Despite numerous technical advances in recent years, many occupational health problems still persist in modern dentistry. These include percutaneous exposure incidents (PEI); exposure to infectious diseases (including bioaerosols), radiation, dental materials, and noise; musculoskeletal disorders; dermatitis and respiratory disorders; eye injuries; and psychological problems. PEI remain a particular concern, as there is an almost constant risk of exposure to serious infectious agents. Strategies to minimise PEI and their consequences should continue to be employed, including sound infection control practices, continuing education and hepatitis B immunisation. As part of any infection control protocols, dentists should continue to utilise personal protective measures and appropriate sterilisation or other high-level disinfection techniques. Aside from biological hazards, dentists continue to suffer a high prevalence of musculoskeletal disorders (MSD), especially of the back, neck and shoulders. To fully understand the nature of these problems, further studies are needed to identify causative factors and other correlates of MSD. Continuing education and investigation of appropriate interventions to help reduce the prevalence of MSD and contact dermatitis are also needed. For these reasons, it is therefore important that dentists remain constantly informed regarding up-to-date measures on how to deal with newer technologies and dental materials.

Cyanoacrylate (CA) and its homologues have a variety of medical and commercial applications as biological adhesives and sealants. Homologues of CA are being widely promoted in surgery as a tissue adhesive to replace traditional suturing techniques. Potential benefits of using CA adhesives include better cosmetic results, more rapid wound closure, and perhaps most significantly, the potential for significant reductions in percutaneous injuries from suture needles, which would in turn also reduce the risk of transmission of infectious diseases. Nevertheless, certain concerns have been raised regarding the potential toxicity of CA within patients, as well as among health professionals who are occupationally exposed when using CA compounds. Reported toxicity of CA in the workplace may result in dermatological, allergic and respiratory conditions. To help reduce the occupational burden, therefore, medical staff using CA adhesives should avoid direct contact with the compound and use appropriate personal protective measures at all times. Maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in surgical suites and operating theatres may also be useful in minimizing the exposure to volatile CA adhesives.

Aims:To investigate the prevalence and nature of some occupationally related health problems in dentists in southern Thailand. Design: A cross-sectional study using a self-report questionnaire distributed to all 220 dentists working in 14 provinces in southern Thailand in 1997. Participants: One hundred and seventy-eight dentists aged between 22 to 54 years responded. Results: The most common occupational health problems were musculoskeletal pain (78 per cent) and percutaneous injury (50 per cent). Associated factors were analysed using multivariate analysis. About 22 per cent of these dentists had a history of contact dermatitis mostly caused by allergy to latex gloves, 15 per cent had eye problems, and 3 per cent had hearing problems. Conclusions: Continuing education in the avoidance of percutaneous injuries would be beneficial, as exposure to potential infectious agents is of concern. Further studies are needed to identify causes of musculoskeletal pain and to identify appropriate interventions to reduce its prevalence, as would similar measures to reduce exposure to agents which may be producing contact dermatitis.

Three heat-cured and three autopolymerized acrylic denture bases with different mixing proportions and/or processing methods were investigated for the amount of residual monomer content and methyl methacrylate (MMA) released into saliva after incubation during the first and second 24 hours after processing. A corresponding range of concentrations of MMA was also used to test for cell cytotoxicity using a culture of human oral fibroblasts. The results showed that the amount of residual monomer was dependent not only on the type of polymerization but also on the amount of liquid in the mixture ratio and the processing method. The acrylic resin that had the lowest residual monomer also released the smallest amount of MMA but resins which have higher residual monomer may not necessarily release higher amounts of MMA. MMA, tested in the same range of concentration as the MMA found leached from acrylic resin in this study, was found to be toxic in the cell culture. Therefore, it is recommended that dentists attempt to reduce the amount of leachable substances before insertion of new dentures. In addition, it is recommended that dentists advise their patients not to wear newly made dentures overnight, as this may cause mucosal irritation from the potential accumulation of leachable substances.

A number of sources of bacterial aerosols exist within and outside the dental clinic. The concentration of bacterial aerosols and splatters appears to be highest during dental procedures, especially those generated by some procedures such as ultrasonic scaling, or using a high speed drill. Several infectious diseases could be transmitted to staff and patients by airborne bacterial and other contaminants in the dental clinic. Air-conditioning and ventilation systems should be regularly maintained to reduce environmental contaminants and to prevent recirculation of bacterial aerosols. Pre-procedural rinsing by patients with mouthwashes as well as vacuum and electrostatic extraction of aerosols during dental procedures could also be employed. Dental staff should also consider appropriate immunizations and continue to use personal protective measures, which reduce contact with bacterial aerosols and splatters in the dental clinic.

Methyl methacrylate (MMA), a monomer of acrylic resin, has a wide variety of dental, medical and industrial applications. Concerns have been raised regarding its potential toxicity in dental use, both for the patient and also in the workplace. Dental patients are also exposed to MMA leached from some dental appliances and the effects, at least in vitro, appear toxic to cells and may cause local mucosal irritation or even an allergic reaction. When exposed to MMA in the dental clinic, dentists and other dental staff appear to occasionally suffer hypersensitivity, asthmatic reactions, local neurological symptoms, irritant and local dermatological reactions. The integrity of latex gloves may also be compromised after exposure to MMA during dental procedures. MMA is not thought to be carcinogenic to humans under normal conditions of use. Techniques should be employed to reduce patients' exposure to MMA during dental procedures in order to reduce the risks of possible complications. Dental staff should avoid direct contact with MMA and room ventilation should be optimised.

Cyanoacrylate (CA) and its homologues have a variety of medical, dental and commercial applications as adhesives. The increasing use of CA in dentistry, particularly as an adhesive and sealing glue, has raised concerns regarding its potential toxicity in humans. Reported toxicity of CA is uncommon in the dental workplace, but may manifest as conditions such as urticaria, contact dermatitis and other dermatoses. Dental staff using CA adhesives should avoid direct contact with CA and use appropriate personal protective measures. Maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in the working environment may be useful in minimising the toxicity of volatile CA adhesives.

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