Patient safety and risk management is crucial aspect in dental practice. Occupational hazards come along with every procedures in medical/ dental clinical setup, but it’s the skill of the operator that can prevent or manage the mishap. Avoiding the mishap should be the primary goal of the clinician. 

During operative dental procedures patient safety is of utmost importance. Accidents can happen, but the risk of these must be minimized or totally eradicated and this approach is known as risk management.

Patient safety measures during dental treatment

The dangerous vulnerable areas of the patient during a dental treatment are: 

• Eyes
• Ears 
• Airway 
• Oral Soft tissues 

Eyes of the patient can get injured by slippage of instruments or any other material used during dental treatment. It can occur to the clinician or any other assisting staff at clinic. The operator, the assistant, and the patient should wear protective eyewear to prevent eye damage. When high speeds are used, particles of old restorations, tooth structure, bacteria, and other debris are discharged at high speeds from the patient’s mouth. Patient safety measures include use of high-volume evacuation or suction applied by the dental assistant near the operating site. The light curing unit used emits light and can have an impact to the eyes of the patient as well as dental team. Dental personnel and patients should be protected from high-intensity visible light with the use of colored plastic shields.

Ear precautions of the patient as well of dental team is important, as dental treatment involves noises. Any noise above 75 to 80 decibels are known to cause ear damage. Handpiece wear and eccentric rotating instruments can cause increased noise. Patient safety measures includes use of well maintained equipments and instruments, ear plugs and room sound proofing. 

Aspiration of any dental instruments such as files during root canal treatment, any restorative material can be very risky and may be fatal too.  In view of patients, to avoid this mishap, rubber dam should be used. If the patient has already aspirated, trying to get the material out by making patient sit upright and shifting to medical set up as soon as possible and a chest x-ray must be done at earliest. Inhalation of aerosols by dental team is a risk as well. Wearing of respirators or masks by dental team can help avoid inhalation of unwanted things in the dental setup. 

Iatrogenic soft tissue damage by instruments or sudden movement of patient in the dental chair during the operative procedure can occur. Dental materials spillage in oral cavity such as sodium hypochlorite or irritational dental material can cause patient discomfort. Burns, lacerations, grazes, surgical emphysema can occur due to chemical agents. 

Take home message 

Avoiding these mishaps and knowledge to manage if it occurs is important. Its better to take all the precautions before commencement of the procedure to ensure patient safety and also the safety of healthcare personnel. 

Article by Dr. Siri P.B.