The role of biomaterials as occupational hazards in dentistry

Many of the biomaterials and auxilliary products used in dentistry are chemically and biologically reactive and may be of concern in occupational safety programmes. Observations from 1936 to 1975 indicated that most occupational problems were related to skin contact with procaine, soaps, eugenol, iodine, formalin, phenol, and other disinfectants. Methyl methacrylate monomer was identified as an irritant and allergen in the later part of this period. Investigations from 1975 to 1985 indicated that disinfectants and detergents were still important causes of dermatoses, whereas reactions to procaine had been replaced by reactions to pantocaine. Furthermore, adverse reactions to methyl methacrylate monomer and to elastomeric impression materials had replaced the former iodine, tricresol and eugenol reactions. In recent studies the frequency of occupation-related dermatoses varied from 21 per cent to 43 per cent, depending on the prevailing material usage in the various specialties. Reactions to local anaesthetics seemed to have disappeared. Transient, irritative reactions of the eyes and airways have been observed, mostly associated with exposure to volatiles from resin-based materials, X-ray chemicals and cleansers. The occupational problems related to biomaterials in dentistry seem to have been fairly constant over the years, reflecting the type of materials in common use, and with dermatological disorders being a tenacious companion. Neuropathological conditions in dental technicians have been associated with prolonged exposure to vapours of methyl methacrylate monomer. The more recent extensive use of volatile resin-based materials, and the use of protective gloves seems to have created new problems that need to be investigated.