Tobacco dependence education in U.S. Dental assisting programs' curricula.

The aim of this study was to assess the level of tobacco dependence education (TDE) in the curricula of U.S. dental assisting programs and to compare the findings to those from a similar assessment of dental hygiene curricula. In the 2012-13 academic year, a 51-item survey was sent to directors of all 298 accredited dental assisting programs. Assessed were curricular TDE content, time spent on each topic, expected levels of clinical competence, and resources used. Of the 298 potential participants, 89 programs returned completed surveys, for a response rate of 30%. Of the 13 TDE-related content areas, those most often covered were oral disease related to tobacco use (100%) and general diseases related to tobacco use (93%); those least often covered were stages of (behavior) change (29%), how to develop a comprehensive tobacco intervention program in a private office setting (23%), and strategies for community-based tobacco control (22%). Responding program directors indicated the following levels of tobacco cessation intervention at which students should demonstrate competence: brief, 44%; moderate, 55%; intensive, 8%. Less than half of the reporting programs conducted a formal assessment of clinical competence in any TDE-related skills; however, skills in assessing patient tobacco use and associating head and neck findings to tobacco use were formally or informally assessed by 74% and 61%, respectively. Compared to dental hygiene programs, TDE appeared to play a smaller role in the curricula of dental assisting programs, and dental assisting programs were less likely to formally assess clinical competence in TDE.

Iranian healthcare workers' perspective on hand hygiene: a qualitative study.

BACKGROUND: Hand hygiene (HH) has been identified as one of the simplest, but most important, methods to prevent cross-infection in healthcare facilities. In spite of this fact, the HH compliance rate remains low among healthcare workers (HCWs). Several factors may affect HH behavior. In this study, we aimed to assess various aspects of HH from the perspective of HCWs. METHOD: This qualitative study was conducted in two hospital settings in Shiraz, Iran. Eight focus group discussions (FGDs) and six in-depth interview sessions were held with ICU and surgical ward nurses, attending physicians, medical and nursing students and supporting staff. Each FGD and interview was transcribed verbatim, open codes were extracted, and thematic analysis was conducted. RESULTS: Three themes emerged from the thematic analysis including: "the relationship between personal factors and HH compliance," "the relationship between environmental factors and HH compliance" and "the impact of the health system on HH adherence, including the role of adequate health systems, administrative obligations and the effect of surveillance systems." CONCLUSION: Several factors played a significant role in improving HCWs HH compliance, such as the regular adherence to health system tenets. HH compliance may be improved through application of realistic policies and better supervision. In addition, appropriate education may positively affect HH behavior and attitudes.

A qualitative study of the causes of improper segregation of infectious waste at Nemazee Hospital, Shiraz, Iran.

BACKGROUND AND OBJECTIVES: Medical waste management is a major concern for healthcare facilities. One important element is the segregation of infectious waste from domestic, non-infectious waste. The aim of this qualitative study was to identify factors that negatively affect proper segregation at Nemazee Hospital, which is affiliated with Shiraz University of Medical Sciences. METHODS: Study data came from focus groups involving hospital workers. Participants expressed their opinions regarding barriers to proper segregation of medical wastes. The participants gave their permission to have their comments recorded. Data analyses were based on a grounded theory approach. RESULTS: The results indicated that managerial weakness was an important factor in suboptimal disposal of medical waste. It appears that hospital authorities should pay better attention to educational planning, organizational resources and supervision. Together, these considerations should help reduce waste-management errors. The results also suggest that healthcare worker training needs improvement. In general, patients and their companions, as well as the local population, did not appear to have sufficient knowledge concerning disposal of infectious medical waste. CONCLUSIONS: Hospital authorities should conduct a broad review of medical waste management, including improved employee training. This step should have a positive effect on local health, as well as the environment. Improvement is also needed in the infection prevention performance of hospital healthcare workers. This approach should reduce additional production of infectious waste and costs associated with healthcare.

Are The Predictors of Hookah Smoking Differ From Those of Cigarette Smoking? Report of a population-based study in Shiraz, Iran, 2010.

BACKGROUND: The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran. METHODS: In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. RESULTS: Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking <1 year; 13.4% smoked 1-2 years and 73.9% smoked>2 years. Almost half of those surveyed (48.9%) smoked <10 cigarettes per day (cpd); 28.4% smoked 10-15 cpd; 14.8% smoked 16-19 cpd, and 8%>20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. CONCLUSIONS: Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women.

Contamination of handpieces during pulpotomy therapy on primary teeth.

PURPOSE: The purpose of this in vivo study was to determine the potential for internal bacteriol contamination of low-speed handpiece/ contraangle systems. METHODS: Clinical contamination was measured for 24 pulpotomies on primary first or second molar teeth from 20 subjects. The investigators used microbiologic analysis to determine the extent of bacterial contamination from the patient's saliva using enriched trypticase soy agar (ETSA) plates. Analysis for the presence of blood also occurred. RESULTS: Microbial analysis indicated aerobic and anaerobic bacterial contamination at all 3 culturing sites from all 24 handpieces (100% contamination, 95% confidence intervals [CI] = 86%-100%). Aerobic and anaerobic bacteria levels (CFU/mL) were not significantly different (P = .43 overall, P > .25 for each of the 3 evaluated sites). The sites also did not have significantly different CFU/mL levels (P = .13 overall, P = .63 for aerobic, P = .14 for anaerobic). The analysis showed no blood contamination at any of the 3 culturing sites for any of the 24 handpieces (0% contamination, 95% CI = 0%-14%). CONCLUSIONS: The in vivo data suggest that low-speed handpiece/contraangle systems can become bacterially contaminated during the performance of pulpotomies and, unless properly sterilized between patients, there is the potential for pathogenic micro-organisms to enter, adhere, and then emit during use on subsequent patients.

Sampling water from chemically cleaned dental units with detachable power scalers.

UNLABELLED: Power toothbrushes (PTBs), in combination with abrasive dentifrices, may encourage wear of dental cements at crown margins. PURPOSE: This study's purpose was to determine the effect chemical cleaning had on the microbial quality of water emitted from dental unit waterlines (DUWL), 3-way syringes, and power scalers. METHODS: Ten randomly selected dental units with attached self-contained independent water reservoirs filled with deionized water were used. An ultrasonic scaler was paired with each of the ten units. This combination was retained for the duration of the study. Water samples were collected at the beginning of the fall semester and again after two weeks. Analysis indicated unacceptable levels of microorganisms and the need for a shock treatment, which included cleanings on 3 consecutive days. Water samples were collected following the initial shock treatment and for the following 4 weeks. Weekly cleanings were performed as part of routine equipment maintenance. Water specimens from the 3-way syringes and scaler handpieces were spiral plated on R2A agar plates. Incubation was at room temperature for 7 days. Plates were examined and the number of colony-forming units per milliliter (CFU/mL) was determined for each specimen. RESULTS: The first sampling showed that none of the 3-way syringes and one of the power scalers produced potable water after sitting unused for 6 weeks and receiving only one chemical cleaning. Improvement was noted after the second cleaning with specimens from 8 units having bacterial levels <500 CFU/mL. Three power scalers emitted potable water. Improvements in the bacterial levels of the power scalers were noted following the shock treatment; all of the power scalers emitted potable water. CONCLUSIONS: Practitioners should routinely treat dental units and power scalers with products that will maintain acceptable microbial water quality. Administration of a shock treatment may be necessary prior to beginning a weekly maintenance protocol. Shock treatments are beneficial if units or power scalers have not been used for an extended period of time.

Comparison of ultrasonic cleaning schemes: a pilot study.

OBJECTIVE: Ultrasonic cleaning is an effective method for cleaning dental instruments prior to sterilisation. However, there are few studies that directly compare precleaning and ultrasonic cleaning solutions. This study evaluated the efficacy of different ultrasonic cleaning schemes. METHOD AND MATERIALS: Twenty representative dental instruments, five of which were soiled with a mixture of blood and hydroxyapatite, were used in a series of cleaning runs. Cleaning employed a presoaking agent, ultrasonic cleaning, or a combination of both. Two presoaking agents (Non-ionic Ultrasonic Cleaning Solution and ProEZ Foaming Enzymatic Spray) plus five ultrasonic cleaners (UltraDose, General Purpose Cleaner, Co-enzyme Concentrate, Enzol Enzymatic Detergent, and Non-ionic Ultrasonic Cleaning Solution) were compared, with tap water serving as a control. There were two cleaning times: seven and 15 minutes. After rinsing, the working ends of the instruments underwent scrubbing for 20 seconds using a dental polishing brush held in a haemostat. After scrubbing, the brush and instrument were placed in a tube containing sterile saline. Vortexing of the tube lasted 30 seconds. Testing for the post-cleaning presence of blood involved Hemastix dipsticks. These sticks measure minute amounts of blood in urine and can detect as few as 35 red blood cells per ml. Comparisons of colour change were made to a standard scale followed by assignment of numeric values. RESULTS: Tap water was the poorest cleaning solution, while UltraDose was the most effective. Blood removal improved when cleaning time was increased from seven to 15 minutes. The combined effect of a presoak immersion followed by ultrasonic cleaning was the most effective cleaning scheme overall. Cleaning by either ultrasound or presoaking only was less effective. Some instruments were more difficult to clean than others. CONCLUSION: Within the constraints of the small number of test runs performed, it was concluded that application of a presoak agent before ultrasonic cleaning produced the most effective instrument-cleaning regimen.

An investigation of the microbial contamination of dental unit air and water lines.

AIM: The objective of this study was to measure the microbial contamination released from dental unit air lines (DUAL) and dental unit water lines (DUWL). MATERIALS AND METHODS: Emissions from DUAL and DUWL from five dental units supplied by a central water source (tap) and a centralised air supply were sampled three times over a five- week period. Air was forced through sterile water and then plated onto selective agar using apparatus designed to spread the sample solution evenly, and then incubated at room temperature for seven days. Colonies were then counted and the concentration of bacteria present was determined and expressed as colony forming units per millilitre (cfu/ml) per minute. The same procedure was used to evaluate five other dental units, which had attached independent water reservoir (bottle) systems (IWR). Only deionised water was added to the bottles and unit waterlines were cleaned weekly with alkaline peroxide based solution. Values were expressed as cfu/ml. RESULTS: Air and water specimens obtained from dental units supplied with tap water had microbial counts significantly (t-test, p < 0.05) greater than IWR dental units. CONCLUSIONS: Results indicate that IWR can reduce the numbers of micro-organisms released from DUWL. However, the effectiveness of such systems should be routinely monitored. Emissions from DUAL seems to reflect the levels of microbial contamination present in DUWL.

Occupational exposures occurring among dental assistants in a UK dental school.

PURPOSE: The cross-infection risks for dentists have been well recognised, and much has been published regarding the incidence of occupational exposures to patient body fluids. Less has been reported regarding the risks to dental assistants. The purpose of this study was to evaluate the incidence of occupational exposures to patient body fluids among dental assistants, to assess the rate of reporting of such incidents, and to evaluate the association of various factors with these exposures. METHOD: All 84 dental assistants working at Birmingham Dental Hospital were asked to complete a confidential questionnaire to provide retrospective information regarding the nature and incidence of any occupational exposures they had experienced. RESULTS: An overall response rate of 94% was achieved. Dental nurses experienced fewer occupational exposures than dental students at the same institution, and reported incidents more frequently. More injuries occurred after the treatment session. Handling local anaesthetic syringes was associated with more injuries, and percutaneous injuries predominated. Trainee nurses had experienced more occupational injuries in the preceding six months than their qualified colleagues. There was no significant association with any of the other factors evaluated. CONCLUSIONS: The general incidence of occupational exposures among the dental assistants in this survey was low in comparison to dental students at the same institution. A further reduction may be possible by increasing the training of unqualified nurses with particular regard to post-treatment handling of sharp dental instruments and equipment.

Comparing infant oral glucose clearance with and without a water rinse.

The purpose of this study was to test the hypothesis that a small rinse of water in an infant's mouth immediately following formula consumption would significantly improve oral glucose clearance. Though statistically significant results were not obtained at all time intervals, this study lends validity to the hypothesis that a small water rinse immediately following formula feeding could help enhance oral glucose clearance in infants.