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Knowledge, Attitudes, and Perceptions of Dental Assistants Regarding Dental Asepsis and Sterilization in the Dental Workplace

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Knowledge, Attitudes, and Perceptions of Dental Assistants Regarding Dental Asepsis and Sterilization in the Dental Workplace Hindawi International Journal of Dentistry Volume 2021, Article ID 5574536, 7 pages https://doi.org/10.1155/2021/5574536 Research Article Knowledge, Attitudes, and Perceptions of Dental Assistants regarding Dental Asepsis and Sterilization in the Dental Workplace Syed Sarosh Mahdi ,1,2,3 Zohaib Ahmed ,4 Raheel Allana ,5 Francesco Amenta ,2 Daniyal Agha ,1 Mohammad Wasay Latif ,1 Umer Daood ,6 and Carina Mehanna 7 1Faculty of Dentistry, Jinnah Medical & Dental College, Sohail University, Karachi, Pakistan 2Centre of Clinical Research, Telemedicine and Telepharmacy, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy 3Athena Centre for Advanced Research in Health Care, Camerino, Italy 4Dental Public Health Graduate, College of Dental Medicine, Columbia University, New York City, NY, USA 5Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan 6Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126 Jalan Jalil Perkasa 19, Bukit Jalil 57000, Wilayah Persekutuan Kuala Lumpur, Malaysia 7Postgraduate Program Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut, Lebanon Correspondence should be addressed to Syed Sarosh Mahdi; [email protected] Received 23 January 2021; Revised 17 May 2021; Accepted 4 June 2021; Published 17 June 2021 Academic Editor: Sreekanth Kumar Mallineni Copyright © 2021 Syed Sarosh Mahdi et al. (is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aims and Objectives. (is study aims to assess the knowledge, attitude, and perceptions of dental asepsis and sterilization among dental assistants in Pakistan. Materials and Methods. A cross-sectional study was carried out. A 27-item prepilot tested close- ended questionnaire was designed and administered online to collect data on knowledge of asepsis, sterilization, instrument handling, disinfection, hand-hygiene practices, dental practice, age, education, and experience level from March 2020 to June 2020. Results. Out of 70 dental assistants, the majority were aged between 21 and 29 years (44.30%), more than two-thirds (85.41%) of the dental assistants were working in a hospital, while 14.29% were working in private clinics, only 7.1% had a diploma in the dental assistant program, and 74% had more than 2 years of experience in practice. Dental assistants working in private practice (76.30) had a higher mean knowledge scores compared to those working in hospital (74.25), while those with less than 2 years of experience (75.61) had a higher scores compared to those with 2–5 years of experience (73.96). Conclusion. Better compliance with recommended infection control and waste management practices is needed for all dental assistants. Continuing education programs targeting such awareness are vital to improve the management of hazardous waste practices among dental assistants. 1. Introduction and poor infection control practices [2]. Dental team is at a very high risk of exposure to infections caused by blood- Dental professionals are exposed to several occupational borne pathogens like hepatitis B virus (HBV), human im- hazards due to the nature of their work and proximity to munodeficiency virus (HIV), and hepatitis C virus (HCV) their patients. (ese risk factors include exposure to mi- [1]. Dental work force is also highly susceptible to other crobial and chemical hazards [1]. (e risk of occupational pathogens like streptococci and many other diseases of viral exposure to infectious diseases in dental practice is increased and bacterial origin that colonize the mouth and respiratory with lack of knowledge regarding infection control protocols tract [3, 4]. (ere are many routes of infection transmission 2 International Journal of Dentistry in the dental office, including blood, bodily fluids, droplets, study to assess the knowledge, attitude, and perceptions for needle-stick injury, contaminated water sources from the dental asepsis and sterilization among dental assistants dental units, and aerosols as well as indirect transmission working in Karachi, Pakistan. which occurs through contact with contaminated surfaces and instruments [5–7]. (is has led to increased concerns 2. Methodology regarding infection control and cross-infection practices in dental settings, which has been investigated in many (e study was authorized by the ethical Review Board of countries including North America and Europe [8–12]. Jinnah Medical and Dental College, Karachi, Pakistan, (e correct application of infection control protocols following approval from participating sites. To protect the and precautions can significantly reduce the risk of cross privacy and confidentiality of participants, the survey was infection in dental settings [1]. Compliance with infection kept anonymous with no identifiable information. Partici- control guidelines is paramount in breaking the chain of pation in the study was voluntary with no compensation, infection of communicable diseases and safe delivery of and all participants received information regarding the aims dental care [13]. (e Center for Disease Control and Pre- and purpose of the study prior to their participation. vention (CDC) published the guidelines for infection control A nonprobability convenience sampling was utilized to in dental settings in 1993 and most of the international take the sample from an accessible population. (e ques- guidelines are based on these guidelines, but they have tionnaire created for this study included questions about changed and evolved over time [14]. (ese preventive in- asepsis and sterilization procedures. We divided the ques- fection control protocols were laid down primarily as a tionnaire into subcategories according to the procedure response of the outbreak of the human immunodeficiency involved. (e first group of questions were regarding pre- virus (HIV) epidemic of the 1980s, as these protocols have sterilization; group 2, verification of biological processes been upgraded and revised regularly following their adap- involved in sterilization cycles; group 3, autoclave use. tion over the years [14]. Following its worldwide adoption, Category 4 questions were regarding documentation of the these were called the universal precautions and were sterilization process. Twenty-seven questions were created implemented globally to prevent the transmission of blood- largely tailored to the standard precautions advocated by borne diseases like HBV, HBC, and HIV [15]. (e Occu- World Health Organization’s (WHO’s) health governing pational Safety and Health Administration (OSHA), which standards and recommended guidelines for dental practi- is a regulatory body in the United States, also based its blood- tioners in the local disinfection and decontamination unit borne pathogen infection control standards on the universal (LDU) HSE, 2012 (revised edition 2014), which has been precautions following their acceptance [15]. (ese guidelines adapted by many developed countries [24]. were further expanded with recommendation that all work (e questionnaire was validated via a convenience surfaces, instruments, and equipments should be cleaned sample from a small number of dental assistant trainees and disinfected after coming into contact with blood, saliva, (n � 24). (e validity of the content was evaluated through and other infectious materials [16]. Work surfaces should be expert opinion and further analysis was carried out. (e disinfected before arrival of new patient and after com- ethical committee also suggested a few minor changes in the pletion of the procedure on each patient [16]. Vaccinations questionnaire. (e final questionnaire showed average in- of the dental workforce were made mandatory where ternal consistency (Cronbach’s alpha 0.68) with participants available as some forms of exposures are inevitable, as it taking on average 9.3 (±2.4) minutes to complete. provides protection against vaccine-preventable diseases (e findings of the pilot survey questionnaire were not [17]. (e reuse of syringes, saline solution, and vials between included in the key report. (e principal investigator wrote patients has resulted in multiple outbreaks of hepatitis B and to a number of dental associations, requesting their assis- hepatitis C infections and hence was completely prohibited tance in having dental assistants complete the research [17]. All these guidelines have ultimately increased com- questionnaire. (e questionnaire was administered in En- pliance on aseptic methods during administration of par- glish language as it is considered the official language in enteral medications [18–20]. Pakistan. (e questionnaire was administered personally Many studies have shown poor compliance with in- and through referrals, an online link was forwarded to fection control protocols despite the issuance of such various dental establishments in Karachi. A total of 70 re- comprehensive infection control guidelines [21]. Moreover, sponses were received by the research team during this this issue is of more concern in developing countries where period from a total of 105 dental assistants approached. (e such guidelines and protocols have not been well docu- response rate was found to be 66.6%. mented and established [22]. Many hospitals lack infection (ere were 3 questions related to demographic variables control
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