title: High incidence of blood exposure due to imperceptible contaminated splatters during oral surgery.
abstract: OBJECTIVE
  To evaluate the incidence of blood exposure during outpatient oral surgery from splattering caused by use of high-speed rotary instruments at the Referral and Teaching Center, University Dental Hospital.
  
  
  METHODS
  Twenty-five consecutive patients who had impacted mandibular third molars were selected. The attending surgeon wore an operation gown and visor mask, and carried out the tooth extraction with the regular procedure. We counted the number of bloodstains found on the operation gown and visor mask, and confirmed the presence of diluted and invisible bloodstains using a leucomalachite green presumptive test, which was able to detect dilutions up to 1:4,000.
  
  
  RESULTS
  There were 469 separate bloodstains on the gown and visor mask of oral surgeons, which came from 19 (76%) of 25 patients during impacted mandibular third molar surgery. Presumptive tests for invisible bloodstains resulted in 1,206 positive reactions, 2.57-fold greater than the visible stains, from 88% of the cases. All of the surgeons were right-handed and the common areas of staining were the right forearm, face, and thorax regions.
  
  
  CONCLUSIONS
  Dental procedures with high-speed instruments exposed surgeons to possible blood-borne infections by splashing in nearly 90% of the cases. Greater than 50% of the stains were invisible to the naked eye. Based on our results, strict compliance with barrier precautions, including routine use of an operation gown and visor mask, is recommended whenever oral surgery is carried out with high-speed rotary instruments.
authors: First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan. ishihama@dent.osaka-u.ac.jp
authors: Kohji
authors: K
authors: Ishihama
authors: Seiji
authors: S
authors: Iida
authors: Hidehiko
authors: H
authors: Koizumi
authors: Takenobu
authors: T
authors: Wada
authors: Tadafumi
authors: T
authors: Adachi
authors: Emiko
authors: E
authors: Isomura-Tanaka
authors: Tadashi
authors: T
authors: Yamanishi
authors: Akifumi
authors: A
authors: Enomoto
authors: Mikihiko
authors: M
authors: Kogo
mesh_terms: D000293:Adolescent; D000328:Adult; D001801:Blood Stains; D017848:Blood-Borne Pathogens; D003754:Dental High-Speed Equipment / Q000009:adverse effects*; D003815:Dentists; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000379:methods*; D008297:Male; D008964:Molar, Third / Q000601:surgery; D016273:Occupational Exposure; D011446:Prospective Studies; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery; D016635:Universal Precautions