposure. Because HRCT is able to detect radiological changes of occupational lung disease very early, the prevalence of pneumoconiosis in our participants was quite high. CONCLUSIONS: Pneumoconiosis identified by HRCT was present in almost half of DPTs surveyed. Appropriate education and workplace protection should be given to DPTs in order to prevent exposure to hazardous materials in dental prosthetics laboratories.

Dental technology services and industry trends in New Zealand from 2010 to 2012.

OBJECTIVE: To provide a snapshot of the New Zealand dental technology industry and influencing factors. BACKGROUND: Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. METHODS: A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. RESULTS: The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. CONCLUSION: Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

A survey of the sociodemographic and educational characteristics of oral health technicians in public primary health care teams in Minas Gerais, Brazil.

BACKGROUND: To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. METHODS: A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. RESULTS: Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. CONCLUSIONS: The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.

Knowledge, attitudes and practices of oral health professionals with regard to the hepatitis B virus in their workplace, Harare.

Objective: To assess the knowledge, attitudes and practices of Harare oral health professionals regarding Hepatitis B Virus (HBV) in the workplace. Design: A cross sectional study was conducted using a structured 36 item interviewer administered questionnaire to collect data from consenting participants. Setting: The study was conducted at private and public dental practices in Harare. Participants: Oral health professionals comprising dentists, dental therapists and technicians were purposively sampled and interviewed. Results: Eighty nine study participants were interviewed. Seventy four (83%) and 69 participants (77.5%) knew about the potential transmission through contact with blood and saliva respectively. Forty seven (52.8%) participants knew that HBV infection is incurable. Thirty five participants (39.3%) were unaware of the ability of HBV to remain infective in dried blood. Although 22 participants (25%) stated that there was potential for transmission of HBV to patients at their workplace, 81participants (92%) felt they were at risk of contracting HBV infection at work. Sixty one participants (69%) reported being vaccinated, but on verifying the vaccine doses the participants received, 35 (39.3%) received three doses, 15(17%) two doses and 11 (12.4%) one dose. Forty six per cent of the fully vaccinated participants (16 of 35) had a post-HBV vaccination test. Seventy nine (87%) and 83(93.3%) professionals stated consistent use of face masks and gloves during procedures respectively. Conclusion: Although the oral health professionals in Harare appreciated the risk of HBV transmission in dental settings, they had incomplete knowledge of HBV infection and there was poor uptake of HBV vaccination among these professionals.

Current status, crisis and trends in Chinese dental technicians.

BACKGROUND: Chinese dental technicians play a significant role in the globalised market of dental prosthesis fabrication, but this subject has not been investigated in detail. The demand for dental prostheses increases as individuals pay increasing attention to their oral health. Therefore, it is important to investigate the status of Chinese dental technicians. OBJECTIVE: To evaluate the current status of Chinese dental technicians. METHODS: Dental technicians' resumés, which reveal information regarding dental technician manpower, degrees, working age and salary, etc., were analysed and compared with those abroad. We also estimated the future demands of dental technician manpower, and discussed some potential solutions. RESULTS: There are fewer dental technicians in China than in other developed countries; they are also of a lower standard. Male technicians outnumber females. The education level of technicians is insufficient, and the education programme is still in its exploratory stage. CONCLUSIONS: The development of dental technician teams in China represents both an opportunity and a challenge. It is important to move forward from the current situation to yield long-term development. This article provides information on the Chinese dental technology industry, identifies the problems and offers solutions for its development.

International migration of Lithuanian oral health professionals: a survey of graduates.

AIM: To assess the intentions of general dentists, dental specialists, dental hygienists, assistants and technicians graduated from Lithuanian educational institutions in 0032010 to engage in practice in foreign countries. MATERIAL AND METHODS: A questionnaire survey was carried out among all graduates (N = 347) general dentists, dental specialists, dental hygienists, assistants and technicians in Lithuania in 2010. The response rate was 82.7%. RESULTS: 32.4% of graduates from all oral health specialties mentioned their intentions to emigrate from Lithuania. The highest rate of emigration intentions was found among dental assistants (35.5%) and general dentistry graduates (26.9%). Factors related to higher reported intentions to emigrate were relatives or friends residing in other states, self-rating of personal unhappiness, or residing in large cities. As many as every fourth (23.1%) dental hygienist, assistant and technician graduates had already planned, arranged and organised for emigration. Major destination countries are the UK, Ireland, Norway and Sweden. Of all oral health professionals, the highest rate of reported intentions to emigrate was among dental hygienists, assistants and technicians, therefore many of them will not join the professional community in Lithuania. CONCLUSION: The survey gives indications about the possible magnitude of emigration of oral health professionals from Lithuania and is the first study of its kind. The results show that Lithuania is a major sending country in the context of international oral health professionals' migration flows.

Dental alloys used for crown and bridge restorations by dental technicians in New Zealand.

OBJECTIVE: To determine the range and elemental composition of alloys used for PFM and crown-and-bridge restorations by New Zealand dental laboratories, and to understand the reasons for their selection. MATERIALS AND METHODS: Two waves of data collection were carried out via post and telephone interview. The source population was dental laboratories advertised with the Yellow Pages Group in 2007/2008. RESULTS: A total of 83 out of 109 laboratories (76.1%) responded. Of those, 35 laboratories (42.1%) reported producing fixed-prosthodontic restorations. The range of alloy types (consisting of high noble, noble and base-metal alloys), brand names (55 products) and manufacturers was determined, along with the reasons for their selection. Ten international dental alloy manufacturers were identified as being used, with the leading manufacturer being Ivoclar-Vivadent (40.9%), followed by Argen (25.3%). Most laboratories select their alloys based on price and physical properties. The average laboratory carries three to four alloy products. CONCLUSION: Alloy selection by dentists and dental technicians is strongly influenced by economic factors. While the study identified the range of alloys being used for fixed restorations in terms of alloy type and brand name, further research is needed to determine the proportions of fixed restorations produced from high noble, noble and base metal alloys, together with dental practitioners' attitudes to, and preferences in, alloy selection.

High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians.

BACKGROUND: Occupational and chronic exposure to solvents and metals is considered a possible risk factor for Parkinson's disease and essential tremor. While manufacturing dental prostheses, dental technicians are exposed to numerous chemicals that contain toxins known to affect the central nervous system, such as solvents (which contain n-hexane in particular) and metals (which contain mercury, iron, chromium, cobalt and nickel). METHODS: We performed an epidemiological and clinical study on all 27 dental technicians working in a school for dental technicians. We asked all the technicians to fill in a self-administered questionnaire on extrapyramidal symptoms, and the General Health Questionnaire (GHQ), a self-administered screening instrument, to detect any psychiatric disorders. Moreover, we invited all 27 dental technicians to undergo a neurological examination and provide a detailed occupational history in our clinic. RESULTS: Of the 14 subjects who underwent the neurological examination, four had postural tremor and one had a diagnosis of Parkinson's disease. CONCLUSION: We found a high prevalence of extrapyramidal signs and symptoms in this group of male dental technicians working in a state technical high school in Rome. We believe that this finding may be due to the presence of toxins in the dental technician's work.

Survey on the use of CAD-CAM technology by UK and Irish dental technicians.

Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dental technicians' use and reporting of this technology.Purpose The aim of this cross sectional survey was to identify the extent digital technology has infiltrated the workplace and to investigate the factors affecting the use of CAD-CAM technology by dental laboratory technicians within Ireland and the UK.Materials and methods A web-based questionnaire was composed (Opinio, Object Planet Inc. Oslo, Norway) and distributed to UK and Irish dental technicians. Answers to all questions were anonymous and grouped such that general information was gathered initially, followed by branching of the survey into two sections depending on whether or not the respondent worked with CAD-CAM technology. Results were compiled and statistical analysis (Fisher's Exact test, SPSS, IBM, Armonk, New York, USA) was performed in order to investigate any correlation between various demographic variables and the answers provided.Results The survey was distributed to 760 UK technicians and 77 Irish technicians. The total number of completed surveys was 105, which yielded a total response rate of 14%. Most technicians reported using some form of CAD/CAM aspect in the workflow, and this was more significant for technicians working in large laboratories. Most training received was company-led. Large laboratories were also significantly correlated with less outsourcing of CAD/CAM work and a change in dental material use leading to the increase of zirconia and the decrease of noble alloys. Dental technicians did not report any significant change in working relationships and staffing as a result of CAD/CAM incorporation. High initial investment cost was the most common reason quoted from non-users, along with the lack of such technology in their working environment.

Work-related musculoskeletal disorders among Jordanian dental technicians: Prevalence and associated factors.

BACKGROUND: Dental technology is a profession that requires precise manual skills and dexterous handling of small tools. There is an abundance research on work-related musculoskeletal disorders (WMSDs) affecting dentists, dental hygienists and dental assistants, yet very few articles investigated WMSDs among dental technicians. OBJECTIVES: This study aimed to determine the prevalence of WMSDs among Jordanian dental technicians and their associated factors. METHODS: A cross-sectional design was conducted. A sample of Jordanian dental technicians (n = 81) were asked to complete a validated structured self-administrated questionnaire to measure WMSDs and its associated factors. RESULTS: A sample of 81 dental technicians completed the survey (50.6% younger than 30 years, 61.7 were males). Pain complains were significantly higher in female, younger technicians, and with increased workload. All participants reported WMSDs in at least one body part in the last 12 months. The most common pain areas reported were in the neck (70.4%) and shoulders (71.6%). CONCLUSION: This study found a high prevalence of musculoskeletal complaints in dental technicians. Future studies are indicated to investigate the actual mechanisms causing WMSDs among dental technicians.

An analysis of present dental professions in Sweden.

Dentistry in Sweden is predicted to have a shortage of dentists in the future and the division of labour within dentistry will be a more debated question. In order to forecast the effects of such a shortage the professional status of the involved groups must be made clearer. The objective of this paper is to analyse the emergence and present professional status of clinical dental professions in Sweden. The study was conducted on the basis of theories on professions, and their roles in organizations was analysed. The results were applied on the historical emergence, establishment and consolidation of clinical dental professions in Sweden. The results show that a large sector of salaried dentists has not diminished the professional status of the Swedish dentists. Professional ambitions such as many clinical subspecialties and a strong element of research have not been restrained by the public health ambitions in the Public Dental Health Service (PDHS). Presently, other dental professions are dental hygienists, dental technicians and dental nurses. Of these the only other licensed group, the dental hygienists, are an emerging profession. They have an uphill struggle to obtain a full professional status, mainly because their knowledge domains are neither specific nor exclusive to their group. Development of a common core curriculum on a clearly academic level would enhance their professional status. Dental technicians and nurses are lacking fundamental traits as professions. There appears to be little need for additional groups of clinical professions besides dentists and dental hygienists in Swedish dentistry. In conclusion,this analysis provided better understanding of the present status of the Swedish dental professions, to prepare for future restructuring of the dental care system. Further work will be needed to understand the impact of professional traits on the management of groups of professionals.

Dental technicians' experiences with all-ceramic extra-coronal restorations.

The aim of this study was to identify the dental technicians' experiences with extra-coronal all-ceramic restorations. A questionnaire was mailed to all laboratories registered in The Norwegian Association of Dental Laboratory Owners (n=186). The response was 149 (80%). All-ceramic restorations were produced by 93 (62%) of the responding laboratories. A few of these (1 7%) produced the majority (67%) of the restorations. The dental technicians reported low rates of remakes (median 2%) for all-ceramic restorations. The low production and the limited number of laboratories that perform this work show that there is room for extended training and more expertise in this field.

Relationship between radiological (X-ray/HRCT), spirometric and clinical findings in dental technicians' pneumoconiosis.

INTRODUCTION: Pneumoconiosis in dental technicians' has rarely been evaluated. OBJECTIVES: To evaluate clinical, functional and radiological impacts of exposure to dust on respiratory functions via chest X-ray (CXR), high-resolution computed tomography (HRCT) and spirometry in dental technicians. METHODS: Demographic data, respiratory symptoms, spirometry results, CXR and HRCT scans of 32 dental technicians were evaluated. The opacities on the radiological images were categorized based on their intensity. We investigated the relation of radiological scores with clinical, radiological and functional findings. RESULTS: The mean age of the study population was 31 ± 9 years and mean employment duration was 14 ± 9 years. Twenty-two (69%) technicians had a history of smoking. The most common symptom was phlegm, while dyspnea prevalence was higher in those with an elevated International Labour Office (ILO) profusion score (P < 0.01). Parenchymal opacities were determined in 10 (31%) technicians by CXR and in 22 (69%) technicians by HRCT (P < 0.01). There was a positive correlation between ILO profusion score and HRCT score (r = 0.765, P < 0.01). ILO profusion score and HRCT score showed positive correlation with employment duration (r = 0.599, P = 0.01; r = 0.514, P = 0.01, respectively), while exhibiting negative correlation with FVC (r = -0.509, P < 0.05; r = -0.627, P = 0.01 respectively), FVC% (r = -0.449, P < 0.05; r = -0.457, P < 0.05, respectively) and forced expiratory volume in 1 s (r = -0.473, P < 0.05; r = -0.598, P = 0.01, respectively). CONCLUSIONS: We believe that a combined approach including spirometry, CXR and HRCT modalities should be employed in demonstrating respiratory disorders associated with exposure to inorganic dusts in dental technicians.

The healthcare system and the provision of oral healthcare in European Union member states: Part 5: Romania.

Romania is one of the newest member states of the European Union (EU). It has 13 dental schools, 14,841 dentists and 2,935 dental technicians providing oral health care for a population, at 31 December 2014, of 21.3 million. The shift from a communist system to a democratic or capitalist society has contributed to an enormous change in the proportion of public and private sector oral health services. The lack of public funds during the post-communist years has contributed to a dependency on private oral healthcare rather than the government financed public provision. Affordability and social awareness have together established a mixed economy for oral health care costs and oral healthcare is growing slowly compared with other developed EU member states. At the same time, there has been overproduction of new dentists (currently 1500 graduate annually). This has led to un and under-employment and emigration of dentists to other EU member states. This paper explains the current oral healthcare system in Romania and changes in recent years.

A look at allied dental education in the United States.

BACKGROUND: The American Dental Association conducts surveys of educational programs in dental assisting, dental hygiene and dental laboratory technology. The 2002-2003 survey included questions about enrollment, graduates, program information and trends. METHODS: The ADA Survey Center mailed the Survey of Allied Dental Education to 548 program directors of dental assisting, dental hygiene and dental laboratory technology educational programs. They also sent several follow-up notices as a reminder to complete the survey. A 100 percent response rate is mandatory for continued accreditation by the Commission on Dental Accreditation. Association staff members resolved inconsistencies in the data and analyzed them before producing a final report. RESULTS: The number of applications to, first-year enrollment in and number of graduates in dental hygiene and dental assisting educational programs have increased during the last five years. During the same period, the number of applications to, and graduates of, dental laboratory technology educational programs decreased, but first-year enrollment increased slightly. CONCLUSIONS: Results from these surveys help address the concerns of the public and the profession regarding allied dental manpower levels. They also provide information for those interested in applying to individual allied dental educational programs. PRACTICE IMPLICATIONS: Private dental practices employ the majority of graduates of allied dental educational programs. Recent graduates of dental assisting and hygiene programs continue to supply the office staff members needed to support the delivery of dental care.