Infection control has become one of the most discussed topics in dentistry. Dental care professionals are at an increased risk of cross infection while treating patients. With rise in the number of people infected with hepatitis B and AIDS viruses, cross infection has become of paramount concern to the dentist and his patient. The objective of this study is to assess the infection control practice in private dental units in Riyadh, Saudi Arabia.
Methodology
The study was accomplished using a cross sectional survey confined to private dental practices in Riyadh City. A total sample size of 130 dental units was chosen using the proportional allocation method. Three hospitals, 45 clinics and 39 centers were selected randomly. A self-administered questionnaire was completed. Odd ratio (OR) and 95% confidence interval (95% CI) were used to calculate the likelihood of compliance among the studied dentists.
Results
Of the 206 questionnaires, 203(98.5%) were completed. The mean age of responding dentists was 36.8 + 6.7 years. Dentists working in private dental clinics were from different nationalities. About two thirds 139 (68.5%) of dentists were general practitioners and 64 (31.5%) were specialists in different dental specialties. The experience of around two thirds of the studied dentists ranged from 6 to 15 years with a mean of 13.2 + 6.1 years. More than one half of the studied dentists examined 6 to 10 patients daily. A total of 137 (67.5%) reported that they had a history of a needle stick injury during treatment of patients. A total of 144 (70.9%) dentists stated that they had been vaccinated against hepatitis B virus. A total of 189 (93.1%) dentists mentioned that they always took a medical history of each patient before treatment. All the studied dentists stated that they always used gloves for each patient during dental treatment. More than 90% of dentists always wore a facemask during dental treatment. More than half of those wearing a facemask reported changing it after each patient. Protective glasses (eye glasses or eye protector or single face shield) were always worn by more than 70% of dentists. Only 13 (6.4%) dentists in this study always used a rubber dam during dental treatment. More than 96% of dentists said that the Hepatitis virus and AIDS are the most important infectious diseases in dental practice. The primary source of infection control information for the studied dentists were colleagues (78%). Of the studied dentists, 166 (82%) said that they refused to treat AIDS and 68 (33%) to treat hepatitis patients. Only 37.9% of the dentists sterilized hand-pieces by autoclaving, and 53.7% wiped them with disinfectant. About 44% of dentists disposed of used needles and sharp instruments in a special safety container. Dentists working in clinics were more than three times likely to be compliant to infection control practice than those working in other places, which was statistically significant (OR=3.23, CI=1.07-10). The probability of compliance among dentists of age < 40 years was one tenth of those > 40 years of age, and this difference was also statistically significant (OR=0.11, CI=0.03-0.36). Arab dentists were one fourth more likely to be compliant than non-Arabs, and this was statistically significant (OR=0.26, CI=0.08-0.88). Dentists with <15 years experience were one fifth likely to be compliant than those with over 15 years experience, and was statistically significant (OR=0.2, CI= 0.06 - 0.63).
Conclusion
The observation that very few respondents followed the full requirements of infection control practice developed by ADA and CDC is significant. The compliance with internationally recommended procedures was weak for a number of procedures. Universal cross infection control procedures are to be implemented when treating each patient.