The vast majority of root canal treatments in Sweden are performed in general dentistry. For root canals, good hygiene is important so that bacteria do not remain in the tooth, which is of great importance for the success of treatment.
– We know that the result is not ideal. In a recent study, a third of root-filled teeth had signs of inflammation at the root tip. “I wanted to know if there was something that could improve the outcome,” says PhD student Leona Malmberg, who wrote the thesis.
I investigated how knowledge of infection control during root canal treatment emerges in general dentistry. This was done, among other things, through surveys of approximately 800 general dentists in Sweden and Norway.
Not everyone used hand sanitizer
The answers showed that there are still gaps in knowledge about simple healthcare hygiene.
– Although most people said they followed routine procedures, one in ten said they did not use hand sanitizer at all in relation to root canal treatment. Leona Malmberg says they just used gloves instead.
Another notable finding is that a third of them did not receive any additional training in this field after basic education. Many also did not know that it is very difficult for treatment to be successful if there is already an infection in the tooth.
– It indicates that they did not take seriously that it was about infection prevention. If you do not have this understanding, there is a risk that you will not take healthcare hygiene seriously enough.
Stress during the pandemic may have had an effect
In a partial study, Leona Malmberg also compared how clean teeth were when general dentists washed before a root canal compared to specialist dentists. The difference was huge. In general dentists, approximately one-third of washed work areas had positive bacteria samples after disinfection. The corresponding figure was seven percent in the specialized clinic.
The study was conducted during the pandemic and showed significant changes over time. Initially, when general dentists treated only emergency patients, the number of positive bacteria samples was lower. As the study progressed, the percentage of surfaces containing bacteria increased.
– It is thought-provoking and suggests that hygiene procedures are followed less well the more compressed a person’s schedule is. Although personal responsibility is great, organizations also need to make sure their employees can follow routines, whether through time in the schedule or additional training, says Leona Malmberg.
This is how the studies were done
In a survey, 819 general dentists were asked, among other things, to answer questions about infection control during root canal treatment and their sources of knowledge.
Two studies collected data on dental staff’s experiences during the pandemic, for example what made it difficult or easy to follow hand hygiene guidelines. 1,246 dentists, dental hygienists and dental nurses were included in the studies.
In a prospective observational study, the ability of general dentists to reduce contamination on the tooth surface before a root canal was evaluated, compared with dentists in a specialist practice. The study included 353 teeth undergoing root canal treatment, 153 in general dentistry and 200 in specialty dentistry.
thesis:
Endodontic infection control in general dentistry: barriers, facilitators and clinical practice,Malmö University.
communication:
Leona Malmberg, PhD student at Malmö University Faculty of Dentistry, [email protected]
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