Dog‐assisted therapy in the dental clinic. Part B. Hazards and assessment of potential risks to the health and safety of the dental therapy dog

It may state two separate claims as one.

A healthy human ear can hear sounds in the frequency range between 20 and 20,000 Hz, whereas dogs can readily perceive high-frequency sounds up to 45,000 Hz.

“A healthy human ear can hear sounds in the frequency range between 20 and 20,000 Hz, whereas dogs can readily perceive high‐frequency sounds up to 45,000 Hz (Heffner, 1983), analogous to other members of the carnivore animal order (Malkemper, Topinka, & Burda, 2015).”

• cites Heffner, 1983 sourceNot checked — no full text of the source

It may state two separate claims as one.

Risks to the health and safety of the dental therapy dog in dental clinics are present but are low if the dental clinical staff and dog handlers comply with best practices.

“Risks to the health and safety of the dental therapy dog in the clinics are present but are low if the dental clinical staff and dog handlers comply with best practices.”

It may state two separate claims as one.

Patients may accidentally harm the dental therapy dog, and different considerations apply depending on whether the patient is a child or adult, has cognitive impairment, or has a mental or behavioural disorder.

“Patients may accidentally harm the dog due to their action. Different considerations apply whether the patient is a child or an adult, a person with a cognitive impairment, or if the patient has a mental or behavioural disorder.”

It may state two separate claims as one.

Aerosols contain mainly gram-positive organisms (Staphylococcus epidermidis and Micrococcus spp.), gram-positive rod-shaped bacteria, endospore-forming and nonspore-forming bacteria, and mould fungi (e.g., Cladosporium and Penicillium).

“Aerosols contain mainly gram‐positive organisms (Staphylococcus epidermidis and Micrococcus spp.), gram‐positive, rod‐shaped bacteria, and those creating endospore as well as nonspore‐forming bacteria and mould fungi (e.g., Cladosporium and Penicillium; Kobza, Pastuszka, & Bragoszewska, 2018; Watanabe, Tamaki, Yokota, Matsuyama, & Kokeguchi, 2018).”

• cites Kobza, Pastuszka, & Bragoszewska, 2018 sourceCheck pending
• cites Watanabe, Tamaki, Yokota, Matsuyama, & Kokeguchi, 2018 sourceCheck pending

It may state two separate claims as one.

Workplace hazards in the dental clinic that apply to both humans and therapy dogs are allergies, sharps injury, eye injury, stress, rhinitis, hearing impairment, and other hazards.

“Workplace hazards in the dental clinic that apply to both humans and therapy dogs are allergies, sharps injury, eye injury, stress, rhinitis, hearing impairment, and other hazards.”

• Also stated in: § Workplace hazards in a dental clinic setting · plain

  “Prevailing hazards associated with risks for occupational health problems for dental clinic staff members apply also to a dental therapy dog.”

It may state two separate claims as one.

Poisoning is possible if a leaking or knocked-over container of medication or substance trickles to the floor, and the dental therapy dog may consume the spill regardless of whether it is innocuous or a schedule one drug or substance.

“Poisoning is possible if a container with a medication or a substance is leaking or knocked over and the contents somehow trickle to the floor. The dental therapy dog may be tempted by the smell and taste to consume the spill out regardless of whether it is innocuous or a schedule one drug or substance.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

A dental therapy dog positioned too close to an operation field risks eye damage if the clinical work generates high-velocity particulates.

“A dental therapy dog positioned too close to an operation field risks eye damage if the clinical work generates high‐velocity particulates.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Accidental breakages, knocked-over bottles, solution spills, and leakages on benchtops or floors are instantaneous hazards for all stakeholders, and for a dental therapy dog also depend on how well the dog has been trained and is being monitored.

“Accidental breakages, knocked‐over bottles, solution spills, and leakages on benchtops or floors are instantaneous hazards for all stakeholders, and for a dental therapy dog also dependant on how well the dog has been trained and is being monitored.”

It may state two separate claims as one.

The chances are high that items such as used burs, unsheathed needles, empty plastic packs, metal matrix bands, and endodontic files may fall to the floor undetected, and the exploratory nature of dogs could result in trauma from biting or ingesting dropped items.

“The chances are high that innocuous items such as used burs, unsheathed needles, empty plastic packs, metal matrix bands, and endodontic files may fall to the floor undetected, and the exploratory nature of dogs could result in trauma from biting or ingesting dropped items.”

It may state two separate claims as one.

Emotionally unstable patients may suddenly turn aggressive, scream, or shout during dental treatment and frighten the dog; some dental therapy dogs may be accustomed to such behaviour and not show signs of stress although the dog may not feel comfortable.

“Emotionally unstable patients may suddenly turn aggressive, scream, or shout during the dental treatment and thereby frighten the dog. Some dental therapy dogs may be more accustomed to such behaviour and not show signs of stress although the dog may not feel comfortable.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Extremely loud bursts of sound, such as gunshots or explosions, can rupture the eardrum or damage the bones in the middle ear resulting in an immediate and usually permanent hearing loss.

“Extremely loud bursts of sound, such as gunshots or explosions, can also rupture the eardrum or damage the bones in the middle ear resulting in an immediate and usually permanent hearing loss (National Institute on Deafness and Other Communication Disorders, 2019).”

• cites National Institute on Deafness and Other Communication Disorders, 2019Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

In humans, sounds more than 85 dB SPL can damage sensitive structures in the inner ear on one or both sides and cause noise-induced temporary or permanent hearing loss.

“In humans, sounds more than 85 dB SPL can damage sensitive structures in the inner ear on one or both sides and cause noise‐induced temporary or permanent hearing loss.”

• cites National Institute on Deafness and Other Communication Disorders, 2019Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Sounds of less than 75 dB SPL are unlikely to cause hearing loss even after prolonged exposure.

“Sounds of less than 75 dB SPL are unlikely to cause hearing loss even after prolonged exposure.”

• cites National Institute on Deafness and Other Communication Disorders, 2019Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim. The paper may give no reason why it holds.

A dental therapy dog that undergoes an acute stress response during a treatment session risks becoming unusable because the animal will associate the negative experience with the dental clinic operatory and become very reluctant ever to enter a dental clinic.

“A dental therapy dog that undergoes an acute stress response during a treatment session risk becoming unusable because the animal will associate the negative experience with the dental clinic operatory and become very reluctant ever to enter a dental clinic.”

It may state two separate claims as one.

The inverse square law applies to sound, so the further a dental therapy dog is from a noise source, the lower the risk of hearing impairment.

“As for other physical phenomena, the inverse square law also applies to sound. Hence, the further away the dental therapy dog is from the source of the noise, the lower the risks of hearing impairment.”

Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it.

Many share the view, based on sound level measurements and questionnaire responses, that dental clinic staff members are placing their hearing health at risk in a typical daily work environment.

“However, many share the view, based on sound level measurements and questionnaire responses, that dental clinic staff members are placing their hearing health at risk in a typical daily work environment (Burk & Neitzel, 2016; Myers, John, Kimball, & Fruits, 2016).”

• cites Burk & Neitzel, 2016 sourceCheck pending
• cites Myers, John, Kimball, & Fruits, 2016 sourceCheck pending

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Elderly patients may have problems with their balance and unintentionally step on the dental therapy dog or stumble and fall over the dog.

“Elderly patients may have problems with their balance and unintentionally step on the dental therapy dog or even stumble and fall over the dog.”

It may state two separate claims as one.

Dog hearing becomes impaired around 8-10 years of age, with loss across the entire frequency range but primarily in the high-frequency area, similar to humans.

“At around 8–10 years of age, the hearing of dogs becomes impaired. The hearing loss is across the entire frequency range, although primarily in the high‐frequency area, just like humans. (Ter Haar, Venker‐van Haagen, van den Brom, van Sluijs, & Smoorenburg, 2008).”

• cites Ter Haar, Venker‐van Haagen, van den Brom, van Sluijs, & Smoorenburg, 2008 sourceNot checked — no full text of the source

It may state two separate claims as one.

Transient hearing loss can be measured amongst clinicians after use of ultrasound scalers, although the noise that is heard is resonance generated when the tip of the ultrasound scaler contacts the tooth or restoration surface.

“Transient hearing loss can be measured amongst clinicians after use of ultrasound scalers, although the noise that is heard is resonance generated when the tip of the ultrasound scaler contacts the tooth or restoration surface (Chopra, Thomas, Mohan, & Sivaraman, 2016).”

• cites Chopra, Thomas, Mohan, & Sivaraman, 2016 sourceNot checked — no full text of the source

It may state two separate claims as one.

A child's behaviour may be unpredictable, so there is a risk that the child may harm the dental therapy dog, for example by accidentally poking fingers into the dog's eye or pinching the dog.

“A child's behaviour may be unpredictable; hence, there is a risk that the child's way of behaving may harm the dental therapy dog. Young children may for instance accidentally poke their fingers into the dental therapy dog's eye or pinch the dog.”

It may state two separate claims as one.

All risks for the health and safety of the dental therapy dog identified and appraised in the paper are conceivable risks, and currently there is no scientific data to substantiate whether the rates of the individual risks are low, medium, or high.

“However, all the risks for the health and safety of the dental therapy dog that we have identified and appraised are conceivable risks, and currently, there is no scientific data to substantiate whether the rates of the individual risks may be considered as low, medium, or high.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

An arrangement in which the dental therapy dog moves to a floor carpet after the first few minutes reduces the risks of harmful noises and maintains a more distant position away from the hazards described.

“Such an arrangement will reduce the risks of harmful noises and maintain a more distant position away from the hazards described in the previous sections.”

It may state two separate claims as one.

Some patients, mostly children, may put their fingers in their mouth and then pet the dental therapy dog's legs; the dog may later groom its leg by licking and thereby end up with human bacteria, viruses, or fungi.

“Some patients, mostly children, may put their fingers in their mouth to show the dentist, for instance, a loose tooth or to point at where it hurts and after that continue to pet the dental therapy dog's legs. The dental therapy dog may later groom his or her leg by licking and thereby end up with human bacteria (virus and fungi).”

Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

The use of a dental therapy dog is an antianxiety approach that may provide the necessary support to overcome anxiety and achieve the objective of completing necessary dental care, thus avoiding the risks associated with use of sedation or general anaesthesia.

“The use of a dental therapy dog is an antianxiety approach that may provide the necessary support to overcome anxiety and achieve this objective, thus avoiding the risks associated with use of sedation or general anaesthesia.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Exposure to the microorganisms identified in aerosols is not considered a significant occupational hazard for dental care professionals.

“The exposure to the microorganisms identified in aerosols is not considered a significant occupational hazard for dental care professionals (v).”

• cites vNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. It may state two separate claims as one.

A large dog may be too heavy for a small person, and a little dog may be too fragile if the patient needs to grasp around the dog's body or leg to feel safe and relaxed during dental treatment.

“A large dog may be too heavy for a small, tiny person and a little dog may be too fragile if the patient needs to grasp around the dog's body or the dog's leg to feel safe and relaxed during the dental treatment.”

It may state two separate claims as one.

Introducing a dental therapy dog to work with patients in a dental clinical setting creates hazards, but these seem manageable given proper training and adherence to established clinical protocols.

“Introducing a dental therapy dog to work with patients in a dental clinical setting creates hazards, but these seems to be manageable given proper training and adherence to established clinical protocols.”