1. Hand Hygiene Among General Practice Dentists: A Survey of Knowledge, Attitudes and Practices

Journal of the American Dental Association (JADA) published an article entitled Hand Hygiene Among General Practice Dentists: A Survey of Knowledge, Attitudes and Practices, which examines understanding attitudes, and practices of dentists in general practice towards hand hygiene, which is one of the most important elements of infection control in clinical dentistry. It was established during the research that even though most dentists know about the role of hand hygiene to prevent cross-contamination and provide the patient with safety, there is a great gap between awareness about the topic and its practice. Washing their hands with soap and water is a regular practice of most dentists, particularly during the beginnings of a working day, but the frequent application of alcohol-containing hand disinfectants particularly between patients remains a much less practiced custom. Furthermore, the survey pointed out the fact that a great number of practitioners have merely moderate levels of knowledge on the hand hygiene recommendations of the CDC, and their behaviors are not always in accordance with modern recommendations. Several adherence-related barriers were noted, such as lack of time when schedules are filled, the fears of irritating the skin by washing their hands too often and not having access to the sufficient number of resources needed to hand sanitize in the clinical place. Though professionals see the significance of hand hygiene, it has been discovered that a substantial percentage of dentists failed to stay up to the mark when it came to high levels of hygiene during the day. The authors summarized that increasing the hand hygiene compliance rates in the dental setting can be achieved by a complex strategy. These entail the enhancement of professional training, advance public awareness of evidence-based recommendations, and facilitation of the supply of alcohol-based hand rubs, and deployment of regular surveillance and feedback mechanisms. Another most important issue highlighted in the article is that improved hand hygiene behaviors among the dental professionals is not only the key to the safety of patients but also to the intake of diseases by the practitioners themselves in an era of increased interest in the infection control in health care settings. 

2. Trigeminal nerve injury associated with injection of local anesthetics
Needle lesion or neurotoxicity?

This article, published in the Journal of American Dental Association (JADA) is an exploration into the etiology of trigeminal nerve injuries, that is, whether they are caused through mechanical trauma of the injection needle, or of the neurotoxic nature of local anesthetics. It is through national pharmacovigilance, clinical assessment and reports on Denmark based pharmacovigilance study that concentrates on the most popular dental anesthetics: 2 percent lidocaine, 23 percent mepivacaine, 3 percent prilocaine and 4 percent articaine. 4% articaine was shown to be disproportionally associated with nerve damage, mainly after injections of the mandibular block (the inferior alveolar nerve). Despite the previous assumptions that nerve trauma might arise by contact with a needle or penetration by the needle itself particularly in deep blocks, the results indicate that the contributing factor might be neurotoxicity agent, and not a physical damaging agent. Solutions with higher concentration of articaine (4 percent), prilocaine (4 percent) seem to have a greater potential of producing adverse neurosensory disturbances (NSDs), especially those affecting lingual nerve, which is susceptible to it because of its location and thickness of perineurium. The sensation of tingling, numbness, or pain lasted weeks, or months, in more than half of the cases examined, and some patients did not recover completely. The article highlights the need of clinicians to take concentration and neurotoxicity of local anesthetics into consideration when choosing to use them in nerve block. It ends by strongly advising dentists not to use 4% anesthetic solutions in the usual practice of inferior alveolar nerve blockades when lower-concentrate alternatives are in place to limit injuries to the nerves in the long term. The study is an important input in patient safety in dentistry which makes more justified choices in terms of using local anesthetic.