Sir, recent research into hearing loss, hearing aids, and dementia1 has concluded that people with hearing loss have a 20% higher risk of developing dementia than people with no hearing loss. This is reduced to 6% if hearing aids are worn. This link intensifies the need for dentists to consider and manage the risk to themselves, and to their staff.
The association between the use of the air rotor handpiece and hearing loss is well researched and documented2,3,4with dentists using this equipment suffering twice the incidence of hearing loss and tinnitus compared to the general population. The association was noted even among dental students after as little as 15 minutes' exposure.5
The air rotor handpiece operates with noise levels reportedly between 70 and 82 dBA, with peaks up to 105 dBA. The Control of Noise at Work Regulations 20056 sets action by employers at certain noise exposure levels. These include risk assessments, provision of hearing protection, and health surveillance, including hearing tests.
A quick scan through advice and guidance given relating to PPE shows a heavy influence from the COVID pandemic, a concentration on prevention of cross infection and protection of eyes and skin, and a total absence of reference to noise levels and hearing impairment, for example Practice Support Manual.7
Ear protection devices (EPDs) range from the simple cotton wool ear plug, to devices which block certain levels of noise or certain sounds and allow normal conversation.
Should guidance now be reviewed to include specific reference to the risk of hearing loss and subsequent dementia, and to the responsibility of employers to protect their staff?
References
Cantuaria M L, Pedersen E R, Waldorf F B et al. Hearing loss, hearing aid use, and risk of dementia in older adults. JAMA Otolaryngol Head Neck Surg 2024; doi: 10.1001/jamaoto.2023.3509.
Sound Relief Hearing Center. Hearing loss and tinnitus among dentists. Available at: https://www.soundrelief.com/hearing-loss-and-tinnitus-in-dentists/ (accessed January 2024).
Murray I D. High rates of hearing loss and tinnitus amongst dentists: peril of the high-speed handpiece. 2019. Available at: https://www.oralhealthgroup.com/features/high-rates-of-hearing-loss-and-tinnitus-amongst-dentists-peril-of-the-high-speed-handpiece/ (accessed January 2024).
Grover A. Hearing loss in dentistry: a silent topic. 2022. Available at: https://www.todaysrdh.com/hearing-loss-dentistry-silent-topic/ (accessed January 2024).
Bowman D C, Blanchett L J, Doemling D B. Temporary auditory threshold shift from following sophomore operative technique laboratory. J Dent Educ 1980; 44: 261-263.
HSE. The Control of Noise at Work Regulations 2005. Available at: https://www.hse.gov.uk/noise/regulations.htm (accessed January 2024).
Scottish Dental Practice Clinical Effectiveness Programme. Practice Support Manual. Available at: https://www.psm.sdcep.org.uk/ (accessed January 2024).
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Aukett, J. Ear protection for dental practitioners. Br Dent J 236, 148 (2024). https://doi.org/10.1038/s41415-024-7086-4
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DOI: https://doi.org/10.1038/s41415-024-7086-4
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