Needlestick injuries (NSIs) are a common occupational hazard in dental practices. The potential physical repercussions are serious, including the possibility of bloodborne disease transmission. Less talked about are the psychiatric consequences of NSIs, especially post-traumatic stress disorder (PTSD).

How PTSD is defined

According to the Mayo Clinic, medical PTSD is a mental health condition that's triggered by a terrifying event. Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event.

The 4 stages of PTSD

1. Impact Stage: This occurs right after the traumatic event. Those afflicted are typically struggling to come to terms with what happened. They are most likely to be in shock, highly anxious, and dealing with guilt. 

2. Denial Stage: Still experiencing strong feelings of the traumatic event, individuals may attempt, either consciously or unconsciously, to avoid difficult emotions during this stage.

3. Short-term Recovery Stage:  In this stage, individuals attempt to find solutions to return to a sense of normalcy. Hopefully, they are reaching out and accepting help from others and/or treatment from a professional. Otherwise, they may become disillusioned about their job and profession. 

4. Long-term Recovery Stage: The after-effects of trauma can be long lasting and show up in the form of anxiety and nightmares. With ongoing help and/or treatment, these symptoms can lessen and eventually be overcome.

How to manage PTSD

The mental impact of a sharps injury varies from person to person. There’s no right or wrong way to react, nor is there a one-size-fits-all treatment for dental anxiety.

Some positive things you can do to help manage PTSD:

• Educate yourself on PTSD so it’s less intimidating
• Join a support group
• Practice relaxation techniques such as  yoga, deep breathing, and meditation
• Take part in daily physical activity
• Talk to someone you trust
• Avoid alcohol and drugs

Other, more involved alternatives:

Cognitive Behavior Therapy (CBT). Is a type of psychotherapy that focuses on identifying, understanding, and changing thoughts. 

Eye Movement Desensitization and Reprocessing (EMDR). Another form of psychotherapy involving processing trauma-related memories. Unlike CBT, EMDR asks people to pay attention to either a sound or a back and forth movement while thinking of the traumatic memory. 

Present Centered Therapy (PCT). This therapy centers around dealing with current issues as opposed to directly processing the trauma.

Medications. These are sometimes used alone or in conjunction with one of the aforementioned treatments. The most common prescribed medicines are selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. 

Strategies  to avoid an additional  needlestick

Being proactive in preventing a needlestick injury can help. Here are things you can do:

• Avoid bending needles by using a needle system like SimpleCAP that allows you to avoid recapping altogether; OSHA does not permit bending needles

• Plan for the disposal of needles before use
• Promptly dispose of used sharps after use
• Follow standard OSHA precautions and general hygiene practices consistently
• Participate in a bloodborne pathogens training program
  

Be open

While it’s often difficult to talk about, seeking help for PTSD is essential for a healthy life. If not treated, it could become a bigger issue.