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)

Impact of pedagogical method on Brazilian dental students' waste management practice.

The purpose of this study was to conduct a qualitative analysis of waste management practices among a group of Brazilian dental students (n=64) before and after implementing two different pedagogical methods: 1) the students attended a two-hour lecture based on World Health Organization standards; and 2) the students applied the lessons learned in an organized group setting aimed toward raising their awareness about socioenvironmental issues related to waste. All eligible students participated, and the students' learning was evaluated through their answers to a series of essay questions, which were quantitatively measured. Afterwards, the impact of the pedagogical approaches was compared by means of qualitative categorization of wastes generated in clinical activities. Waste categorization was performed for a period of eight consecutive days, both before and thirty days after the pedagogical strategies. In the written evaluation, 80 to 90 percent of the students' answers were correct. The qualitative assessment revealed a high frequency of incorrect waste disposal with a significant increase of incorrect disposal inside general and infectious waste containers (p<0.05). Although the students' theoretical learning improved, it was not enough to change behaviors established by cultural values or to encourage the students to adequately segregate and package waste material.

An investigation of the disposal of dental clinical waste in Bangkok.

This study investigated the disposal of clinical waste within dental surgeries in Bangkok, Thailand and followed the waste trail to the rubbish tips. A questionnaire was sent to all dental practices in the Bangkok Metropolitan Area. The response rate was 57.7 per cent. At the same time, rubbish collectors and scavengers were interviewed to see if they encountered clinical dental waste. Few dentists complied with all recommendations for the disposal of waste. Most waste was disposed of into the domestic rubbish stream. Rubbish collectors and scavengers knew what dental rubbish looked like and some had had needle-stick injuries. Although recommendations can be made to the dental profession to alter their behaviour, real improvement is unlikely without changes to legislation and social policy.

Audit of waste collected over one week from ten dental practices. A pilot study.

An audit of the waste practices of ten general dental surgeries identified problems that have occurred due to the lack of specific dental guidelines or codes of practice in this area. Occupational health and safety requirements for types and locations of sharps containers, and lack of consensus on what constitutes a sharp, were identified as areas needing attention. Cross-infection control items, such as gloves, masks, single-use cups, and protective coverings, were found to constitute up to 91 per cent of total waste. When infectious waste was reclassified by the audit team as 'that waste which was visibly blood stained,' a reduction in waste in this category was made, during the audit, at each practice. The practice of disposing of radiographic fixer and developer into the sewerage system occurred in three out of the ten practices, even though the Australian Dental Association Inc. has discouraged this practice.