WASHINGTON, USA: Although dental practices generally use a scavenging system to minimize exposure to nitrous oxide, many do not execute the recommended control steps—such as checking equipment for leaks—when performing dental procedures. To investigate the extent to which these exposure controls are used, the National Institute for Occupational Safety and Health (NIOSH) conducted a survey among members of professional practice organizations representing dentists, dental hygienists and dental assistants.
The anonymous NIOSH survey was completed by 284 dental professionals in private practice who had used nitrous oxide on adults or children in the previous week. The use of scavenging nasal hoods or local exhaust ventilation (LEV) around a patient’s mouth when using nitrous oxide was almost universal, with more than 93 percent of respondents employing this equipment.
However, adherence to other recommended precautionary practices was lacking to varying degrees. Fifty-one percent reported that they did not check for leaks before using the gas on adult patients, and 47 percent did not check prior to a procedure on pediatric patients. Other findings were that 13 percent of dental staff started the nitrous oxide gas flow before an airway mask had been applied to the patient and that 8 percent failed to turn off the nitrous oxide gas flow before turning off the oxygen flow to the patient.
Furthermore, 13 percent of the dental practices did not have standardized procedures for minimizing nitrous oxide exposure, and 3 percent reported a lack of training on safe handling and administration of nitrous oxide.
“Successful management of nitrous oxide should include nasal scavenging masks, supplementary LEV if needed, adequate general ventilation, regular inspection of nitrous oxide delivery and scavenging equipment for leaks, availability of standard procedures to minimize exposure, periodic training and medical surveillance,” NIOSH stated.
The study, titled “Exposure control practices for administering nitrous oxide: A survey of dentists, dental hygienists, and dental assistants,” was published in the June edition of the Journal of Occupational and Environmental Hygiene.
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