Are dentists and their staff taking proper precautions to prevent cross-infection in the dental office? OSAP has prepared the following checklist. Answers are drawn from current dental infection control recommendations from the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), and OSAP.
1. Do you heat-sterilize all your instruments, including handpieces, between patients?
In keeping with Centers for Disease Control and Prevention, American Dental Association and OSAP recommendations, dental care providers should be heat-sterilizing all instruments that penetrate or contact a patient’s oral tissues. Although autoclaves are most commonly used to sterilize dental instruments, some offices may have other types of heat sterilizers. Chemical-vapor sterilizers (chemiclaves) and dry-heat sterilizers also are appropriate for sterilizing dental instruments. The dental team should heat-sterilize instruments that have been used on a patient before they are introduced to treat the next patient.
Most dental instruments are designed to withstand repeated heat sterilization.
2. How do you know that the sterilizer is working properly?
Most practices use a variety of methods to ensure that the office sterilizer is doing its job. In addition to monitoring the sterilizer’s gauges and readouts for proper temperature and (for autoclaves and chemical-vapor sterilizers) pressure, the dental team should wrap and seal instruments in packaging equipped with a chemical that changes color on exposure to heat and/or some other combination of sterilizing conditions. These color-change indicators also help to identify instrument packages that have been sterilized, so there’s no chance that contaminated instruments could inadvertently be selected to treat the next patient. In addition, the dental team should routinely test their sterilizer using a vial or envelope containing spores. Called biologic monitoring, subjecting commercially prepared, sealed spore strips or vials to a sterilization cycle, then culturing the spores to ensure they have been killed, is the highest guarantee that a sterilizer is functioning and being utilized properly. Most practices use biologic monitoring weekly or monthly in combination with color-change indicators on each instrument packet and monitoring of the sterilizer gauges and readouts.
3. Do you change your gloves for every patient?
Every dental care provider should use new gloves for each and every patient. For procedures that are likely to involve splash or spatter, the dental team will also don a new mask, as well as wear protective eyewear and apparel (possibly a gown or clinic jacket).
4. Do you disinfect the surfaces in the operatory between patients?
Between patients, the dental team should disinfect all surfaces they are likely to touch during treatment. This eliminates the possibility of a dentist or auxiliary dental care provider transferring germs from a contaminated surface to the patient. To save time in preparing the treatment room for the next patient (and hopefully minimize their time in the waiting area), many practices choose to cover surfaces, such as light handles, tubing and chair controls, with a plastic barrier film that keeps the surface underneath free of debris. Instead of disinfecting these surfaces between patients, the dentist or dental team member simply removes and discards the barrier and places a new, clean barrier on the surface for the next patient.
Most practices choose to cover some surfaces and disinfect others between patients. Some practices disinfect all surfaces between patients; others use protective barriers for all surfaces in the treatment room.
OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. The organization offers an online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the Safest Dental Visit for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit www.osap.org.