Impact of a virtual educational intervention on knowledge and awareness of biomedical waste management among Peruvian dental professionals.

Waste from healthcare is a significant global issue, with around 85% of it being common waste and the remaining 15% being hazardous waste that is infectious and toxic. Dentistry uses various materials that create a substantial amount of biomedical waste capable of impacting the environment. Therefore, the purpose of this study was to assess the effects of a virtual educational program on the knowledge and awareness of dental material recycling and reuse, as well as biomedical waste management, among dental professionals in Peru. The current study was a longitudinal and quasi-experimental evaluation of 165 dentists from Peru. A validated questionnaire consisting of 30 items was administered at three different intervals (pre-test, immediate post-test, and 14-day post-test). Statistical analysis was conducted using the Mann Whitney U and Kruskal Wallis H tests to compare scores between categories of each sociodemographic variable, and the Cochrane's Q and Friedman test was used for related measures comparison. A significance level of p < 0.05 was considered. When comparing the percentage of correct responses regarding recycling and reuse of dental materials and biomedical waste management between the pre-test and the immediate post-test, a significant improvement in knowledge was observed for most of the questionnaire items (p < 0.05). At 14 days after the test, those who studied at a private university, unmarried, bachelors, non-specialists, non-teachers and have less than 10 years of professional experience did not did not retain knowledge on biomedical waste management (p < 0.05) or recycling and reusing dental materials (p < 0.05) to a significant extent. There was a significant enhancement in dentists' knowledge and awareness of managing biomedical waste, recycling, and reusing dental materials following the educational intervention. This improvement was observed across all sociodemographic variables considered in the study. However, this knowledge was not retained beyond two weeks for those who studied at a private university, unmarried, bachelor, with no specialty, non-teachers and with less than 10 years of professional experience. Government authorities should encourage oral health professionals to conduct research with educational interventions focused on improving and evaluating the sustainability and environmental impact of dental practices. This will enable professionals to better understand, control and evaluate the consequences of their practical work.

The effect of rotation speed of XP-endo Shaper on apically extruded debris during endodontic procedures: an In Vitro study / El efecto de la velocidad de rotación de XP-endo Shaper sobre los desechos extruídos apicalmente durante los procedimientos de endodoncia: un estudio in vitro

Abstract The aim of this study was to evaluate the effect of using a higher rotation speed with the XP-endo Shaper (XPS) on apically extruded debris and operation time during endodontic treatment and retreatment procedures. Sixty mesial roots of mandibular first molar teeth were randomly assigned to four groups (Initial treatment groups: XPS used at 1000 or 3000rpm rotation speeds and Retreatment groups: XPS used at 1000 or 3000rpm rotation speeds). During the initial treatment and retreatment procedures preweighed eppendorf tubes were used to collect apically extruded debris, and the operation time was recorded in seconds. The extruded debris was quantified by subtracting the preinstrumentation from the postinstrumentation weight of the Eppendorf tubes. Data were analysed using two-way ANOVA at a significance level of 0.05. In all groups, the use of the XPS at 1000 or 3000rpm rotation speeds had no statistically significant effect on the amount of apically extruded debris (p>0.05). The use of the XPS at a 3000rpm rotation speed significantly decreased the instrumentation time (p<0.05). In summary, the use of the XPS at high rotation speeds in initial treatment and retreatment procedures did not have a significant effect on the amount of apically extruded debris but significantly decreased the operation time.

Resumen El objetivo de este estudio fue evaluar el efecto del uso de una mayor velocidad de rotación con XP-endo Shaper (XPS) sobre los desechos extruidos apicalmente y el tiempo de operación durante el tratamiento endodóntico y los procedimientos de retratamiento. Sesenta raíces mesiales de los primeros molares mandibulares se asignaron aleatoriamente a cuatro grupos (grupos de tratamiento inicial: XPS usado a velocidades de rotación de 1000 o 3000rpm y grupos de retratamiento: XPS usado a velocidades de rotación de 1000 o 3000rpm). Durante el tratamiento inicial y los procedimientos de retratamiento se utilizaron tubos Eppendorf pesados previamente para recoger los desechos extruidos apicalmente, y el tiempo de operación se registró en segundos. Los residuos extruidos se cuantificaron restando la preinstrumentación del peso postinstrumentación de los tubos Eppendorf. Los datos se analizaron mediante ANOVA bidireccional a un nivel de significación de 0,05. En todos los grupos, el uso del XPS a velocidades de rotación de 1000 o 3000rpm no tuvo un efecto estadísticamente significativo sobre la cantidad de detritos extruidos apicalmente (p>0.05). El uso del XPS a una velocidad de rotación de 3000rpm disminuyó significativamente el tiempo de instrumentación (p<0.05). En resumen, el uso del XPS a altas velocidades de rotación en los procedimientos de tratamiento inicial y retratamiento no tuvo un efecto significativo en la cantidad de detritos extruidos apicalmente, pero disminuyó significativamente el tiempo de operación.

Safe practices of biomedical and dental waste management amongst practicing dental professionals amid the COVID-19 pandemic.

BACKGROUND: Biomedical waste can potentially compromise the environment and public safety if not safely disposed. OBJECTIVE: The aim was to assess the understanding and safe practices of biomedical and dental waste amongst the dental practitioners and practical year students amid the COVID-19 pandemic. METHODS: A structured and validated questionnaire consisting of 21 closed ended questions was used to collect data from dental practitioners and students working in hospitals and clinics. The questionnaire was distributed in paper and digital form amongst the participants. Descriptive analysis was performed for categorical and numerical variables. Spearman correlation test was used to assess the relationship between awareness and waste disposal practices of dentists. A p-value of≤0.05 was considered as statistically significant. RESULTS: More than three fourth of the participants were aware of proper dental waste disposal steps. One half was aware of the color-coded segregation of biomedical waste management. Two third of the participants were deploying safe biomedical waste practices. Nearly 68% subjects allocated separate labeled containers for disposal of COVID-19 suspected patient's waste. Furthermore, 71.63% participants were practicing PCR test before aerosol procedures. While 88.65% participants believed that the COVID-19 pandemic has increased the financial burden in terms of safe practices and dental waste management. CONCLUSION: The awareness and practices of the participants towards dental waste management was found to be moderate. Satisfactory COVID-19 prevention and transmission measures were observed amongst the participants. BMW management lessons should be included in the academic curriculum and training program needs to be adopted for mass awareness.

Characteristics of wastewater originating from dental practices using predominantly mercury-free dental materials.

Dental materials are currently undergoing a revolution. Mercury use, including traditional amalgam (mercury-containing) material used in dental fillings, is now being widely regulated under the Minamata convention, and dental amalgam is currently being replaced by resin formulations in dentistry. These resin-based materials can be tuned to offer varying material properties by incorporation of a range of nano- and micro-particle based 'fillers' for different dental properties and applications. However, these innovations may have a concomitant effect on the waste streams associated with common dental applications, in particular the potential for higher concentrations of novel micro- and nanomaterials within wastewater streams, and a potential route for novel nanomaterials into the wider Environment. These new materials may also mean that wastewater filtering apparatus commonly deployed at present, such as amalgam separators, may be less efficient or insufficient to capture these new filler materials in dental facility wastewater. In this work, we analyse dental wastewater streams from three dental facilities in Ireland with differing amalgam separators in place. The potential overall toxicity, particulate load and physicochemical properties are analysed. The overall risk posed by these new materials is also discussed.

Mercury hygiene and biomedical waste management practices among dental health-care personnel in public hospitals in Lagos State, Nigeria.

BACKGROUND: Indiscriminate disposal of hospital wastes including mercury/amalgam wastes pose a serious threat to life and environment. There is a growing concern about biomedical waste (BMW) management among health care workers, however there are limited reports on BMW management by dental personnel in developing countries. OBJECTIVES: This study investigated the level of knowledge of BMW, observance of proper mercury hygiene and BMW management practice among public dental personnel in Lagos State, Nigeria. METHODS: A cross-sectional study regarding BMW management across public hospitals in Lagos State, Nigeria was conducted following institutional ethics committee approval. A self-administered questionnaire was utilized to obtain data from different facilities selected by purposive and simple random sampling techniques as applicable. The questionnaires were distributed among 437 respondents by convenience sampling. The resulting data were statistically tested using Chi-square and G-test with p-value < 0.05 indicating significant level. RESULTS: Amongst 437 respondents, majority were females (62.5%) and the highest proportion fell within the age range of 25-34 years (44.4%). Only 17.2% of the respondents had good knowledge of BMW management/legislation and 4.1% had good BMW practice. Less than half (49.4%) of respondents disposed mercury-contaminated materials inside the trash and majority (92.2%) did not observe proper mercury hygiene. Significantly better mercury hygiene practices were observed in secondary facilities (p=0.040). CONCLUSION: A minor proportion of public dental personnel had good knowledge and practice of proper mercury hygiene and BMW management. This shows there is an urgent need for training of health personnel on proper BMW handling and disposal in developing countries like Nigeria.

Management of dental waste in dental offices and clinics in Jeddah, Saudi Arabia.

Management of dental wastes became a recent challenge facing health care practitioners and is one of the highly-sensitive environmental problems. The main purpose of this study was to assess oral health care provider's knowledge and behavior about dental waste management and evaluate their behavior toward it. A cross-sectional descriptive study was conducted on 314 dental health care providers working in four dental colleges, and 20 private dental clinics in Jeddah, Saudi Arabia. A pretested questionnaire composed of close-ended questions was used. The mean age of the participants was 27 years. About 78% of the participants reported that they were working in the public sector. Only 33.4% of the study sample received professional training on waste management. The mean behavior and knowledge scores were 3.7 ± 1.3 (out of 6) and 1.4 ± 1.3 (out of 8), respectively. Statistically significant association was noted between gender and knowledge scores but not between gender and behavior scores. On the other hand, statistically significant associations were noted between both knowledge and behavior scores and rank of the participant, type of practice, and years of experience. Oral health care providers' knowledge about the effective procedure that should be followed for segregating, collecting, transporting, and treating dental waste was weak and substandard. There is an urgent need to develop policies and regulations for dental waste management in Saudi Arabia. Implications: This study shed light for the first time on the knowledge and behavior of dentists in Jeddah, Saudi Arabia in regard to the dental waste management. Participants knowledge and behavior in regard to dental waste segregation, collection, transportation, and treatment were determined to be week and substandard. Currently, different procedures related to dental waste management in health care facilities are not clearly described. The urgent need for the development of policies and regulations for the dental waste management is obvious. This study can be a starting point for future nation-wide surveys to assess knowledge, behavior and practices related to dental waste management among oral health care providers. In addition, more efforts should be directed to incorporate this subject into dental curriculum and continuous education courses.

A relação entre os profissionais da área odontológica e o plano de gerenciamento de resíduos de serviços de saúde / The relationship between dental professionals and the waste management plan of health services / La relación entre los profesionales de la odontología y el plan de gestión de residuos de servicios de salud

O presente artigo situa-se na linha de pesquisa do Curso de Especialização em Direitos Humanos e Saúde, oferecido pela Escola Nacional de Saúde Pública Sergio Arouca ­ Fundação Oswaldo Cruz, com foco na interseção entre o direito, a saúde e o ambiente. Trata-se de uma pesquisa bibliográfica, baseada no exame da legislação brasileira e de produções acadêmicas especificas a esse respeito. Seu objetivo é discutir a relação entre os profissionais da área odontológica e o plano de gerenciamento de resíduos de serviços de saúde. A relevância da pesquisa se encontra na hipótese de que a odontologia está enquadrada numa modalidade de prestação de serviços de saúde responsável pela produção de grande variedade de resíduos que acarretam diferentes tipos de riscos sanitários, sociais e ambientais, por conseguinte, necessita de dispositivos legais que fundamentem e legitimem o adequado gerenciamento dos resíduos odontológicos e, ao mesmo tempo, gere as condições para evitar comportamentos imperitos, imprudentes e negligentes por parte dos profissionais da área. (AU)

This article is located in the search line of Specialization in Health and Human Rights, offered by the National School of Public Health Sergio Arouca - Oswaldo Cruz Foundation, focusing on the intersection between law, health and the environment. This is a literature search, based on an examination of the Brazilian legislation and specific academic productions in this regard. Your goal is to discuss the relationship between dental professionals and waste management health services plan. The relevance of the research is the assumption that dentistry is framed in a mode of delivery of health services responsible for the production of wide range of waste that cause different types of health risks, social and environmental risks, therefore, requires legal provisions to justify and legitimize the proper management of dental waste and, at the same time, generate the conditions to avoid behaviors inexpert, reckless and negligent on the part of professionals. (AU)

Este artículo pertenece a una de las líneas temáticas del Curso de Especialización en Derechos Humanos y de Salud, ofrecido por la Escuela Nacional de Salud Pública Sergio Arouca ­ Fundación Oswaldo Cruz, con foco en la intersección entre el derecho, la salud y lo ambiental. Se trata de una búsqueda bibliográfica, en la que se examina la legislación brasileña y producciones académicas específicas. El objetivo es analizar las relaciones que se establecen entre los profesionales de la odontología y el plan de gestión de residuos de servicios de salud. La relevancia del tema radica en el hecho de que la actividad odontológica es prestadora de servicios sanitarios responsables por la producción de una amplia gama de residuos, asociados a diferentes tipos de riesgos sanitarios, sociales y ambientales y, por lo tanto, requiere de disposiciones legales justificar y legitimar la gestión adecuada de sus residuos y, al mismo tiempo, generar las condiciones para evitar comportamientos imperitos, imprudentes y negligentes por parte de los profesionales. (AU)

Clinical Evaluation of a Chairside Amalgam Separator to Meet Environmental Protection Agency Dental Wastewater Regulatory Compliance.

OBJECTIVES: The aim of this study was to evaluate the performance of a commercially available chairside amalgam separator (CAS) in a clinical setting in which a relatively high number of amalgam restorations are placed. Performance parameters investigated included service life, amalgam collected, mercury concentrations in effluent, and solids retention efficiency. METHODS AND MATERIALS: CASs were tested per International Organization of Standardization (ISO) 11143:2008 prior to installation in a military dental treatment facility and after removal from service (n=4) in order to confirm compliance with the recently enacted United States Environmental Protection Agency (EPA) Effluent Limitations Guidelines and Standards for the Dental Category. During the units' time in service, biweekly effluent grab samples were collected from the high-volume evacuation system of each chair (n=6) and analyzed for total mercury concentration by inductively coupled plasma mass spectrometry (ICP-MS). The mean total accumulated solids at the end of service life (n=6) was determined for potential design optimization. The service life expectancy in a military dental treatment facility was determined in terms of calendar and workdays. Procedural data were collected to determine the daily mean number of amalgam surfaces placed during the service life of each chairside amalgam separator (n=9). RESULTS: The CAS evaluated met minimum EPA compliance requirements when used in a military dental treatment facility. The solids removal efficiency at the end of service life was 99.82% ± 0.14% (n=4). The mean service life (n=8) was 131.6 ± 45.1 calendar days (67.1±37.6 workdays). Effluent mercury concentrations ranged from 0.05 to 11.93 mg/L. Total solids accumulated in each CAS (n=6) at the end of service life was 195.4 ± 63.4 g. The mean number of amalgam surfaces placed per workday during the service life span of each CAS was 8.4 ± 1.4.

Environmental sustainability and waste within the dental practice.

This paper forms part of a series of papers, seven in total, which have been requested by colleagues to help them as clinicians understand sustainability as it relates to dentistry. This paper focuses on waste and how the dental team can influence how waste is processed and disposed of. It is the authors' hope that this series of papers stimulates interest, debate and discussion and, as well as being economically responsible, ultimately motivates and inspires the dental team to be more socially and environmentally sustainable which in turn will help promote health and illness prevention.

Assessment of Awareness About Various Dental Waste Management Practices Among Dental Students and Practicing Clinicians

Abstract Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce "Know-Do gap" between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.

Variability of Greek dental solid waste production by different dentist groups.

The objective of this work was to compare the composition and production rate of Greek dental solid waste (DSW) produced by three dentist groups of Xanthi, Greece, defined according to the country of their dental education/training: (1) dentists educated in Greece and other European Union (EU) countries, (2) dentists educated in Turkey, and (3) dentists educated in former Soviet Union and repatriated to Greece. All DSW produced by a total of 2542 patients in 20 dental practices from Xanthi, Greece, was collected, manually separated, and weighed over a period of four working weeks and classified according to Greek regulations. Production data below are presented as average (standard deviation in parenthesis). The average unit production rates of total DSW were 415(303) and 51.2(19.1) g/patient/day for dentists educated in Greece and other EU countries, 365(160) and 64.0(21.7) g/patient/day for dentists educated in Turkey, and 302(349) and 54.3(46.8) g/patient/day for dentists educated in former Soviet Union. Daily DSW production was correlated with daily number of patients and regression correlations were produced. Statistical analysis using the Kruskal-Wallis non-parametric test was conducted to compare DSW production medians by the three dentist groups. Dentists educated in Turkey had statistically higher median patient-based unit production rates at α = 0.05 for total dental, total hazardous, total infectious, total toxic and domestic-type waste, compared to the other dentist groups.

Awareness of Biomedical Waste Management among Dentists associated with Institutions and Private Practitioners of North India: A Comparative Study.

AIM: The present study aimed to obtain information about knowledge, execution, and attitude toward biomedical waste (BMW) and its management. MATERIALS AND METHODS: In the present study, a self-administered closed-ended questionnaire was designed to conduct a cross-sectional survey. It was distributed among 614 dentists (institution associated or private practitioners) in the cities of North India. The questionnaire comprised 36 questions regarding knowledge, execution, and attitude toward BMW and its management. Frequency distribution and chi-square test along with paired t-test were used to compare the data obtained between the private practitioners and institution-associated dentists. RESULTS: The study showed that 80% private practitioners were aware of the categories of BMW as compared with 100% of institution-associated dentists. However, 41% dentists associated with institution were disposing the chemical waste directly into sewer and a surprising high number of private practitioners were discarding directly without any treatment. Furthermore, regarding the mandatory maintenance of BMW records, 100% institution-associated respondents were aware, whereas only 6.5% private practitioners knew about it. Regarding BMW management not frequently being followed, 78% of private practitioners believed extra burden as the reason. CONCLUSION: Most of the dentists had adequate knowledge regarding BMW policies and its management. Although it was being practiced in mostly all the institutes on a regular basis, the majority of private practitioners were not practicing it due to various reasons, such as financial burden, lack of availability of service, and poor attitude toward its management. CLINICAL SIGNIFICANCE: There is a need to make it compulsory and organize training sessions to educate the dental personnel and to establish the importance of proper management.

Composition, production rate and characterization of Greek dental solid waste.

The overall objective of this work is to determine the composition, characterization and production rate of Greek dental solid waste (DSW). This information is important to design and cost management systems for DSW, for safety and health considerations and for assessing environmental impact. A total of 141 kg of DSW produced by a total of 2542 patients in 20 dental practices from Xanthi, Greece was collected, manually separated and weighed over a period of four working weeks. The waste was separated in 19 sub fractions, which were classified in 2 major categories, according to Greek regulations: Domestic-type waste comprising 8% and hazardous waste comprising 92% by weight of total DSW. The latter was further classified in infectious waste, toxic waste and mixed type waste (infectious and toxic together), accounting for 88.5%, 3.5% and 0.03% of total DSW by weight, respectively. The overall unit production rates (mean ±â€¯standard error of the mean) were 381 ±â€¯15 g/practice/d and 53.3 ±â€¯1.4 g/patient/d for total DSW, 337 ±â€¯14 g/practice/d and 46.6 ±â€¯1.2 g/patient/d for total infectious DSW, 13.4 ±â€¯0.7 g/practice/d and 2.1 ±â€¯0.1 g/patient/d for total toxic DSW and 30.4 ±â€¯2.5 g/practice/d and 4.6 ±â€¯0.4 g/patient/d for domestic-type waste. Daily DSW production was correlated with daily number of patients and regression correlations were produced. DSW was subject to laboratory characterization in terms of bulk density, calorific value, moisture, ash and volatile solids content. Measured calorific values were compared to predictions from empirical models.

Composition, Production Rate and Management of Dental Solid Waste in 2017 in Birjand, Iran.

BACKGROUND: The presence of toxic and pathogenic agents in the dental waste products has made it to be classified as "hazardous waste." OBJECTIVE: To assess dental waste production rate and composition and approaches used to manage these waste products in 2017 in Birjand, Iran. METHODS: 48 dental clinics were evaluated in two months of 2017. Sampling was performed from each clinic 3 times a week. Samples were manually divided into 5 categories of chemical-pharmaceutical, infectious, semi-household, sharp and cutting materials, and toxic waste products, and weighed. A checklist containing 25 questions was used to evaluate the aspects of waste management in dental clinics. RESULTS: The total amount of waste products generated in dental clinics was 7848.02 kg/ year in which semi-household waste had the highest quantity (4263.411 kg/year) and toxic waste had the lowest quantity (9.275 kg/year). Components with the highest amounts in dentistry waste products were nylon gloves (16.7%), paper and cardboard (13.4%), latex gloves (10.8%), and pharmaceuticals (10.2%). Waste separation was restricted to sharp and cutting waste. More than half (57%) of dental units were equipped with amalgam filter. Fixing solutions were directly discharged to sewage in 48.6% of clinics. There was no program to reduce waste generation in 54% of the clinics. Autoclave was the main tool for sterilizing dental instruments. CONCLUSION: This study showed a remarkable share of recyclable materials in the composition of dental waste and lack of special approach to manage waste in dental clinics. It is necessary to plan for minimizing generation of, separating, and recycling waste at source.

Investigating cross-contamination by yeast strains from dental solid waste to waste-handling workers by DNA sequencing.

Trying to widen the discussion on the risks associated with dental waste, this study proposed to investigate and genetically compare yeast isolates recovered from dental solid waste and waste workers. Three samples were collected from workers' hands, nasal mucosa, and professional clothing (days 0, 30, and 180), and two from dental waste (days 0 and 180). Slide culture, microscopy, antifungal drug susceptibility, intersimple sequence repeat analysis, and amplification and sequencing of internal transcribed spacer regions were performed. Yeast strains were recovered from all waste workers' sites, including professional clothes, and from waste. Antifungal susceptibility testing demonstrated that some yeast recovered from employees and waste exhibited nonsusceptible profiles. The dendrogram demonstrated the presence of three major clusters based on similarity matrix and UPGMA grouping method. Two branches displayed 100% similarity: three strains of Candida guilliermondii isolated from different employees, working in opposite work shifts, and from diverse sites grouped in one part of branch 1 and cluster 3 that included two samples of Candida albicans recovered from waste and the hand of one waste worker. The results suggested the possibility of cross-contamination from dental waste to waste workers and reinforce the need of training programs focused on better waste management routines.

Awareness of Biomedical Waste Management in Dental Students in Different Dental Colleges in Nepal.

AIM: The aim of this study is to assess the awareness of biomedical waste management in dental students of various dental colleges of Nepal. METHODOLOGY: A structured pretested questionnaire was used among 434 (323 males and 111 females) undergraduate dental students of five different dental colleges of Nepal. First part of the questionnaire was used to describe demographic profile of the participants. Second part of the questionnaire assessed the knowledge, attitude, and practice regarding biomedical waste management. Chi-square test was applied to find out the association between different responses obtained from different colleges. RESULT: Majority (91.82%) of participants had a positive attitude towards safe management of biomedical waste. Regarding the knowledge of BMW management policies, majority of the students (83.1% to 98.9%) had positive attitude towards the safe management of biomedical waste, whereas more than 50% of the students were unaware of the guidelines laid down by Government of Nepal. Regarding biomedical waste disposal technique in the hospital, only 29.9% to 79.8% are aware; this shows that there is lack of strict protocol in the BMW management. Association between different responses and colleges for "improper waste management causes various health hazards" ranged from 93.3% to 98.9%. CONCLUSION: There exists a lacuna in the knowledge and practice of biomedical waste management among the undergraduate dental students in Nepal. Since the students had positive attitude towards addressing this concern, workshops and trainings related to proper biomedical waste management would be a step forward towards attaining a healthy environment for the future.

A Odontologia e o meio ambiente: como os Odontólogos tem realizado o descarte de reveladores e fixadores / Dentristy and environment: how Dentists have perfomed the disposal of developers and fixers

O exercício da Odontologia visa garantir higidez e a plena saúde bucal, entretanto, essa nobre atividade implica na geração de resíduos, os quais devem ser devidamente tratados para que sejam minimizados os impactos negativos sobre o meio ambiente e a sociedade. Muitos dos materiais utilizados na Odontologia são potencialmente danosos ao meio ambiente, caso seu descarte não seja realizado da forma correta. Em virtude disto, mostra-se essencial a conscientização dos cirurgiões-dentistas acerca do manejo e descarte recomendado, com vistas a amenizar, senão anular, os efeitos nocivos ao meio ambiente e à população. O descarte inadequado dos resíduos odontológicos acarreta poluição do solo e das águas, tendo consequências imensuráveis. Diante do enorme risco ocasionado pelo descarte inadequado dos resíduos odontológicos, faz-se necessário apurar quais condutas devem ser tomadas com vistas a minimizar tais riscos bem como quais os órgãos competentes para fixar diretrizes e regulamentar o assunto. Primordial é a consciência do dentista, que é o responsável por manusear diretamente os compostos e descartar seus resíduos. Igualmente importantes são a regulamentação e a fiscalização, as quais podem ser desempenhadas, concorrentemente, pelas diferentes esferas de governo. A nível federal, a Anvisa detém competência legal para tratar do assunto, havendo inclusive penalidades para condutas inadequadas. Entretanto, dada a carência de pessoal, a fiscalização federal nem sempre é realizada a contento, motivo pelo qual uma maior participação das administrações municipais mostra-se fundamental nesse processo. O presente trabalho consistiu em pesquisa realizada com 84 cirurgiões-dentistas do município de Guaratinguetá-SP, cujo objetivo principal foi verificar a destinação que estava sendo dada aos resíduos de reveladores e fixadores odontológicos e, subsidiariamente, também tomar conhecimento da consciência ecológica dos participantes. Ao término da pesquisa, identificou-se que a grande maioria dos cirurgiões-dentistas promovia a destinação de resíduos de maneira incorreta, mediante descarte na rede de esgoto (73,81%) e no meio ambiente (8,33%). Verificou-se também que 82,14% dos participantes não tiveram em sua formação acadêmica nenhuma disciplina que abrangesse o tema descarte de reveladores e fixadores odontológicos e 92,86% jamais presenciaram palestra ou congresso que tratasse do tema. No tocante à composição química de reveladores e fixadores, 78,31% dos entrevistados não detinham tal conhecimento. Conclui-se que apenas pequena parcela dos profissionais procede corretamente quanto ao descarte dos resíduos químicos, mostrando oportuna a inclusão de conteúdo na grade curricular dos cursos de Odontologia(AU)

ABSTRACT The practice of dentistry aims to guarantee hygiene and full oral health, however, this noble activity implies the generation of waste, which must be properly treated in order to minimize negative impacts on the environment and society. Many of the materials used in dentistry are potentially harmful to the environment if their disposal is not performed correctly. Because of this, it is essential to raise the awareness of dentists about the recommended management and disposal, with a view to mitigating, if not annulling, the harmful effects on the environment and the population. Inadequate disposal of dental waste results in pollution of the soil and water, with immeasurable consequences. In view of the enormous risk posed by the inadequate disposal of dental waste, it is necessary to determine which measures should be taken with a view to minimizing such risks as well as which bodies are competent to set guidelines and regulate the subject. Primordial is the awareness of the dentist, who is responsible for handling the compounds directly and discarding their waste. Equally important are regulation and oversight, which can be performed concurrently by different spheres of government. At federal level, Anvisa has legal competence to deal with the matter, including penalties for inappropriate conduct. However, given the shortage of personnel, federal supervision is not always carried out satisfactorily, which is why a greater participation of municipal administrations is fundamental in this process. The present study consisted of a survey carried out with 84 dentists in the city of Guaratinguetá-SP, whose main objective was to verify the destination that was being given to dental developers and dental fixatives, and, in the alternative, also to be aware of the ecological awareness of the participants. At the end of the research, it was identified that the great majority of dental surgeons promoted the disposal of waste in an incorrect manner, by discarding the sewage network (73.81%) and the environment (8.33%). It was also verified that 82.14% of the participants did not have in their academic formation any discipline that covered the discard theme of dental developers and fixators and 92,86% never attended a lecture or congress that dealt with the theme. Regarding the chemical composition of developers and fixatives, 78.31% of interviewees had no such knowledge. It is concluded that only a small number of professionals proceed correctly regarding the disposal of chemical residues, showing timely inclusion of content in the curriculum of the Dentistry courses(AU).

Geração de resíduos odontológicos de diferentes especialidades clínicas / Generation of dental waste during different clinical specialties

Objetivo: Investigar a massa de resíduos de serviços de saúde (RSS) de origem odontológica produzida com o atendimento clínico de diferentes especialidades em instituição de ensino público no estado de São Paulo. Material e método: Foram pesados os RSS de origem odontológica gerados nas diferentes clínicas da Faculdade de Odontologia assim como anotados os procedimentos odontológicos aplicados em cada atendimento em formulário específico. Resultado: Ao total foram pesquisadas 10 especialidades odontológicas, com a realização de 229 atendimentos e peso médio por atendimento de 166,62 g de RSS odontológicos. Observou-se um número médio de 1,17 a 2,83 de procedimentos por atendimento e que o peso médio por atendimento por especialidade variou entre 84,08 e 387,39 g, sendo que as especialidades que mais geraram RSS odontológicos foram às relacionadas à prática de cirurgia, enquanto que a especialidade que menos gerou massa de resíduos foi a Odontopediatria. Dos 133 procedimentos utilizados na Faculdade de Odontologia, 39 procedimentos foram isolados a partir dos atendimentos que aplicaram apenas um procedimento. Gerou-se um índice de potencial de geração de RSS odontológicos para cada um destes 39 procedimentos e verificou-se que o procedimento "exodontia de dente permanente" apresentou o maior potencial de geração de RSS. Observou-se que os estudantes de Odontologia focavam mais na segurança do paciente do que na observância da destinação dos RSS gerados. Conclusão: Constatou-se com a presente pesquisa que na ausência de um plano de gerenciamento de RSS na instituição, há a possibilidade de uma produção exagerada de RSS odontológico na Universidade(AU)

Objective: To investigate the mass of dental waste produced within different specialties of clinical care in a public education institution in the state of São Paulo. Material and method: The researcher weighed the waste of dental origin generated in the different clinics of the Faculty of Dentistry as well as noted the dental procedures applied in each attendance in a specific form. Results: A total of 10 dental specialties were studied, with 229 consultations and average weight per clinical care of 166.62 g of dental waste. It was observed that the average number of procedures performed by specialty care varied between 1.17 and 2.83 and that the average weight per clinical care per specialty varied between 84.08 and 387.39 g, and the specialties that generated the most dental waste were those related to the practice of surgery, while the specialty that generated less mass was the Pediatric Dentistry. 39 of the 133 procedures were isolated among those clinical cares that applied only one procedure. An index of potential dental waste generation was calculated for each of these 39 procedures and it was verified that the procedure "permanent tooth exodontia" presented the greatest potential of waste generation. It was observed that dentistry students focused more on patient safety than on observing the destination of dental waste generated. Conclusion: It was verified with the present research that in the absence of a dental waste management plan in the institution, there is the possibility of an overproduction of odontological waste in the University(AU)

O reencape de agulhas e descarte de resíduos odontológicos do Grupo E por estudantes de uma universidade pública brasileira / Manejo de agujas y deseche de residuos odontológicos del grupo e por estudiantes de una universidad pública brasileña / Handling of needles and dental waste disposal of group e by students of a Brazilian public university

RESUMO A prática da odontologia predispõe o académico a sofrer acidente com material biológico. Objetivou-se neste trabalho verificar a adesão às precauções padrão, em especial a recomendação de não reencapar agu lhas, bem como o descarte de resíduos odontológicos nos recipientes do grupo E, baseado no comportamento revelado pelos estudantes de odontologia de uma universidade pública brasileira. Coletaram-se todos os recipientes de descarte utilizados no ano de 2016 nas clínicas da faculdade, os quais foram levados para sala de expurgo para análise. Inicialmente, realizou-se a separação das agulhas conforme o tipo de reencape e também de outros materiais descartados. Posteriormente, procedeu-se à contagem das agulhas colocadas sobre uma bancada forrada, com a ajuda de uma pinça longa. No total, foram analisados 111 recipientes de descarte do grupo E, com 6.729 agulhas descartadas. Destas, 1.078 (16%) estavam reencapadas nos dois lados, 1.960 (29,1%) em um lado e 3.691 (54,9%) sem reencape. Além disso, foram observa dos diferentes materiais não perfurocortantes descartados, incluindo películas radiográficas e dentes humanos. Conclui-se que a adesão dos estudantes às precauções padrão, especialmente à recomendação de não reencapar agulhas, é baixo. Os recipientes de descarte de perfurocortan-tes estão sendo utilizados de maneira incorreta.

RESUMEN La práctica de la Odontología predispone el estudiante a accidentes con material biológico. Este estudio tuvo como objetivo verificar la adhesión de alumnos a las precauciones estándares, en especial la recomendación en el manejo de agujas, así como el deseche de residuos odontológicos en recipientes del grupo E, basado en el comportamiento revelado por los estudiantes de odontología de una universidad pública brasileña. Se recolectaron todos los recipientes de deseche utilizados en el año de 2016 en las clínicas de la facultad, los que se llevaron para el sector de expur go para análisis. Se separaron las agujas según el tipo de manejo y también otros materiales desechados. Se procedió el contaje de agujas sobre una bancada forrada con ayuda de una tenaza larga. En el total, se analizaron 111 recipientes de deseche del grupo E, con 6.729 agujas desechadas. De esas, 1.078 (16%) mantenían su capuchón plástico en ambos lados, 1.960 (29,1%) en solo un lado y 3.691 (54,9%) no tenían su capuchón. Además, se observaron diferentes materiales punzocortantes desechados, entre ellos películas radiográficas y dientes humanos. Se concluye que la adhesión de los estudiantes a las precauciones estánda res, en especial a la recomendación de no manejar agujas, es baja. Los recipientes de deseche de punzocortantes están siendo utilizados de manera incorrecta.