Because it is virtually impossible to constantly monitor the level of infection control in a dental office, it is extremely important that CDC-recommended procedures be followed precisely and thoroughly to avoid any risk of infection. New guidelines from the CDC, specifically for the field of dentistry, touch on the following four broad subject areas, which we will go into more detail about below:
- Hand hygiene
- Dental-unit Water Asepsis
- Surface Asepsis
- Instrument processing
Proper hand hygiene is our first line of defense in preventing and controlling infection. The following are the latest CDC guidelines to ensure proper control:
- Disposable or washable containers should be used for hand washing soaps. Do not simply refill empty containers, they should be cleaned or disposed of.
- Hands should be washed with antibacterial or non-antibacterial soap and water when visibly soiled, while a simple alcohol rub may be used for non-visibly soiled hands.
- During surgery, hands should be washed using soap and water followed by drying and thorough application of an alcohol-based surgical hand rub.
- Fingernails should be kept short and clean, while artificial fingernails and any other hand accessories should be avoided if possible.
- If a Boil Water Advisory should occur, antimicrobial cleansing agents that do not require water should be used. Visibly soiled hands should be washed with soap and clean bottled water.
Dental-Unit Water Asepsis:
Dental water units such as water syringes and ultrasonic scalers can deliver contaminated water if not properly treated. Bacteria, attaching itself to the inner walls of water-line tubing, can produce a dangerous biofilm. The latest CDC water-line recommendations include:
- Use water that meets EPA standards for levels of water bacteria. Follow manufacturer guidelines for maintaining sanitary water delivery.
- Discharge any residual water and air from device for 20-30 seconds after each use.
- During a Boil Water Advisory, do not deliver water to patients through dental water units.
- Disinfect water lines as recommended by the manufacturer after advisory is lifted.
Special care should be taken to ensure that surface areas of clinical equipment used during examination are properly covered or cleaned and disinfected if they become contaminated in any way. Surface covers may be counted on for protecting surfaces that are difficult to clean such as electrical switches.
- For cleaning and disinfecting, a low-level EPA-approved disinfectant can be used to sanitize surface areas. For visibly soiled surfaces, an intermediate-level disinfectant should be used.
- High-level disinfectants should not be used on environmental surfaces.
- Housekeeping surfaces may be cleaned regularly with a mix of detergent and water, and mops or cloths should be cleaned and allowed to dry before their reuse.
Non-single-use items used in the mouth should always be cleaned, packaged, and heat- sterilized prior to their use on another patient. Heat-sensitive items that enter the mouth should be cleaned using low-temperature sterilizers.
- Allow items to dry in the sterilizing unit prior to being handled again.
- All critical level instruments should be packaged.
Implantable devices should never be sterilized without packaging.