High incidence of blood exposure due to imperceptible contaminated splatters during oral surgery.
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.
Ishihama
Kohji
K
First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan. ishihama@dent.osaka-u.ac.jp
Iida
Seiji
S
Koizumi
Hidehiko
H
Wada
Takenobu
T
Adachi
Tadafumi
T
Isomura-Tanaka
Emiko
E
Yamanishi
Tadashi
T
Enomoto
Akifumi
A
Kogo
Mikihiko
M
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