Tufts Dental Medicine

It happened in the blink of an eye. Peter Arsenault, D94, was in his private practice, drilling out a patient’s faulty silver filling. He was wearing safety glasses and a mask. He felt something fly into his eye. A chunk of filling had spun off the handpiece and shot through the narrow space between the bottom of his safety glasses and his cheek.

He ended up in the ER. A month later, another small fragment landed in his eye—again, while wearing safety glasses.

“I realized there was this bottom gap, and when I was drilling, I was in the line of fire” from molten metal, broken burs, pumice and other debris, says Arsenault, an associate clinical professor in the department of comprehensive care at the School of Dental Medicine. “I thought, ‘I can’t be the only dentist this has happened to.’ ”

Conversations with colleagues revealed that, indeed, many had had similar experiences. The national standards for safety glasses, Arsenault learned, address front impact and side shields, but not the gap at the bottom. As a dentist with a mechanical bent—he has degrees in plastics engineering and worked as an engineer before going to dental school—Arsenault and an engineer friend set out to investigate the problem. Their independent research used mannequin heads and spray bottles of red dye to demonstrate that in most styles of safety glasses, the bottom gap exposes the eyes to flying debris when a dentist leans over a patient.

Arsenault brought the issue to the American Dental Association, and is leading a subcommittee on eye safety. Shannon Mills, who serves on the ADA’s standards committee for dental products, hopes the data developed by Arsenault’s group can be used by the American National Standards Institute (ANSI), the nonprofit that oversees protective products for U.S. industries, to develop new standards for dental eyewear.

The national standards for safety glasses address front impact and side shields, but not the gap at the bottom.

“[The ADA] doesn’t write the standards, but we can write supporting documentation and work with ANSI” to make changes, Mills says. Arsenault’s group hoped to have its findings ready by the end of 2015, and Mills says the standards committee is putting together a working group of dental professionals, safety experts and industry representatives to consider solutions.

Requirements for dental safety eyewear were put into place in the early 1990s, driven by concerns about blood-borne pathogens, not projectiles. “Because of the way patients and dentists are positioned in the operatory, the standards for safety eyewear used in other industrial settings don’t provide adequate coverage for dentists,” Mills says.

It’s difficult to get an accounting of how many dentists suffer eye injuries, Arsenault says, because emergency departments do not record patients’ professions or how the injuries occurred.

Mills, a vice president at Northeast Delta Dental, is all too familiar with the bottom gap. As a dental student in the 1970s, long before eyewear was a standard in dental practice, a doctor said to him, “If I didn’t know better, I’d swear you had pieces of gold in your eye.” And yes, he did—the result, apparently, of polishing crowns and other restorations. Later, while serving in the Air Force, Mills ran the technical evaluation program for dental equipment, including safety glasses.

“When [Peter Arsenault] came to us, I said, ‘I know exactly where you’re going with this,’ ” says Mills.

Contact Helene Ragovin at helene.ragovin@tufts.edu.