Infection Control In The Dental Office
By: Setina Evans RDH , May 16,2022
Guidelines for specific instructions on the methods of infection control are standardized by the Centers for Disease Control and the Occupational Safety and Health Administration.
The staff of the dental office must practice within these guidelines in order to prevent cross contamination and protect themselves and others from infectious diseases.
The chemicals used for disinfection in the dental office should have the ability to destroy benchmark organisms which cause legionnaires disease, HIV/AIDS, STDs, Hepatitis ABCD, herpes simplex virus, flu influenza (H1N1) virus and tuberculosis etc.
The disinfectant should be approved by the Environmental Protection Agency, Food and Drug Administration, Centers for Disease Control, and the Federal Insecticide Fungicide and Rodenticide Act.
At The Beginning Of The Day
The suction unit is run for 60 seconds. The waterline is flushed and cleared by running the Ultrasonic scaler, air water syringe and high-speed hand piece. The floor is cleaned.
The operatory is prepared for a patient by disinfecting the cupboards, counters, dental unit and dental equipment. Protective barriers are then placed
on surfaces that become contaminated during procedures, for example, light handles,head rest, saliva ejectors and air water syringe handles.
Before dental treatment, the patient is prepared by receiving a pre-procedural mouth rinse, protective eye-wear, a bib, and vital signs taken. Sterilized instruments in sealed pouches are opened in front of the patient.
After Every Patient
The clinical staff disposes contaminated gloves and hands are washed. The dental operatory is decontaminated. All surfaces touched during treatment of patients are disinfected.
Disposable materials that come in contact with blood are placed in bags labelled Bio-Hazard. Contaminated needles, sharps and used anesthetic capsules are disposed of in a puncture-proof bio-hazard container.
Contaminated instruments are washed and placed in an Ultrasonic cleaner then washed, dried and placed in sealed pouches and sterilized in an autoclave at 250° F (121° C), 270°F (132°C) or 275°F (135° C) for 20-30 mins depending on specific instructions by the manufacturer of certain dental instruments.
After sterilized instruments are removed from the autoclave, they are dried and stored in clean cupboards and drawers.
High speed or low speed hand-pieces are to be cleaned and lubricated based on the manufacturers instructions. Remove dirt, dust, and bio-material before sterilizing.
Small drops of lubricant should be placed into the drive air hole of the hand-pieces. Then run the hand-piece at a slow speed until only lubricant comes out of the head. Then continue to expel any excess lubricant through bearings and chuck.
To ensure proper running of the hand-piece long enough, install bur in a chuck and run the hand-piece for 20 -30 seconds on a paper towel. Running the hand-piece eliminates excess oil and prevents sluggish hand-piece performance after sterilization.
Flush water through the hand-piece for 30 seconds in the operatory to clean out the internal water line.
Avoid placing heavy instruments for example extraction forceps on top of scalers or lighter instruments when loading the autoclave.
Instruments that came in contact with blood especially those used during a surgical procedure are to be washed separately from other instruments.
Always use utility gloves when washing contaminated instruments and report any needle stick or injury to hands.
If something falls on the floor during a dental procedure leave it until after. If it is something needed urgently , call a team member to get it.
Avoid going into cupboards or drawers during dental procedures as much as possible.
The clinical staff is required to wear a laboratory coat, mask, face shield, gloves, protective eye-wear, and sometimes hair cover, as part of their personal protective equipment.
It is recommended that the staff be fully immunized, to include vaccination against hepatitis B and now recently Covid-19.
After treating a patient
After disinfecting dental unit
After removing contaminated gloves
After using restroom
Before treating a patient
Before putting on gloves