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Introduction: After wearing a complete denture, the patient most care for his/her denture and most maintain a good hygiene habit for long term use of the prosthesis. Even after giving denture care instructions at the denture delivery appointment many patients may not fully understand the instructions. This study was performed to assess the denture hygiene habit and denture care procedure being undertaken by complete denture patients coming for treatment in a private dental college. Methods: A descriptive cross-sectional study was conducted among 140 complete denture wearing patients visiting Department of Prosthodontics, Chitwan Medical College from Sep 2021 to Mar 2022. A questionnaire was prepared and used to collect data which included various questions regarding denture hygiene and denture care being undertaken by patients. Descriptive statistical analysis (frequency and percentage) was performed on the data collected by using SPSS Statistical Software Package (version 21.0). Results : A total of 140 responses were included in this study. Out of the patients who responded 52.85% (N=74) were wearing the same denture for less than 5 yrs while 27.85% (N=39) were wearing the denture for more than 5 yrs. Most of them i.e., 73.5% were removing the prosthesis at night time and 61.4% were keeping the denture inside water when removing at night. Out of the participants, 81.42% were cleaning the prosthesis outside of mouth while 18.5% were cleaning the denture both inside and outside of the mouth. All of them were using a toothbrush to clean the denture. More than half (52.14%) of the participants didn’t know for how long they should use complete denture. Conclusion: From the responses obtained in this study it can be concluded that the complete denture wearing patients visiting Chitwan Medical College have fair denture hygiene habits as well as fair knowledge on denture care practice.

Background: Indiscriminate disposal of hospital wastes including mercury/amalgam wastes pose a serious threat to life and environment. There is a growing concern about biomedical waste (BMW) management among health care workers, however there are limited reports on BMW management by dental personnel in developing countries. Objectives: This study investigated the level of knowledge of BMW, observance of proper mercury hygiene and BMW management practice among public dental personnel in Lagos State, Nigeria. Methods: A cross-sectional study regarding BMW management across public hospitals in Lagos State, Nigeria was con- ducted following institutional ethics committee approval. A self-administered questionnaire was utilized to obtain data from different facilities selected by purposive and simple random sampling techniques as applicable. The questionnaires were dis- tributed among 437 respondents by convenience sampling. The resulting data were statistically tested using Chi-square and G-test with p-value < 0.05 indicating significant level. Results: Amongst 437 respondents, majority were females (62.5%) and the highest proportion fell within the age range of 25–34 years (44.4%). Only 17.2% of the respondents had good knowledge of BMW management/legislation and 4.1% had good BMW practice. Less than half (49.4%) of respondents disposed mercury-contaminated materials inside the trash and majority (92.2%) did not observe proper mercury hygiene. Significantly better mercury hygiene practices were observed in secondary facilities (p=0.040). Conclusion: A minor proportion of public dental personnel had good knowledge and practice of proper mercury hygiene and BMW management. This shows there is an urgent need for training of health personnel on proper BMW handling and disposal in developing countries like Nigeria. Keywords: Biomedical waste management; mercury hygiene; dental personnel; Nigeria.

In this review, life cycle assessment (LCA) principles are coupled with circular economy (CE) in order to address LCA examples in the biomedical sector worldwide. The objectives were (1) to explore the application of LCA in the medical, pharmaceutical, and dental fields; (2) to describe the ways of biomedical waste management; (3) to emphasize on the problem of dental waste in private and public dental sectors; and (4) to propose ways of “green circulation” of the dental waste. A literature search was performed using the Google Scholar, PubMed, and Scopus search engines covering the period from January 2000 until May 2020, corresponding to articles investigating the LCA and circular economy principles and legislation for biomedical and dental waste, their management options, and modern ways of recycling. The results showed that incineration seems to be the best management way option involved despite the mentioned drawbacks in this technology. Different adopted models are well defined for the dental field based on the 3Rs’ module (reduce, reuse, recycle). Replacing disposable products with reusable ones seems to be a good way to tackle the problem of waste in medical and dental sectors. Interventions on the selection and better biomedical and dental waste management will ensure eco-medicine and eco-dentistry of the future. These new terms should be the new philosophies that will change the way these fields operate in the future for the benefit of the professionals/patients and the community. Supplementary Information The online version contains supplementary material available at 10.1007/s43615-020-00001-0.

The aim of this study was to phenotypically and genotypically identify coagulase-negative Staphylococcus (CoNS) recovered from the nostrils of waste workers and from dental waste; 135 strains were ...

The dental restorative material mercury amalgam has been used for centuries and during this time waste disposal methods have developed considerably. This review provides an overview of how mercury is managed in dental clinics, as well as outlining some possible environmental implications that could occur with poor waste management.

Objectives: The health-care sector generates enormous amount of biomedical waste (BMW) and dental waste forms a subset of this hazardous waste. It is, therefore, imperative for the upcoming dental health professionals to be aware of the hazards related to improper waste management and the existing rules and regulations for the same. To gauge the gaps in knowledge and find ways to rectify the same, the aim of this study was to assess the knowledge, attitude, and practice of biomedical waste management among dental students. Materials and Methods: A cross-sectional study was carried out in a dental teaching hospital, wherein a pre-validated and tested, structured closed-ended questionnaire was adopted and given to the clinical students of dentistry. The responses were self-recorded by the participants after which statistical analysis was carried out using Chi-square test to compare the levels of knowledge, attitude, and practice among the study groups. Results: Out of 168 participants, 97% agreed that waste needs to be segregated but 70% were unaware of the legislations regarding BMW management. About half of the participants across all groups gave incorrect responses regarding correct disposal of various types of wastes. Only 10.1% of students correctly disposed mercury. Among the study groups, postgraduate students fared better than house surgeons and students. More than 90% of students believed that they required additional training in BMW management. Conclusion: An overall positive attitude was seen among all students toward safe management of BMW. However, their knowledge and practice toward the same calls for attention on the part of educational institutions in providing continuous educational programs and monitoring the correct disposal of wastes. This was validated by the fact that increase in educational qualification showed better performance toward this subject.

Despite the advancing technological methods to prevent diseases, outbreaks become more common due to the ineffective waste disposal methods followed in dental clinics. In safe and effective disposal of wastes, the key step is the separation or segregation of the wastes produced depending on its nature and composition. The present study aims at determining the awareness on safe disposal of liquid dental waste among undergraduate dental students. For the study, a pre tested questionnaire consisting of 10 questions assessing the awareness and knowledge about waste disposal of liquids in dental clinics was prepared and circulated to a total of 100 undergraduate dental students of varying age groups via an online survey planet link. The responses provided by the students were collected, diagrammatically represented and analysed to determine the comprehension levels and understanding on the type of waste disposal system implemented and followed in the respective dental clinics. In addition to this, the requirement to layout a proper apprehension on the same was monitored.94 % of the population are aware of the waste produced in the dental industry ,72.% of individuals believed that more than 2 liters of liquid waste are produced on an average daily basis. 53% of population were aware that mercury was one of the essential components of liquid waste. 85%, who felt that the wastes produced had to be separated before disposal. 89% of the population were aware that dental wastes affect the people living around the disposal area and 71% felt that dental wastes could be recycled.The knowledge and awareness levels among dental students was adequate on the different types of liquid wastes produced in dental clinics and the effective solution to minimize this waste and dispose them safely. Further, the results of the survey conducted were educated the need and necessity to inculcate the correct management techniques of dental wastes and to make dental students realise the importance of this subject.

To assess the knowledge, attitude and practice of biomedical waste management among undergraduate dental students of a private teaching hospital in Chennai. Biomedical wastes are all wastes that are being generated during diagnosis, treatment or immunisation of human beings in the testing of biologicals and it's contaminated with human fluids. The waste generated by the healthcare workers during the treatment of patients is the most dangerous of all wastes and has a higher potential for infection and injury. This was an online questionnaire-based study, conducted on an online survey platform in April. The questionnaire was circulated among the Undergraduate dental students (third and fourth years and interns) of Saveetha dental college and hospitals, Chennai. The responses were collected and tabulated using the excel sheet and were exported to the SPSS software by IBM for statistical analysis. Among the interns, 85% had good knowledge and practice of biomedical waste management. 85% had a positive attitude towards the management of BMW. Amongst the final years, 80% had good knowledge, only 65% had a positive attitude and only 18% of the final years practice good BMW management. In the third year, 50% had good knowledge, 58% had a positive attitude and 58% had a good practice of biomedical waste management. The interns had good knowledge, a more positive attitude and good practice of biomedical waste management compared to the third and final years.

BACKGROUND: Biomedical waste can potentially compromise the environment and public safety if not safely disposed. OBJECTIVE: The aim was to assess the understanding and safe practices of biomedical and dental waste amongst the dental practitioners and practical year students amid the COVID-19 pandemic. METHODS: A structured and validated questionnaire consisting of 21 closed ended questions was used to collect data from dental practitioners and students working in hospitals and clinics. The questionnaire was distributed in paper and digital form amongst the participants. Descriptive analysis was performed for categorical and numerical variables. Spearman correlation test was used to assess the relationship between awareness and waste disposal practices of dentists. A p-value of≤0.05 was considered as statistically significant. RESULTS: More than three fourth of the participants were aware of proper dental waste disposal steps. One half was aware of the color-coded segregation of biomedical waste management. Two third of the participants were deploying safe biomedical waste practices. Nearly 68% subjects allocated separate labeled containers for disposal of COVID-19 suspected patient’s waste. Furthermore, 71.63% participants were practicing PCR test before aerosol procedures. While 88.65% participants believed that the COVID-19 pandemic has increased the financial burden in terms of safe practices and dental waste management. CONCLUSION: The awareness and practices of the participants towards dental waste management was found to be moderate. Satisfactory COVID-19 prevention and transmission measures were observed amongst the participants. BMW management lessons should be included in the academic curriculum and training program needs to be adopted for mass awareness.

Dental materials are currently undergoing a revolution. Mercury use, including traditional amalgam (mercury-containing) material used in dental fillings, is now being widely regulated under the Minamata convention, and dental amalgam is currently being replaced by resin formulations in dentistry. These resin-based materials can be tuned to offer varying material properties by incorporation of a range of nano- and micro-particle based 'fillers' for different dental properties and applications. However, these innovations may have a concomitant effect on the waste streams associated with common dental applications, in particular the potential for higher concentrations of novel micro- and nanomaterials within wastewater streams, and a potential route for novel nanomaterials into the wider Environment. These new materials may also mean that wastewater filtering apparatus commonly deployed at present, such as amalgam separators, may be less efficient or insufficient to capture these new filler materials in dental facility wastewater. In this work, we analyse dental wastewater streams from three dental facilities in Ireland with differing amalgam separators in place. The potential overall toxicity, particulate load and physicochemical properties are analysed. The overall risk posed by these new materials is also discussed.

A significant amount of dentistry's carbon emissions originate from travel (64.5%). Dental-associated travel affects air quality, releasing over 443 tonnes of nitrogen oxides (NOx) and 22 tonnes of particulate matter (PM2.5) annually. This reduction in air quality reduces over 325 quality-adjusted life years (QALY) per year. Wider health impacts associated with noise and traffic incidents doubles the impact on health in QALYs. Dental procedures that require shorter appointment times have disproportionately higher emissions due to patient travel. The dental team can reduce appointment times by combining visits for family members or combining operative procedures, or reducing appointment frequency based on patient risk. Community oral health programmes and preventive programmes reduce travel emissions. The number of physical dental appointments can be reduced using information technology such as global positioning systems (GPS), telemedicine and teleconferencing. The mode of travel is important, with the air and carbon emissions generated by active travel negligent compared to a private car. Travel plans can help encourage active travel, as can flexible working hours, cycle to work schemes, cycle racks and shower facilities. Practices should consider purchasing locally sourced or sustainably transported goods and, ideally, use local dental laboratories.

Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions. Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce “Know-Do gap” between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts. Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.

Management of dental wastes became a recent challenge facing health care practitioners and is one of the highly-sensitive environmental problems. The main purpose of this study was to assess oral health care provider's knowledge and behavior about dental waste management and evaluate their behavior toward it. A cross-sectional descriptive study was conducted on 314 dental health care providers working in four dental colleges, and 20 private dental clinics in Jeddah, Saudi Arabia. A pretested questionnaire composed of close-ended questions was used. The mean age of the participants was 27 years. About 78% of the participants reported that they were working in the public sector. Only 33.4% of the study sample received professional training on waste management. The mean behavior and knowledge scores were 3.7 ± 1.3 (out of 6) and 1.4 ± 1.3 (out of 8), respectively. Statistically significant association was noted between gender and knowledge scores but not between gender and behavior scores. On the other hand, statistically significant associations were noted between both knowledge and behavior scores and rank of the participant, type of practice, and years of experience. Oral health care providers' knowledge about the effective procedure that should be followed for segregating, collecting, transporting, and treating dental waste was weak and substandard. There is an urgent need to develop policies and regulations for dental waste management in Saudi Arabia.

This report investigates to analyse the production of waste in dental offices of Qaem Shahr city. In this study, from 120 dental offices in Qaem Shahr city, 21 offices were selected through random sampling. Sampling taken from 3 offices in 3 consecutive working days (on Sundays, Mondays and Tuesdays). The components were classified into three groups based on their specificity and potential. Total annual waste produced in Dentist Offices in Qaem Shahr city is 557.80 kg. In dental office, the amount of biohazard, chemical and pharmaceutical and domestic type wastes were 64.10, 2.70 and 33.20 respectively. Production percentages of biohazard, the highest weighted mean for potentially biohazard (155.25±0.63 g) and the lowest for chemical and pharmaceutical (6.35±1.85 g). Keywords: Dental waste, Biohazard waste, Domestic type waste, Chemical and pharmaceutical waste, Qaem shahr

The overall objective of this work is to determine the composition, characterization and production rate of Greek dental solid waste (DSW). This information is important to design and cost management systems for DSW, for safety and health considerations and for assessing environmental impact. A total of 141 kg of DSW produced by a total of 2542 patients in 20 dental practices from Xanthi, Greece was collected, manually separated and weighed over a period of four working weeks. The waste was separated in 19 sub fractions, which were classified in 2 major categories, according to Greek regulations: Domestic-type waste comprising 8% and hazardous waste comprising 92% by weight of total DSW. The latter was further classified in infectious waste, toxic waste and mixed type waste (infectious and toxic together), accounting for 88.5%, 3.5% and 0.03% of total DSW by weight, respectively. The overall unit production rates (mean ± standard error of the mean) were 381 ± 15 g/practice/d and 53.3 ± 1.4 g/patient/d for total DSW, 337 ± 14 g/practice/d and 46.6 ± 1.2 g/patient/d for total infectious DSW, 13.4 ± 0.7 g/practice/d and 2.1 ± 0.1 g/patient/d for total toxic DSW and 30.4 ± 2.5 g/practice/d and 4.6 ± 0.4 g/patient/d for domestic-type waste. Daily DSW production was correlated with daily number of patients and regression correlations were produced. DSW was subject to laboratory characterization in terms of bulk density, calorific value, moisture, ash and volatile solids content. Measured calorific values were compared to predictions from empirical models.

Infectious wastes are potential sources of pathogenic micro-organisms, which may represent a risk to the professionals who manage them. In this study, we aimed to characterize the infectious bacteria present in dental waste and waste workers. The dental waste produced over 24 h was collected and waste workers were sampled by swabbing. Isolate resistance profiles were characterized by Vitek® and PCR and biofilm formation by Congo Red agar, string test and microtitre assay. To assess similarity between the waste and the workers' samples, a random amplified polymorphic DNA test was used. Twenty-eight bacteria were identified as clinically relevant. The most frequent gene was blaTEM present in five Gram-negative micro-organisms, and one blaSHV in Klebsiella pneumoniae. All Pseudomonas aeruginosa were positive to extracellular polymeric substances formation, except one isolated from a worker. Klebsiella pneumoniae had negative results for the string test. Pseudomonas aeruginosa showed better adherence at 25°C after 48 h of incubation and K. pneumonia had the best biofilm formation at the same temperature, after 24 h. The similarity between P. aeruginosa recovered from dental waste and from workers was low, however, it is important to note that a pathogen was found on a worker's hands and that improvements in biosafety are required. Significance and impact of the study Infectious dental waste can contain clinically relevant bacteria with important resistance and biofilm profiles. These micro-organisms could be transmitted to waste workers, other professionals and patients if the principles of biosafety measures are neglected. To our knowledge, no study has ever evaluated the microbial characterization and the potential contamination risk of dental infectious waste and waste handlers. The presence of clinically relevant bacteria in the hands and nasal mucosa of waste workers highlights the need for studies in this field to clarify the risk of these pathogens in dental healthcare services, and to stress the need for an efficient waste management.

Healthcare wastes are those generated inside healthcare services, including dental clinics. Workers coming into close proximity to hazardous healthcare waste are potentially at risk. In an attempt to assess the knowledge and attitudes of workers dealing with infectious waste, a questionnaire was administered. The biological risk was investigated by evaluating the microbial load and screening some clinically relevant micro-organisms in the nasal mucosa, hands and coats of these workers. The results showed that 66.6% of the study population had incomplete primary education. Only two workers have had their blood tested to confirm anti-HBs levels. Microbial load evaluation on hand surfaces of morning workers showed statistically significant lower microbial loads after the workday when compared with the beginning of the work period. It is important to highlight that some clinically relevant bacteria, such as Pseudomonas aeruginosa and Klebsiella pneumoniae were isolated from worker’s hands. This study revealed the need for more training programmes regarding awareness of safe waste disposal protocols and also the necessity of discussing vaccination and its implications. Data regarding microbial loads of the worker’s hands, mostly at the beginning of the workday when handwashing is recommended worldwide, emphasise that hygiene measures should receive more attention during training exercises.

Considering the high mercury load of dental wastewater (DWW), the aim of current research is investigation of mercury removal from DWW using Micro-Algae dynamic membrane (DM) in a dynamic membrane bioreactor (DMBR) using synthetic DWW and compare its performance with a control membrane bioreactor (CMBR). Subsequently, the optimal Micro-Algae DM was developed at 200 rpm of agitation rate using axial-flow agitator and 18 LMH imposed flux, over a Kubota membrane. Then, mercury removal was investigated for Synthetic DWWs of 300–800 ppb mercury concentrations using the DM and CM (control membrane) during short term filtration tests. According to obtained results After 24 h DM permeate mercury removal was completed, However CM permeate flow was still containing mercury, obviously utilization of Micro-Algae DM was positively affected mercury removal process. Experiment was repeated in presence of activated-sludge. However, during this process, DM mercury removal after 24 h was dropped from 85.88 to 79.02%.

SUMMARY Objectives: The aim of this study was to evaluate the performance of a commercially available chairside amalgam separator (CAS) in a clinical setting in which a relatively high number of amalgam restorations are placed. Performance parameters investigated included service life, amalgam collected, mercury concentrations in effluent, and solids retention efficiency. Methods and Materials: CASs were tested per International Organization of Standardization (ISO) 11143:2008 prior to installation in a military dental treatment facility and after removal from service (n=4) in order to confirm compliance with the recently enacted United States Environmental Protection Agency (EPA) Effluent Limitations Guidelines and Standards for the Dental Category. During the units' time in service, biweekly effluent grab samples were collected from the high-volume evacuation system of each chair (n=6) and analyzed for total mercury concentration by inductively coupled plasma mass spectrometry (ICP-MS). The mean total accumulated solids at the end of service life (n=6) was determined for potential design optimization. The service life expectancy in a military dental treatment facility was determined in terms of calendar and workdays. Procedural data were collected to determine the daily mean number of amalgam surfaces placed during the service life of each chairside amalgam separator (n=9). Results: The CAS evaluated met minimum EPA compliance requirements when used in a military dental treatment facility. The solids removal efficiency at the end of service life was 99.82% ± 0.14% (n=4). The mean service life (n=8) was 131.6 ± 45.1 calendar days (67.1±37.6 workdays). Effluent mercury concentrations ranged from 0.05 to 11.93 mg/L. Total solids accumulated in each CAS (n=6) at the end of service life was 195.4 ± 63.4 g. The mean number of amalgam surfaces placed per workday during the service life span of each CAS was 8.4 ± 1.4.

This paper forms part of a series of papers, seven in total, which have been requested by colleagues to help them as clinicians understand sustainability as it relates to dentistry. This paper focuses on waste and how the dental team can influence how waste is processed and disposed of. It is the authors' hope that this series of papers stimulates interest, debate and discussion and, as well as being economically responsible, ultimately motivates and inspires the dental team to be more socially and environmentally sustainable which in turn will help promote health and illness prevention.

Aim: This aimed to evaluate a new bone formation and to provide a single-stage treatment, i.e., extraction of tooth followed by autogenous dentin demineralized (ADDM) graft in the same extraction socket (ES) – for adult patients who require tooth extraction. Materials and Methods: Two hundred teeth extractions were performed to investigate the efficacy of ADDM graft in the formation of new bone. After demineralization of dentin graft parameters such as exposure of graft, any signs of infections/pus/exudates, pain, and bone density were evaluated. Results: On follow-up, exposure of graft was recorded in five sockets at 1 month and infection was recorded in four sockets. Pain was significantly high at postoperative day 1 and least with 3rd and 6th months. There was a highly significant bone formation (P < 0.01, 0.05) in the ES group at various time intervals, while there were no significant differences in the adjacent bone group. Conclusion: Using ADDM graft in providing a single-stage treatment plan, i.e., extraction of tooth followed by autogenous demineralized dentin graft in the same ES in adult patients – is an alternative for the immediate reconstruction of alveolar bone defects to facilitate the future prosthesis. It also saves the cost of other graft materials which are commercially available in market for the patient and also reduces the infective dental waste globally.

Solid dental waste is a major contributor to the spread and development of diseases. This study was performed to determine the quality and quantity of solid dental waste and to evaluate management ...

Dental practices have a unique position as dental staff use a high number of dental materials and instruments on a daily basis. It is unclear how dentists' and dental care professionals' choices and behaviours around selecting and using materials impact on the amount of unnecessary waste production. Although there are a number of articles exploring the quality and quantity of waste in dental practices, there are no studies on organisational strategies to decrease unnecessary waste. There is no clear economic analysis of the impact on associated cost to dental practices which consequently can affect the access of dental care for disadvantaged groups.This study used an audit approach to explore the potential for sustainability in dental practice by measuring the nature and quantity of dental clinical waste, and assessing the feasibility of measuring the financial costs and potential carbon savings in the management of dental clinical waste.The data from our study would appear to support the view that it is possible to reduce carbon emissions and increase profitability. Successful implementation of an environmentally sustainable approach to waste management will be dependent on the practicalities involved and the financial incentives for adopting such practices.

The objective of this study was to assess the occupational exposure to mercury in dentistry and associated environmental emission in wastewater of Lahore, Pakistan. A total of ninety-eight blood samples were collected comprising 37 dentists, 31 dental assistants, and 30 controls. Results demonstrate that the dentistry personnel contained significantly higher mean concentration of mercury in their blood samples (dentists: 29.835 µg/L and dental assistants: 22.798 µg/L) compared to that of the controls (3.2769 µg/L). The mean concentration of mercury was found maximum in the blood samples of older age group (62.8 µg/L) in dentists and (44.3 µg/L) in dental assistants. The comparison of mercury concentration among dentists, dental assistants, and controls (pairing based on their ages) revealed that the concentration increased with the age and experience among the dentists and dental assistants. Moreover, the mercury concentration in all the studied dental wastewater samples, collected from twenty-two dental clinics, was found to be exceeding the recommended discharge limit of 0.01 mg/L. Therefore, we recommend that immediate steps must be taken to ensure appropriate preventive measures to avoid mercury vapors in order to prevent potential health hazards to dentistry personnel. Strong regulatory and administrative measures are needed to deal with mercury pollution on emergency basis.

Introduction: Biomedical waste is generated routinely in high amounts in the dental office, the correct disposal of which bears importance to the dentist, staff and healthcare workers. This is the first of its kind study in the city of Karad which will provide an important insight into the proper method and knowledge of disposal of health care waste by the dental practitioners. The application of this study will be in accessing the legal necessity and social responsibility of the healthcare personnel’s in the effective management of biomedical waste. Materials and Method: The study population included 100 private practitioners in Karad City, Maharashtra. A self-administered questionnaire was distributed to assess the knowledge, attitude and practices regarding dental waste management. Descriptive statistics was used to summarize the results. Results: of 100 study participants, 73 (73%) were males and 27 (27%) were females. The maximum number of participants belonged to the age group of 34-38 years (29%). Undergraduate qualification was more (80%) and 43% participants had an experience of 0-5 years. Chi-square analysis showed a highly significant association between participant who attended continuing dental education (CDE) program and their practice ofdental waste management. Conclusion: Lack of knowledge and professional training in disposal of biomedical waste becomes a direct threat to the humans as well as the environment. CDE programs would help bring about a change in the management of healthcare waste.

The objective of this work was to compare the composition and production rate of Greek dental solid waste (DSW) produced by three dentist groups of Xanthi, Greece, defined according to the country of their dental education/training: (1) dentists educated in Greece and other European Union (EU) countries, (2) dentists educated in Turkey, and (3) dentists educated in former Soviet Union and repatriated to Greece. All DSW produced by a total of 2542 patients in 20 dental practices from Xanthi, Greece, was collected, manually separated, and weighed over a period of four working weeks and classified according to Greek regulations. Production data below are presented as average (standard deviation in parenthesis). The average unit production rates of total DSW were 415(303) and 51.2(19.1) g/patient/day for dentists educated in Greece and other EU countries, 365(160) and 64.0(21.7) g/patient/day for dentists educated in Turkey, and 302(349) and 54.3(46.8) g/patient/day for dentists educated in former Soviet Union. Daily DSW production was correlated with daily number of patients and regression correlations were produced. Statistical analysis using the Kruskal-Wallis non-parametric test was conducted to compare DSW production medians by the three dentist groups. Dentists educated in Turkey had statistically higher median patient-based unit production rates at α = 0.05 for total dental, total hazardous, total infectious, total toxic and domestic-type waste, compared to the other dentist groups.

Aim The present study aimed to obtain information about knowledge, execution, and attitude toward biomedical waste (BMW) and its management. Materials and methods In the present study, a self-administered closed-ended questionnaire was designed to conduct a cross-sectional survey. It was distributed among 614 dentists (institution associated or private practitioners) in the cities of North India. The questionnaire comprised 36 questions regarding knowledge, execution, and attitude toward BMW and its management. Frequency distribution and chi-square test along with paired t-test were used to compare the data obtained between the private practitioners and institution-associated dentists. Results The study showed that 80% private practitioners were aware of the categories of BMW as compared with 100% of institution-associated dentists. However, 41% dentists associated with institution were disposing the chemical waste directly into sewer and a surprising high number of private practitioners were discarding directly without any treatment. Furthermore, regarding the mandatory maintenance of BMW records, 100% institution-associated respondents were aware, whereas only 6.5% private practitioners knew about it. Regarding BMW management not frequently being followed, 78% of private practitioners believed extra burden as the reason. Conclusion Most of the dentists had adequate knowledge regarding BMW policies and its management. Although it was being practiced in mostly all the institutes on a regular basis, the majority of private practitioners were not practicing it due to various reasons, such as financial burden, lack of availability of service, and poor attitude toward its management. Clinical significance There is a need to make it compulsory and organize training sessions to educate the dental personnel and to establish the importance of proper management. How to cite this article Raghuvanshi M, Sinha S, Mohiddin G, Panda A, Dash KC, Bhuyan L. Awareness of Biomedical Waste Management among Dentists associated with Institutions and Private Practitioners of North India: A Comparative Study. J Contemp Dent Pract 2018;19(3):273-277.

Improved access to dental care has resulted in an increase in waste generation, which became a main concern for national and international authorities from an environment and public health perspectives. Lebanon supports the Global Health Care Waste Project and aims to develop guidelines and policies to alert dental healthcare professionals and improve waste management in dental clinics. This study provides an overview of the existing waste management situation in dental clinics in Lebanon. A survey of waste management practices in 242 randomly chosen dental clinics was conducted during the Annual Congress of The Lebanese Dental Association in 2011 in Beirut. The majority of dentists (90%) acknowledged a lack of written procedures for waste management. The absence of waste segregation at the source was reported by 71% of the surveyed dentists: most of the waste, including amalgam and infectious waste, is manipulated without precaution and ends up in municipal waste. About two thirds of the surveyed dental clinics do not work according to local practices and around half of them do not provide protective clothing or immunisation against hepatit B virus or tetanus. This survey highlights the need for capacity building for dental clinic staff and adoption of effective measures to encourage efficient and responsible dental waste management in Lebanon.

Background: The presence of toxic and pathogenic agents in the dental waste products has made it to be classified as “hazardous waste.” Objective: To assess dental waste production rate and composition and approaches used to manage these waste products in 2017 in Birjand, Iran. Methods: 48 dental clinics were evaluated in two months of 2017. Sampling was performed from each clinic 3 times a week. Samples were manually divided into 5 categories of chemical-pharmaceutical, infectious, semi-household, sharp and cutting materials, and toxic waste products, and weighed. A checklist containing 25 questions was used to evaluate the aspects of waste management in dental clinics. Results: The total amount of waste products generated in dental clinics was 7848.02 kg/ year in which semi-household waste had the highest quantity (4263.411 kg/year) and toxic waste had the lowest quantity (9.275 kg/year). Components with the highest amounts in dentistry waste products were nylon gloves (16.7%), paper and cardboard (13.4%), latex gloves (10.8%), and pharmaceuticals (10.2%). Waste separation was restricted to sharp and cutting waste. More than half (57%) of dental units were equipped with amalgam filter. Fixing solutions were directly discharged to sewage in 48.6% of clinics. There was no program to reduce waste generation in 54% of the clinics. Autoclave was the main tool for sterilizing dental instruments. Conclusion: This study showed a remarkable share of recyclable materials in the composition of dental waste and lack of special approach to manage waste in dental clinics. It is necessary to plan for minimizing generation of, separating, and recycling waste at source.

WOS: 000407804200010 As a result of daily activities, besides domestic wastes, many hazardous wastes also come out. These wastes constitute hazards in terms of environment and human health. Taking these potential hazards into account, waste must be disposed of in such a way as not to jeopardize the environment and human health. Looking at the overall hazardous wastes, it appears that dental wastes are a small fraction. Although it is thought to be a trivial part, it is in fact an important waste resource, with poor management, complicated infection risk and even heavy metal output from materials such as amalgam. Therefore waste characterization and composition should be determined to develop appropriate waste management systems. Just as dental residues are found in many countries, management of "medical waste control" is carried out by regulations in Turkey as well. In this study, it was aimed to determine the composition and characterization of dentistry wastes of Samsun city center. For this purpose, wastes of faculty of Dentistry, 2 dental clinics and 2 private dental examinations were taken and studied in two different days. In this study, wastes are classified by type, so that percentage distributions are calculated and quantities are examined.

Trying to widen the discussion on the risks associated with dental waste, this study proposed to investigate and genetically compare yeast isolates recovered from dental solid waste and waste workers. Three samples were collected from workers' hands, nasal mucosa, and professional clothing (days 0, 30, and 180), and two from dental waste (days 0 and 180). Slide culture, microscopy, antifungal drug susceptibility, intersimple sequence repeat analysis, and amplification and sequencing of internal transcribed spacer regions were performed. Yeast strains were recovered from all waste workers' sites, including professional clothes, and from waste. Antifungal susceptibility testing demonstrated that some yeast recovered from employees and waste exhibited nonsusceptible profiles. The dendrogram demonstrated the presence of three major clusters based on similarity matrix and UPGMA grouping method. Two branches displayed 100% similarity: three strains of Candida guilliermondii isolated from different employees, working in opposite work shifts, and from diverse sites grouped in one part of branch 1 and cluster 3 that included two samples of Candida albicans recovered from waste and the hand of one waste worker. The results suggested the possibility of cross‐contamination from dental waste to waste workers and reinforce the need of training programs focused on better waste management routines.

Dentistry is highly energy and resource intensive with significant environmental impact. Factors inherent in the profession such as enormous electricity demands of electronic dental equipment, voluminous water requirements, environmental effects of biomaterials (before, during and after clinical use), the use of radiation and the generation of hazardous waste involving mercury, lead etc have contributed towards this. With rising temperatures across the world due to global warming, efforts are being made worldwide to mitigate the effects of environmental damage by resorting to sustainability concepts and green solutions in a myriad of ways. In such a scenario, a professional obligation and social responsibility of dentists makes it imperative to transform the practice of dentistry from a hazardous to a sustainable one, by adopting environmental-friendly measures or 'green dentistry'. The NHS in the UK has been proactive in implementing sustainability in healthcare by setting targets, developing guidance papers, initiating steering groups to develop measures and implementing actions through its Sustainable Development Unit (SDU). Such sustainable frameworks, specific to dentistry, are not yet available and even the scientific literature is devoid of studies in this field although anecdotal narratives abound. Hence this paper attempts to present a comprehensive evaluation of the existing healthcare sustainability principles, for their parallel application in the field of dentistry and lays out a blueprint for integrating the two main underlying principles of sustainability - resource use efficiency and eliminating or minimising pollution - in the day-to-day practice. The article also highlights the importance of social values, community care, engaging stakeholders, economic benefits, developing policy and providing leadership in converting the concept of green dentistry into a practised reality.

La gestion des dechets de soins prend de plus en plus de place dans les preoccupations de sante publique. De meme, les methodes de gestion des dechets de soins peuvent en elles-memes entrainer un risque pour la sante et pour l’environnement. L’objectif du travail etait de decrire la gestion des dechets issus des soins dentaires a Dakar. Une etude descriptive transversale portant sur les services dentaires de Dakar et basee sur un questionnaire a permis de determiner la connaissance et l’attitude des chirurgiens-dentistes sur la gestion des dechets issus des soins. Ainsi tous les praticiens ont affirme que leurs structures disposaient de poubelles dont 81,2 % en sacs en plastique, lesquelles etaient, dans 73,2 % des cas, lavees et desinfectees en moyenne une fois par jour. Seules 7,2 % des structures disposaient d’un autoclave et 5,8 % d’un incinerateur. Les trois quarts des personnes interrogees ignoraient le mode d’elimination des dechets contamines et aucun d’eux n’avait procede a une etude sur l’estimation quantitative des dechets de son service. La gestion des dechets issus des soins dentaires n’est pas structuree au Senegal, ni plus generalement dans la plupart des pays en developpement. De plus, les lacunes et l’ineffectivite de la legislation ont pour consequence des menaces de grandes envergures sur la sante publique et l’environnement. Les pouvoirs publics doivent mettre l’accent, entre autres, sur la formation et la sensibilisation des acteurs, en dotant les structures des moyens de contribuer au developpement durable a travers la gestion des dechets issus des soins.

In October 2013, a new international binding treaty instrument called the Minamata Convention on Mercury opened for signature in Minamata City, Japan, the site of arguably the worst public health and environmental disaster involving mercury contamination. The treaty aims to curb the significant health and environmental impacts of mercury pollution and includes provisions addressing the mining, export and import, storage, and waste management of products containing mercury. Importantly, a provision heavily negotiated in the treaty addresses the use of dental fillings using mercury amalgam, an issue that has been subject to decades of global controversy. Though use of dental amalgam is widespread and has benefits, concerns have been raised regarding the potential for human health risk and environmental damage from emissions and improper waste management. While the Minamata Convention attempts to address these issues by calling for a voluntary phase-down of dental amalgam use and commitment to other measures, it falls short by failing to require binding and measurable targets to achieve these goals. In response, the international community should begin exploring ways to strengthen the implementation of the dental amalgam treaty provisions by establishing binding phase-down targets and milestones as well as exploring financing mechanisms to support treaty measures. Through strengthening of the Convention, stakeholders can ensure equitable access to global oral health treatment while also promoting responsible environmental stewardship.

Aims: Dentistry is a profession dedicated to promoting and enhancing oral health and well-being. To accomplish these goals, dentists use a variety of materials and equipment. Unfortunately, some of the materials that are currently in use like silver amalgam, x-ray films etc. including heavy metals and biomedical waste present potential challenges to the environment. Hence the aim of the present study was to assess the management of dental waste in private clinics of Chhattisgarh state, India. Methods and Material: A self- administered questionnaire was designed and distributed among 100 practising dentists, who were private practitioners. The survey form was composed of 27 questions framed based on knowledge, attitude and those regarding the practice of dentists in relation to dental health-care waste management. Chi-square test (with Yates correction; wherever applicable) was used for analysing the factors influencing waste management practices. Results: Programs about waste management practices had significant influence on the knowledge of respondents about waste management guidelines (P value = 0.01), on application of colour coding practice for disposal of waste (P value = 0.01) and on disposal of amalgam (P value = 0.01). The knowledge about waste management guidelines has significant influence on application of colour coding practice for disposal of waste (P value < 0.0001).Conclusions: Though most dentists were aware of the hazardous effect of improper disposal of dental waste; majority of them still practiced improper waste disposal. There is need to retrain the practitioners on the importance and new technologies of proper waste disposal.

A lot of biomedical waste (BMW) is generated in dental practices, which can be hazardous to the environment as well as to those who come in contact with the materials, if not dealt with appropriately. Most of the rules world-wide are not specific for dental BMW management and hinder easy understanding by dental practitioners. Because of lack of clear-cut guidelines either from Dental Council of India or Government of India or Indian Dental Association (IDA) on disposal of dental wastes, this article is designed to explore and review on these issues and formulate a simplified scheme. The guidelines by the Maharashtra Pollution Control Board from the directives of The Ministry of Environment and Forests, Government of India through BMW (Management and Handling) Rules, 1998, (BMW-MH-98), similar guidelines being followed elsewhere in the world, the local BMW disposal company’s rules and the IDA’s Clinic Standardization Program guidelines. We developed and implemented a simplified waste segregation protocol for practicing dentists and dental hospitals. A methodological dental waste segregation protocol was required considering its disposal and ill-effects on health and the environment. The simplified scheme provided a good model to be followed in developing countries like India. The scheme improved understanding among dentists because of its self-explanatory nature.

Background Dental wastes are materials that have been utilized in dental clinics, which are no longer wanted for use and therefore discarded. Improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist. Objective The present study was conducted to assess the knowledge and practices regarding Dental waste management among private practitioners. Method The study population included 186 private practitioners in three districts of Karnataka (Coorg, Mysore, Hassan), south India. A pre-tested self-administered questionnaire was distributed to assess the knowledge and practices regarding dental waste management. Descriptive statistics was used to summarize the results. The data will be statistically analyzed using chi-square test, correlation. Result Out of 186 study subjects, 71(38%) were females and 115(62%) were males, Chisquare analysis showed highly significant association between qualification of the study participants and their knowledge, practice of dental waste management. A statistically significant (0.0001) correlation was found between the knowledge and practice scores. Conclusion There was a lacunae of knowledge regarding proper biomedical waste disposal among the participants. In order to fill this vacuum CDE (Continuing Dental Education) programs have to be conducted in pursuance to maintain health of the community.

Aim To investigate amongst Greek endodontists the incidence of percutaneous injuries, the circumstances associated with them, the therapeutic measures taken after the injuries and their compliance with infection control measures. Methodology One hundred and forty-seven endodontists met the inclusion criteria and were invited to participate in the survey. Personal and professional data, information on percutaneous injuries in the past 5 years and on infection control practices were gathered through interviews based on a questionnaire. Data were analysed using chi-square test, independent samples t-test, one-way anova and Pearson's correlation coefficient. The level of significance was set at P = 0.05. Results The response rate was 84%. The injury rate was estimated at 1.35 per endodontist per year. Endodontic files were associated with 37% of the injuries and fingers were injured in 75% of the most recent cases. Medical assistance was sought in 36% of the most recent injuries. Endodontists who always or usually practiced 4-handed endodontics (P = 0.007) as well as those not performing surgical endodontics (P = 0.007) reported significantly fewer injuries. In 91% of the participants, a complete hepatitis B virus vaccination was reported. Gloves, masks, rubber dam isolation and puncture-resistant containers for disposal of sharp instruments were always used by 98%, 94%, 100% and 81% of the respondents, respectively. Conclusions The injury rate was low. The practice of four-handed endodontics was associated with a reduced number of percutaneous injuries; the performance of surgical endodontics increased their incidence. Greek endodontists showed a high level of compliance with infection control measures.

Objectives: The purpose of this study was to prevent health problems and environmental contamination resulting from inappropriate management of dental wastes and to provide reference data for revision and supplementation of dental clinic waste management guidelines. Methods: From 640 total of dental clinics registered in 16 cities and counties in Gyeongsangnam-do, 100 (60 in Changwon (Masan, Changwon), 29 in Gimhae, and 11 in Jinju) were included in this study. From July 2010 to September 2010, investigators visited the 100 dental clinics and conducted survey interviews using a structured survey questionnaire regarding disposal methods for liquid wastes (suction pump, spittoon container waste, used liquid disinfectants, and X-ray developer), and disposal methods for solid waste (suction pump, spittoon container waste, and general medical waste). Results: All the 100 dental clinics were found to treat liquid waste from suction pumps and spittoon containers in the same manner as general waste water. Nineteen percent of the clinics treated solid waste that was not filtered through the filter of a suction pump as general waste. Fifty or more percent of the clinics treated solid waste in spittoon containers as general waste. Seventy percent of the clinics used disinfectant solution, although most of them treated used disinfectants in the same manner as general waste water. Some clinics treated used X-ray developer and X-ray fixer in the same manner as general waste water. In most of the clinics, used drapes were washed within the clinic. Conclusions: It was found that waste water and dental wastes at some dental clinics were treated in inappropriately. Thus, in conclusion, the development of guidelines regarding proper management of liquid and solid dental waste at dental clinics is required, and hygiene and environmental training for workers at dental clinics is necessary.

The purpose of this study was to synthesize biomaterials from daily dental waste. Since alginate impression material contains silica and calcium salts, we aimed to synthesize calcium silicate cement from alginate impression material. Gypsum-based investment material was also investigated as control. X-ray diffraction analyses revealed that although firing the set gypsum-based and modified investment materials at 1,200°C produced calcium silicates, firing the set alginate impression material did not. However, we succeeded when firing the set blend of pre-fired set alginate impression material and gypsum at 1,200°C. SEM observations of the powder revealed that the featured porous structures of diatomite as an alginate impression material component appeared useful for synthesizing calcium silicates. Experimentally fabricated calcium silicate powder was successfully mixed with phosphoric acid solution and set by depositing the brushite. Therefore, we conclude that the production of calcium silicate cement material is possible from waste alginate impression material.