A national survey was conducted to investigate current procedures in New Zealand dental practices for disposal of clinical waste. A questionnaire was sent out to all dental practices in New Zealand, and non-returns were followed up by two further mailings. From three mailings 767 useable questionnaires were returned (71.3% of those sent out, 79.0% of those potentially valid). Responses indicated that 56.4% of dental practices disposed of bloody swabs into the waste paper bin, and 24.4% disposed of contaminated sharp items into the general household refuse collection. Qualitative interviews with dental practitioners revealed a lack of concern about disposal of contaminated waste into the general waste. The existence of legislation governing waste disposal was not sufficient to motivate many practitioners to comply with guidelines. In some areas there was no specialised waste disposal service available, but some dentists had rejected a specialised service on the grounds of cost or inconvenience. Substantial efforts were made to salvage amalgam waste to be sold for scrap.
Electric pulp testers (EPTs) are widely used to assess tooth pulp vitality. With many unipolar EPTs the electrical circuit is completed through the operator. Since dentists now routinely wear rubber gloves, these might be expected to provide electrical insulation, and therefore to break the circuit. The objective of this investigation was to define the electrical effect of wearing rubber gloves. Two battery-powered unipolar EPTs were examined using a digital storage oscilloscope with an input impedance of 1 M omega. The probe tip was connected directly to the positive input lead of the oscilloscope. Three conditions were tested: (i) with the conductive handle connected directly to the negative input lead; (ii) with the ungloved operator holding the negative input lead in one hand and the conductive handle of the EPT in the other; and (iii) holding the conductive handle in a gloved hand. While the two EPTs produced different patterns of voltage spike, for each there was no difference between conditions (i) and (ii). However, when the conductive handle was held in a gloved hand (condition iii), there was a reduction in peak negative voltage and a change in wave form with positive overshoot. The alteration in wave form could be reproduced by substitution of the operator's gloved hand with a capacitance of 47 pF. These results support the hypothesis that a rubber glove acts partly as a capacitor in series with the electric pulp tester, and will alter the performance of EPTs unless the glove is bypassed electrically.
Summary. A case is reported in which endodontic treatment of an upper central incisor was delayed by repeated failure of the temporary dressing. The cause of failure was not identified until a sewing needle was found lodged in the canal. The patient had repeatedly removed the dressing, possibly in an effort to gain attention.
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