Idiopathic Pulmonary Fibrosis in Dentists May Be Linked to Occupational Exposure

Dentist, dental check up
Dentist, dental check up
Several patients were treated for idiopathic pulmonary fibrosis were identified as dental personnel.

A cluster of patients treated for idiopathic pulmonary fibrosis (IPF) at a tertiary care center in Virginia during 2000 to 2015 were identified as dental personnel (8 dentists, 1 dental technician). Although no clear etiology exists, a Centers for Disease Control and Prevention (CDC) investigation into the cases notes that occupational exposures could have contributed. 

In 2016, a dentist who had been diagnosed with IPF alerted the CDC that there had been multiple IPF cases among dentists at the specialty clinic in Virginia. The number of dentists receiving IPF care at this one center was nearly 23-fold higher than the number of dentists in the US (.893% vs .038%). The average age of the dentists at the time of consultation was 64 years. Among those who died, the average survival time was 3 years (range, 1-7). 

The CDC investigators were able to administer a questionnaire to 1 of the living patients. He reported polishing dental appliances and preparing amalgams and impressions without respiratory protection. Some substances used while conducting these tasks contained silica, polyvinyl siloxane, alginate, and other compounds with known or potential respiratory toxicity. 

Since no published data exists on a link between IPF and dental personnel, the CDC queried the National Occupational Respiratory Mortality System for 4 years (1999, 2003, 2004, and 2007) for “other interstitial pulmonary diseases with fibrosis” listed as the underlying or contributing cause of death. For those who worked in the “office of dentists” the proportionate mortality ratio was 1.52 (95% CI,1.05-2.11), and for dentists themselves it was 1.67 (95% CI, 1.01-2.61). “These findings suggest that a higher rate of IPF might occur among dental personnel than among the general population,” the authors wrote. 

The CDC concluded that further investigation into the risk for IPF in dental personnel is warranted. 

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Nett RJ, Cummings KJ, Cannon B, et al. Dental personnel treated for idiopathic pulmonary fibrosis at a tertiary care center — Virginia, 2000–2015. Morb Mortal Wkly Rep 2018;67:270-273.

This article originally appeared on MPR