Hearing loss in dentistry

[swiminh2o]

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I am an audiologist switching careers into dentistry. When I was in grad school when of my profs. was doing basic research for a company who made dental drills. He was measuring the dB levels that the drills put out (can't remember the dB levels anymore). I am interested to know if any of you dental students are counseled regarding potential hearing loss due to long term exposure to drills? I have a few dentist patients of mine with high frequency hearing loss. I have even fit a few with musician earplugs (have special filters so you can carry a conversation but block majority of noise). I understand the drills have improved over the years (quieter). Just wondering if this issue has been considered?

Swim

 

[UBTom]

You might want to ask Gavin about the new electric handpieces they got there at the Arizona dental school. Those are supposed to be a lot quieter than the air-turbine high-speeds that are standard today. I have yet to try an electric, but if those live up to all they are cracked up to be, that high-pitched whining noise associated with "dental drills" might just become a thing of the past.

 

[ehop24]

i believe that the potential for hearing loss is considered a potential ergonomic issue for dentists, much like carpal tunnel syndrome, and neck/back disorders.

several years back (7? 10? 20? i dont remember which), there was a major push by dental governing bodies for more attention to be paid toward ergonomics in the office. it's as much an issue today as it was then, but it seems that it doesnt quite have the buzz it once did. many industry analysts believe that design and manufacturing costs were the reason the ergonomic movement didnt gain more ground.

before you sit down in lab your first day of dental school, you should be educated about the shortcomings of poor ergonomics in dentistry. i wasnt. was anyone else?

 

[3rdMolarRoller]

When I was interviewed here at NYU they told me about all that stuff...didn't discourage me

 

[ItsGavinC]

I was just thinking about this the other day.

The electric drills are MUCH quieter than the air-turbine counterparts, I'd say there is probably a 70% reduction in noise.

On the flip side, I'm sure it will STILL be noisy in our sim-lab when we go to work with them.

After all, 54 of anything running is going to be loud, or at least highly obnoxious.

Still, with the quieter electric handpiece and the actual time that the dentist spends using it, I don't think there is any risk at all for hearing loss.

 

[UBTom]

Yup, ergonomics is a big deal at my school. During freshman and sophomore years we are graded for positioning during every competancy and practical exam in the preclinic lab courses that involves the mannequin-mounted typodonts.

I do make a conscious effort to properly position myself and the patient during the procedures, but there are still times when I need to do the contortionist's act for certain crucial stages of a procedure, such as refining the margin for a crown prep on the distal of posterior teeth.

I don't know about NYU these days, but back when my sister was a student there, she tells me positioning wasn't that big a deal there and you contort yourself as needed to get the job done. 😛 I do nag her about it now and then though heh heh..

 

[ent_doc]

Originally posted by ItsGavinC
I was just thinking about this the other day.

The electric drills are MUCH quieter than the air-turbine counterparts, I'd say there is probably a 70% reduction in noise.

On the flip side, I'm sure it will STILL be noisy in our sim-lab when we go to work with them.

After all, 54 of anything running is going to be loud, or at least highly obnoxious.

Still, with the quieter electric handpiece and the actual time that the dentist spends using it, I don't think there is any risk at all for hearing loss.

Electric drills still produce quite a bit of sound pressure; see the following abstract from PubMed:

Implications of sound levels generated by otologic devices.

Michaelides EM, Kartush JM.

Michigan Ear Institute, 30055 Northwestern Highway, Farmington Hills, MI 48334, USA. [email protected]

OBJECTIVE: Exposure to loud noise can result in sensorineural hearing loss. In otology, a wide variety of devices are used that have significant noise output, both to the operator and the patient. This study quantifies and compares the sound pressure levels (SPL) of a variety of otologic instruments. METHODS: Using a calibrated sound pressure level meter, the peak and impulse sound pressure levels of several otologic instruments were determined at 1 cm from their application to human temporal bones. Devices measured were an air-powered drill with a cutting burr, an electric micro-drill, and KTP, CO(2), and erbium lasers. RESULTS: Impulse sound pressure levels for the KTP laser, CO(2) laser, microdrill, air-powered drill and erbium laser were 67, 71, 90, 105, and 105 dBA, respectively. Peak sound pressure levels were 81, 89, 102, 118, and 132 dBA, respectively. CONCLUSIONS: Use of the KTP laser, CO(2) laser, and microdrill result in impulse levels of less than 100 dBA. Although the impulse levels of the erbium laser and the air-powered drill were equivalent, the peak sound pressure levels of the erbium laser were significantly higher. These high sound pressure levels may increase the chance for hearing loss. Like any tool, lasers and drills have benefits and risks. The results of this study demonstrate significant differences in SPLs of common otologic lasers and drills. Although noise-induced hearing loss is a function of both SPL and duration of exposure, surgeons should consider these differences when selecting and applying these tools, especially when used on or adjacent to the ossicular chain and stapes footplate.

--> Peak levels from electric drill were only 16dB lower; both were over 100dB SPL (sound pressure level).

If you're constantly using these drills, you definitely are at risk for long-term hearing loss; particularly if you have a genetic predisposition.

Come in for an audiogram periodically
🙂