Controlling infections and cross contamination in the dental office

This summary is based on the article published in the British Dental Journal: General medicine and surgery for dental practitioners: part 4. Infections and infection control (July 2014)

N. Jakubovics, M. Greenwood and J. G. Meechan

Context

Infection control and knowledge of common infectious agents is a cornerstone of safe dental practice.

Purpose of the Article

This paper summarises the measures that need to be taken to control cross infection and discusses some of the infectious agents of concern to dental practitioners.

Key Messages

Measures to control cross infection:

• Hand Hygiene:
  • Before patient contact
  • Before an aseptic task
  • After body fluid exposure risk
  • After patient contact
  • After contact with patient surroundings.

• Personal protective equipment: should be selected on the basis of a risk assessment and will depend on the procedure being carried out.
• Safe working with sharps: It is essential therefore, that appropriate risk assessments, accident reporting procedures and, most importantly, safe working practices are applied for work that involves sharps.
• Sterilisation and disinfection of dental instruments: Sterilisation is aimed at the complete removal of viable organisms, including bacterial spores.
• Surgery design and disinfection: Dental surgeries should be designed with a view to easy cleaning, providing adequate workspace, good ventilation, and separation of clean and dirty zones.
• Dental unit waterlines (DUWLs): To prevent the accumulation of biofilms, systems should be drained down at the end of each day.
• Waste management: Any waste containing human or animal tissue, blood or bodily fluids, drugs, swabs or dressings, or other potentially infectious material must be clearly labelled as ‘clinical waste’ and segregated from non-clinical waste.
• Immunisations and screening: Immunisations provide an additional layer of protection against the transmission of certain pathogens from patients to dental care professionals.

Major infectious agents of concern in a dental clinic: 

Blood-borne viruses, such as hepatitis B virus, and HIV aids.

Respiratory viruses, such as common cold (rhinovirus), coronaviruses, respiratory syncytial virus, adenoviruses, influenza, Mycobacterium tuberculosis, and Methicillin resistant Staphylococcus aureus (MRSA).

Pseudomonads: gram-negative bacteria responsible for lung infections or for infections of wounds or burns.

Prions: infectious proteins that can nucleate the misfolding of natural proteins in brain tissue.

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