Assessment of noise intensity in a dental teaching clinic

Changes in Plasma Levels of Prestin and Otolin-1 in Dental Students

INTRODUCTION

Dentists and dental professionals report a high prevalence of noise-induced hearing loss (NIHL) and related symptoms. Chronic exposure to high-frequency dental instrument sounds, which can damage the outer hair cells (OHCs) of the cochlea, is strongly linked to their NIHL. Similarly, dental students in teaching clinics often report symptoms associated with NIHL. In this study, we measured plasma levels of prestin and otolin-1, two biomarkers associated with inner ear health, in first-year (D1) and third-year (D3) dental students. D1 students were selected for their relatively short exposure to dental clinics, while D3 students represented a group with substantial cumulative exposure. First-year (M1) medical students, who have no exposure to dental instruments, served as the negative controls, while dental faculty, many of whom are diagnosed with NIHL or self-report hearing problems, served as the positive controls.

METHODS

Thirty-one students (D1=11, D3=8, M1=12) and 10 dental faculty volunteered for the study. Participating students completed an online survey about their hearing health, exposure to excessive sounds within and outside school, and use of hearing protection. Sound levels of medical Osteopathic Manipulative Medicine (OMM) and dental Simulation (SIM) labs while in session were recorded with a calibrated sound meter. Plasma levels of prestin and otolin-1 were quantitated using commercial ELISA kits.

RESULTS

The sound level of in-session OMM lab was significantly higher (72.64 ± 1.69 dBA) than SIM lab (65.37 ± 3.97 dBA). Both medical and dental students experienced similar exposure to outside school noises; however, dental students had significantly longer exposure to high-frequency dental instrument sounds in the SIM lab (12.3 hours/week; 74.93-80.51 dBA). Plasma prestin levels were lowest in D3 students (559.88 ± 24.91 ng/ml), followed by D1 students (576.27 ± 71.44 ng/ml). Negative control M1 students had higher levels (675.73 ± 90.23 ng/ml), while the positive control dental faculty group exhibited the highest prestin levels (727.71 ± 128.65 ng/ml). Prestin levels in D3 students were significantly lower than those in M1 students, and the dental faculty group had significantly higher prestin levels than both D1 and D3 students. No differences in otolin-1 levels were observed among the groups.

CONCLUSIONS

Our finding that D3 students, with greater experience using dental instruments in the SIM lab, exhibited the lowest plasma prestin levels may indicate a protective mechanism by the OHCs, downregulating its expression to reduce the risk of NIHL. This is in line with the findings in the dental faculty, who self-reported NIHL or hearing problems and exhibited the highest prestin levels. The lack of changes in plasma otolin-1 levels across groups, combined with students self-reporting excellent hearing health, may offer alternate view of subclinical inner ear damage among dental students. Future studies incorporating audiometry and otoacoustic emission tests along with the inner ear biomarkers may provide better understanding of NIHL in dental students.

Basic characteristics of tongue pressure and electromyography generated by articulation of a syllable using the posterior part of the tongue

The basic function of the tongue in pronouncing diadochokinesis and other syllables is not fully understood. This study investigates the influence of sound pressure levels and syllables on tongue pressure and muscle activity in 19 healthy adults (mean age: 28.2 years; range: 22-33 years). Tongue pressure and activity of the posterior tongue were measured using electromyography (EMG) when the velar stops /ka/, /ko/, /ga/, and /go/ were pronounced at 70, 60, 50, and 40 dB. Spearman's rank correlation revealed a significant, yet weak, positive association between tongue pressure and EMG activity (ρ = 0.14, p < 0.05). Mixed-effects model analysis showed that tongue pressure and EMG activity significantly increased at 70 dB compared to other sound pressure levels. While syllables did not significantly affect tongue pressure, the syllable /ko/ significantly increased EMG activity (coefficient = 0.048, p = 0.013). Although no significant differences in tongue pressure were observed for the velar stops /ka/, /ko/, /ga/, and /go/, it is suggested that articulation is achieved by altering the activity of both extrinsic and intrinsic tongue muscles. These findings highlight the importance of considering both tongue pressure and muscle activity when examining the physiological factors contributing to sound pressure levels during speech.

[Noise levels of dental equipment used in a dental schoolNíveis de ruído gerados por procedimentos realizados em uma escola de odontologia]

Introduction

Dental professionals are exposed to different noise levels in their work environment during their clinical practice, mainly caused by dental instruments and rotary instruments used on a daily basis. Noise levels may vary according to the type of clinical specialty.

Objective

To determine noise levels during dental procedures in dental school clinics.

Materials and Methods

An analytical cross-sectional study was conducted by means of non- probability convenience sampling to determine dental specialties to be evaluated. BENETECH GM1352 30-130dB Digital Sound Level Meter with accuracy +/- 1.5 dB and A weighting was used for measurements. Mann-Whitney U and Kruskal-Wallis H tests were used to identify differences in noise levels among dental specialties.

Results

Measured median noise level was 75.94 dB (RCI 74.21 -77.51), dental surgery was identified to have the highest noise among clinical specialties (median 77.34 and RCI 76.44 -79.4 dB).

Conclusions

Dental surgery, oral rehabilitation, endodontics and pediatric dentistry were found to be the clinical specialties where noise exposure is within the limits established by Colombian regulations for noise in the workplace.

Effect of Titrated Exposure to Non-Traumatic Noise on Unvoiced Speech Recognition in Human Listeners with Normal Audiological Profiles

Non-traumatic noise exposure has been shown in animal models to impact the processing of envelope cues. However, evidence in human studies has been conflicting, possibly because the measures have not been specifically parameterized based on listeners' exposure profiles. The current study examined young dental-school students, whose exposure to high-frequency non-traumatic dental-drill noise during their course of study is systematic and precisely quantifiable. Twenty-five dental students and twenty-seven non-dental participants were recruited. The listeners were asked to recognize unvoiced sentences that were processed to contain only envelope cues useful for recognition and have been filtered to frequency regions inside or outside the dental noise spectrum. The sentences were presented either in quiet or in one of the noise maskers, including a steady-state noise, a 16-Hz or 32-Hz temporally modulated noise, or a spectrally modulated noise. The dental students showed no difference from the control group in demographic information, audiological screening outcomes, extended high-frequency thresholds, or unvoiced speech in quiet, but consistently performed more poorly for unvoiced speech recognition in modulated noise. The group difference in noise depended on the filtering conditions. The dental group's degraded performances were observed in temporally modulated noise for high-pass filtered condition only and in spectrally modulated noise for low-pass filtered condition only. The current findings provide the most direct evidence to date of a link between non-traumatic noise exposure and supra-threshold envelope processing issues in human listeners despite the normal audiological profiles.

Noise Disturbance and Potential Hearing Loss Due to Exposure of Dental Equipment in Flemish Dentists

Long-term exposure to occupational noise is often associated with noise-induced hearing loss (NIHL) among dentists. This study aims to investigate potential hearing loss (HL) and self-reported annoyance as a result of exposure to noise produced by contemporary dental equipment. Methods: Three cohorts participated: 53 dentists with more than 5 years of service, 47 dentists with at most 5 years of service, and 53 pharmacists as controls, age and gender-matched to the first group. After the exclusion of one person, the hearing of 304 ears was screened with the Flemish version of the digit triplet in noise test (DTT). If screening failed, otoscopy and pure tone audiometry (PTA) were performed for both ears. Furthermore, general information, knowledge, exposure, annoyance, general health, and preventive measures were assessed with a custom-made questionnaire. Results: NIHL did not occur significantly more often with dentists than with controls. However, dentists revealed a significantly higher annoyance (related to the noise from their equipment) and reported more complaints than the pharmacists. All three groups indicated lack of knowledge on hearing care. Conclusions: While noise levels in contemporary dentistry are not harmful and do not induce NIHL, the sounds emitted by the devices are disturbing and affect mental health. This study calls for increased awareness of the consequences of sound exposure and stresses the need to monitor and protect the hearing of dentists regularly.

Noise-induced hearing loss in the military dental setting: a UK legislative perspective

INTRODUCTION

Health professionals working in the dental environment are potentially at risk of noise-induced hearing loss (NIHL) due to the use of clinical and laboratory equipment. Workplaces engaging in the practice of dentistry within the UK are subject to legislation from the Control of Noise at Work (CNW) regulations 2005. Clinicians working in the military are at further increased risk of NIHL due to exposure from additional risk factors such as rifles or aircraft engines. To our knowledge, no authors have previously studied the noise levels experienced in a military dental setting or compared noise levels in a typical dental practice with current UK legislation.

METHOD

Measurements of noise levels experienced by a dentist, dental nurse and dental hygienist during a standard conservation procedure were assessed using wearable noise dose-badges. Furthermore, noise levels within a dental technician's work space were also assessed. Noise levels produced by representative clinical and laboratory equipment were assessed and compared with CNW legislation.

RESULTS

The highest level for clinical equipment was produced by the suction apparatus while aspirating up a cup of water at 76 dB. For laboratory equipment, the lower exposure action value (LEAV) of 80 dB would be exceeded in 2.1 hours' use of the trimmer, 3.6 hours' use of the vibrating table and 9 min use of the airline.

CONCLUSIONS

Noise levels experienced by clinicians within the dental surgery were well below the legislative LEAV thresholds for both peak and continuous noise. However, noise levels produced by laboratory equipment were far higher and there is clearly the potential for excessive noise exposure for dental professional in the everyday setting. Dental professionals responsible for dental laboratory settings must be familiar with the CNW regulations and measures put in place that control the inadvertent breach of legislation. Hearing protection must be mandated when using equipment that exceeds the LEAV and an educational programme is required to explain both their correct use and the rationale behind it. Methods of mitigating that risk further require exploration such as alternative methods of completing the tasks performed by the airline or reducing the noise generated by it, such as by reducing the supply pressure or using an alternative nozzle design.