Nonmalignant respiratory disease mortality among dentists in the United States from 1979 through 2018

Background: Dentists can be exposed to dust and nanoparticles from teeth, dental composites, and metal alloys generated during dental procedures, and exposure to dust can cause respiratory diseases, including pulmonary fibrosis. The authors describe mortality from nonmalignant respiratory diseases (NMRDs) among dentists in the United States.

Methods: The authors submitted information on US dentists who died from 1979 through 2018 to a centralized US death records database to obtain underlying causes of death. Decedent data that met records-matching criteria were analyzed using the Life Table Analysis System software (National Institute for Occupational Safety and Health) to calculate proportionate mortality ratios (PMRs), indirectly standardized for age, sex, race, and 5-year calendar period with 95% CIs, for NMRD and a group of International Classification of Diseases, Ninth and Tenth Revision codes approximating idiopathic pulmonary fibrosis.

Results: Among 21,928 dentist decedents with complete race information, 1,583 deaths (7.2%) resulted from NMRD. Proportionate mortality for dentist decedents was significantly lower than the general population for NMRD overall (PMR, 0.66; 95% CI, 0.62 to 0.69), chronic obstructive pulmonary disease (PMR, 0.44; 95% CI, 0.41 to 0.48), and pneumonia (PMR, 0.73; 95% CI, 0.67 to 0.81) but significantly higher than the general population for the pulmonary fibrosis group (PMR, 1.57; 95% CI, 1.37 to 1.80).

Conclusions: Dentists had decreased proportionate mortality for most NMRD and increased proportionate mortality for underlying causes of death associated with pulmonary fibrosis.

Practical implications: Existing engineering controls that reduce inhalational exposures during dental procedures might be inadequate. Improved characterization of these exposures could help inform more effective engineering controls.