In brief
In dental clinics, risks overlap in a small space: aerosol from rotary instruments, infections transmitted through blood and saliva, mercury vapour when old amalgam fillings are removed, dental X-rays, sharp instruments and hours of bent posture. Even in a clinic with a few staff, the obligations of Law No. 6331 apply; the risk assessment should address these five headings one by one, and health surveillance and vaccination tracking should be planned with the workplace physician.
Dental clinic safety: small team, concentrated risk
Dental clinic safety is often overshadowed by patient safety. Sterilisation, infection control and equipment maintenance are already part of daily work; but they do not replace a risk assessment written to protect employees. Even a clinic made up of one dentist, two assistants and a receptionist has employees, and Law No. 6331 on Occupational Health and Safety applies from the first employee.
With the Constitutional Court's 2025 decision, the deferral for less hazardous workplaces with fewer than 50 employees has also ended; the obligation to appoint an OHS specialist and a workplace physician applies to small clinics as well. Confirm your clinic's hazard class from the 6-digit activity code in your SGK registration using our hazard class guide. If your class is less hazardous and you have fewer than 50 employees, we explain the option for the employer to carry out the service personally in our article on OHS in small businesses.
The table below summarises the headings that should be dealt with separately in a small clinic's risk assessment:
| Risk | Source | Key measure | Record |
|---|---|---|---|
| Aerosol and biological | Turbine, ultrasonic scaler, air-water spray | High-volume suction, ventilation, PPE, vaccination | Vaccination and antibody record |
| Sharps | Burs, needles, matrix bands, hand instruments | Safe collection, sharps container close by | Injury record |
| Mercury | Removing old amalgam, amalgam waste | Suction, spill kit, separate waste | Waste and spill record |
| Radiation | Intraoral, panoramic, cone beam imaging | Distance, barrier, not holding the patient | Equipment licence and inspection documents |
| Chemical | Disinfectants, acrylic monomer, acid gels | Safety data sheet, gloves, ventilation | Chemical inventory |
| Ergonomic | Neck and trunk bending, static posture | Positioning, loupes, stool, breaks | Physician assessment |
Dental aerosol and biological risk
High-speed turbines, ultrasonic scalers and air-water sprays create small droplets and aerosol mixed with the patient's saliva and blood. These particles reach the dentist's and assistant's face and eyes and the air they breathe. Rank the measures according to the hierarchy of controls:
- Capture at source. High-volume suction is the assistant's most effective tool. The tip should be kept close to the tooth being treated; a saliva ejector alone does not capture aerosol.
- Reduce the area. Using a rubber dam in suitable procedures reduces the source of splashing fluid.
- Change the air. Ventilation of the treatment room must be adequate. Leave time between patients for the room to air after aerosol-generating procedures.
- Protective equipment. Eye protection or a face shield is worn for every procedure, and gloves are changed for every patient. The procedures in which FFP-class masks will be used are written into the risk assessment; for the classes, see our article on FFP1, FFP2 and FFP3 dust masks.
For bloodborne infections, the hepatitis B vaccine is the key measure. Art. 16 of the Regulation on the Prevention of Risks of Exposure to Biological Agents requires suitable vaccines to be given to employees who are not immune; Art. 12 governs the immediate reporting of accidents or incidents involving biological agents. For the classification of agents, see our article on biological agent risk groups.
Amalgam mercury: removing old fillings and waste
Although many clinics no longer use amalgam for new fillings, the mercury risk has not gone away. Removing old amalgam fillings with a bur releases mercury vapour and fine particles from the heated filling. In clinics that still use amalgam, capsule preparation, collecting residues and possible spills create risk.
Practical measures are:
- When removing old fillings, use plenty of water cooling and high-volume suction; sectioning the filling to remove it reduces heating.
- Prepare amalgam only with sealed capsules and an amalgamator; do not work with open mercury.
- Rooms where amalgam is used should not have carpet or floors with many joints; spilled mercury is trapped in these surfaces.
- Keep a mercury spill kit in the room and show assistants how to use it.
- Amalgam residues, extracted teeth with amalgam and waste from the suction system's separator are collected separately in sealed containers, without mixing them with domestic or medical waste.
The workplace physician decides, based on exposure, which tests are done and how often in the health surveillance of employees exposed to mercury. We plan the necessary tests with authorised laboratories and healthcare providers. For the employee side of medical waste, see our article on medical waste and employee safety.
Dental X-rays and radiation
An intraoral X-ray gives a low dose in a single exposure, but it is repeated throughout the day in a clinic. Panoramic and cone beam computed tomography units work in a separate room and at a higher dose. Installation licences, quality control tests and radiation safety requirements for the equipment are subject to the regulations of the Nuclear Regulatory Authority (NDK); keep these documents in your clinic's OHS file as well.
For employees, three principles are enough: time, distance, shielding.
- During exposure, staff leave the room or stand behind a protective barrier; nobody is in front of the primary beam.
- Staff do not hold the sensor or film in the patient's mouth; a holder is used. If the patient needs support, their companion helps while wearing a suitable protective apron.
- There is a radiation warning sign on the door and in the equipment room; nobody enters the room during exposure.
- The duties of an employee who reports that she is pregnant are reassessed. For the process, see our article on pregnant and breastfeeding employees.
Whether personal dosimeters are used and the definition of a radiation officer are determined under NDK regulations; clarify this question during the equipment licensing process according to the type of equipment in your clinic.
Sharp instruments, chemicals and sterilisation
Sharp instruments. In dental clinics, sharps injuries happen not only during procedures but also when instruments are collected and cleaned. Place the sharps container next to the dental unit, do not recap needles with two hands, and carry hand instruments in cassettes. Be sure to read our article on needlestick and sharps injuries for the steps after an injury.
Chemicals. Surface and instrument disinfectants can irritate the skin and airways; monomers used in denture and acrylic work can be both strong-smelling and allergenic; acid gels used in some bonding procedures are corrosive. File the safety data sheet for each product, follow the mixing instructions and provide alternative gloves for employees with a latex allergy.
Sterilisation. An autoclave works with pressure and hot steam. The door seal, safety valve and the manufacturer's maintenance plan must be followed, and the door must not be opened before the cycle ends. Keep heat-resistant gloves for hot trays.
Working posture
Dentists and their assistants spend most of the day working with the neck bent forward, the trunk slightly rotated and the arms raised. This static posture is the main cause of neck, shoulder and lower back pain. The measures are simple but require habit:
- Raise the patient chair to a height at which the dentist's elbows stay at about waist level; adjust the patient to the dentist, not the dentist to the patient.
- Use positions between 9 and 12 o'clock, and in four-handed working let the assistant pass the instruments.
- Loupes chosen for the correct working distance and declination angle reduce neck bending.
- Use saddle-type or backrest stools with adjustable height.
- Do not schedule long procedures back to back; plan short stretching breaks between appointments.
The OHS file for a small clinic
The basic documents a small clinic should have are: risk assessment, emergency plan and evacuation plan, employees' OHS training records, pre-employment and periodic examination records, vaccination and antibody status, sharps injury records, chemical inventory and safety data sheets, X-ray equipment licence and inspection documents, and waste contracts.
Everyone in the clinic should be included when planning. Sterilisation and cleaning staff are often at greater risk than the dentist from sharp instruments and disinfectant exposure; the receptionist is the person with a role in the emergency plan. If an oxygen cylinder is kept in the clinic for emergencies, the cylinder is secured against falling, kept away from heat sources and not allowed to contact oily materials. Even in a small clinic, the escape route must not be narrowed by a patient chair, compressor or boxes of supplies, there must be an emergency exit sign at the door and in the corridor, and everyone must know where the fire extinguisher is.
We prepare risk assessments for oral and dental health centres and private practices in Bursa and the surrounding provinces, and run vaccination and health surveillance follow-up through our workplace physician service. For other sector-specific topics, see our healthcare facilities page, and to see your physician and specialist time, use the OHS obligation calculator.
Frequently Asked Questions
Does a single-dentist clinic need an OHS specialist and a workplace physician?
Yes, if you have employees. The deferral for small workplaces ended with the Constitutional Court decision. If your clinic is in the less hazardous class and you have fewer than 50 employees, you also have the option, as the employer, of completing the Ministry training and carrying out the service yourself; pre-employment and periodic examinations are excluded from this.
Which vaccinations should be tracked in a dental clinic?
Because of bloodborne infections, the hepatitis B vaccine and antibody status are the basic follow-up. Other vaccines are determined by the workplace physician's risk assessment. The cost of vaccination cannot be passed on to the employee.
Is removing old amalgam fillings a risk for employees?
Yes. When removing with a bur, mercury vapour and particles are released from the heated filling. Plenty of water cooling, high-volume suction and good ventilation reduce exposure; residues are collected separately in a sealed container.
Can the assistant hold the patient's film during an X-ray?
They should not. The film or sensor is fixed with a holder, and staff leave the room or go behind a protective barrier during exposure.
A risk assessment that identifies and scores hazards on site, links each measure to an owner and a date, and has a clear renewal schedule.
Bursa SİSTEMER OSGB Technical Team — written from the field experience of our OHS specialists and workplace physicians. Legal information is valid as of the publication/update date; contact us for an assessment specific to your business.