@article{ref1,
title="Changes in occupational health problems and adverse patient reactions in orthodontics from 1987 to 2000",
journal="European journal of orthodontics",
year="2003",
author="Jacobsen, Nils and Hensten-Pettersen, Arne",
volume="25",
number="6",
pages="591-598",
abstract="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.",
language="",
issn="0141-5387",
doi="",
url="http://dx.doi.org/"
}