I SAID, IS DENTISTRY MAKING YOU DEAF?
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- Published: Friday, 04 March 2022 10:20
- Written by Peter Ingle
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Part of a busy GDP’s career progression was that the high speed drills and ultrasonics which they used, became quieter after a few years. Perhaps not so much as a result of improved technology but their users becoming increasingly deaf. Or so many dentists assumed.
There was the cruel irony that by the time you could afford the state of the art sound system or tickets for the opera, that you wouldn’t be able to appreciate them. Few who have used them will forget the screech of one particular legendary brand of turbine famous for its cutting ability, as well as its ability to survive without lubrication.
A paper published in BDJ Team set out to review the available research on dentistry and hearing loss. Sarah Duerden and Bev Littlemore posed the question “Is noise induced hearing loss increased in dental clinicians who use the high-speed handpiece compared to dental professionals who use other noise inducing dental equipment?”
To provide some background NIHL (Noise Induced Hearing Loss) is estimated to be responsible for 16% of disabling hearing loss, worldwide. Over exposure to hazardous sounds can lead to tinnitus, itself an early warning sign of NIHL, hearing impairment and hearing loss. This in turn can lead to other problems such as hypertension, sleep disturbance, emotional frustration and general annoyance. At this point many readers thinking of their practice principals, must have been nodding their heads in agreement.
Offending dental equipment included not just high speed turbines, but slow speed handpieces, ultrasonic devices, mixers, suction systems and compressors. There was no escape in the dental laboratory with stone mixers and model trimmers contributing to the noise problem. The hard surfaces in dental environments make matters worse by reflecting the noise. Turbines sit at the top of the list of noise makers. While newer models are somewhat quieter, aged, and poorly maintained ones can easily exceed 100dB. The USA National Institute for Occupational Safety advises avoiding exposure to levels greater than 100dB for more than 15 minutes, to minimise hearing loss.
Despite this, at the time of writing, there was no systematic review comparing NIHL in team members using turbines with other dental professionals. Working with UCLan School of dentistry’s ethics lead, the writers set out their research question, and a literature search yielded 58 relevant citations. Further screening left just four studies to be examined. Even these four studies scored poorly for quality and bias. Overall trends were not clear with conflicting findings regarding dentists being more affected that other team members.
Readers of dental SR’s will not be surprised by the conclusions. A firm conclusion, “cannot be reached due to the limitations and low quality of the evidence available.” Again, as expected, “further high quality longitudinal studies are required” in order to assess if NIHL is greater in those that use turbines. The limitation in quality also meant that specific recommendations on suitable preventative measure could not be made, however some areas to consider were offered. These included treatment types being booked, age of equipment and its maintenance. To give practice managers something else to think about, the authors concluded that either passive or active earplugs might become a key part of dental PPE.
Hearing loss
As a retired GDP I have the hearing of an 85 year old but am only 70. I use some very expensive hearing aids and get on pretty well.Sadly I have used ear protection in the last twenty years if work but still have loss. I think the edict to remove curtains and other soft furnishing made things so much worse and noisy.
My nurse for 30 years also uses aids at age 58.
Its a no brainer that dental surgeries are dangerous to your hearing.
There should be much much more awareness of this in the profession
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