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Abstract
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The purpose of the present investigation was to
assess the reasons for changes in occupational health problems and patient
reactions to orthodontic treatment after a survey carried out in 1987.
Questionnaire data on occupation-related health complaints and patient reactions
over the preceding 2 years were obtained from 121 of 170 Norwegian orthodontists
(71 per cent). Most health complaints were dermatoses of the hands and fingers
related to the processing of acrylic removable appliances, to composite bonding
materials, or gloves. A few reactions were of a respiratory or systemic nature.
In total, occupation-related dermatoses were reported by 17.4 per cent (21/121)
compared with 40 per cent previously. Non-dermal complaints comprised 9 per cent
compared with 18.2 per cent in 1987. Patient reactions were distributed equally
between intra-oral reactions affecting lips, gingiva, oral mucosa, and tongue,
and dermal reactions affecting the corner of the mouth, the dorsal part of the
neck, the peri-oral area, cheeks, chin or skin elsewhere. A few patients had
systemic reactions. The assumed eliciting agents of intra-oral reactions were
fixed metallic appliances, acrylic removable appliances, polymer brackets or
composite bonding materials, or were related to elastics. Extra-oral (dermal)
reactions were attributed to metallic, elastic or textile parts of the
extra-oral appliances. Some reactions were verified as allergies. The percentage
of patient reactions in total was estimated to be 0.3-0.4 per cent compared with
0.8-0.9 per cent in 1987. The reduction in occupation-related health complaints
among orthodontists was explained by changes in previously important hygiene
factors such as soaps, detergents, etc., whereas the biomaterials-related
reactions persisted. The reduction in the 2 year incidence of patient reactions
was associated with a marked reduction in extra-oral reactions following
preventive measures such as coating metallic devices, whereas the intra-oral
reactions persisted at the same level as previously. |