Thursday, July 30, 2020

Dentist- the sacrificial lamb of the millennium (Covid-19 effect)


It is interesting to take a look at the life expectancy of dentists. A 2007 article by Randy Lang, “Stress in Dentistry - It could kill you!” in ‘Oral Health’, reported that dental literature confirms dentists are subject to a variety of stress-related physical and emotional problems. He elucidates:
STUDIES AND STATISTICS
* The suicide rate of dentists is more than twice the rate of the general population and almost three times higher than that of other white collar workers.
* Emotional illness ranks third in order of frequency of health problems amongst dentists, while in the general population it ranks tenth.
* Coronary disease and high blood pressure are over 25% more prevalent among dentists than in the general population.
* Dentists suffer psycho-neurotic disorders at a rate of 2 1/2 times greater than physicians.
* The #1 killer of dentists is stress-related cardiovascular disease.
* The dental profession in North America loses the numerical equivalent of one large dental school class each year.
And then, CDC said in its Morbidity and Mortality Weekly Report that the dental professionals were 23 times more likely to have IPF (Idiopathic Pulmonary Fibrosis) than the rest of the population. IPF causes scarring of the lungs. Something in their workplace environment may have been poisoning them, investigators said, although they don’t know what.

Starting from a disadvantageous position

So a dentist’s life is starting with a disadvantage, and literally they are in a unique position. Majority of hours are spent bending over a patient in an awkward position, their necks often bent or crimped, their backs strained while trying to peer into the depths of their patient’s mouths and holding tools for long periods of time. Now with the microscope dentistry, they are forced to sit in a taut straight back position which can be very bad for the spinal health.

Covid-19, the last straw that may break the camel’s back?

Now with all the precautions and preparations that a dentist is supposed to adhere to while attending a patient, it looks like they are the sacrificial lambs of the millennium. Let us take a closer look. 

First of all, take a look at how a dentist has to wear the PPE (Personal Protective Equipment) here . While sealed inside the PPE, one starts sweating profusely. Just watch the above video at 10.59 minute to see his wet shirt in this much short time of showing how to wear and remove the PPE. When the dentist works for hours in the clinic, imagine the wet clothe inside the PPE!

Gloves

In the above video, you will see that the dentist has to wear two pairs of gloves, the first is one size smaller. Even with the correct size glove, how I used to wait for the moment of finishing the dental work so that my hands could be freed and the skin could breathe!
Wearing a pair of gloves one size smaller is unthinkable for me, but the practicing dentist has no other go. He/she has to tolerate the hands being cramped for hours together. This is added to the high incidence of carpel tunnel syndrome among dentists due to repetitive motions and the demands on their hands.
A study was published in 2011 on the ‘Effects of Wearing the Wrong Glove Size on Shoulder and Forearm Muscle Activities'. Almost all subjects mentioned that their hands felt fatigued in the gloves that were one size smaller—a sensation that would likely increase if the gloves were worn for longer periods.  Wearing the wrong glove size led to decreased forearm muscle activation, that resulted in increased shoulder movements. Myofascial pain syndrome in the shoulder may be caused by the continuous operation of inefficient shoulder and forearm muscle activation patterns while wearing gloves of the wrong size during tasks that require manual dexterity.
Healthy hands are important for many activities in our life and if their health is non-optimal, dentists have a compromised life!

Masks

Dentists are more prone to acquire infections through saliva and aerosols. Surgical masks (SMs) are used by dental professionals to reduce microorganisms shedding from the mouth, nose, and face of the patient. Dental clinics are places with a high concentration of various infectious microorganisms, present on the surgical mouth masks used by dental professionals. A recent (2020 February) study performed for the assessment of bacterial and fungal contamination on the used surgical masks among dental professionals found that most of the micro-organisms isolated from the used surgical mouth mask were potentially pathogenic. Dental professionals should change the mask after each dental operatory procedure, especially those beyond 2 hours. Double-layered surgical mask or 95% efficiency for aerosol particles of 3.0 to 5.0 μm in diameter should be provided to patients as well to prevent cross-contamination.
Continuous use of face mask causes reduction of oxygen in the blood, reduction of oxygen to the brain, one starts feeling weak and it can even lead to death.
While wearing the PPE, in 15 to 20 minutes the mask and the clothes get wet. One cannot drink water or use the toilet till the PPE is removed, which may be after several hours. On a lighter note, all lady dentists have to forget about wearing saris and other Indian dresses and hair styling during the clinic hours!


References:

2 comments:

Sam said...

I am looking for article regarding stress management in dentistry.
Dentist stress level

Prof. Dr. Beena Rani Goel said...

Watch this and the next two videos for a stress free living: https://www.youtube.com/watch?v=k33Zqx2QfHE