Infection Control and its Importance

Infections could be transmitted in the dental operatory through several routes:

a. Direct contact with blood, oral fluids, or other infected materials
b. Indirect contact with contaminated objects, such as instruments, environmental surfaces, or equipment
c. Contact of conjunctival, nasal, or oral mucosa with droplets, such as spatter, containing microorganisms from an infected person and propelled by coughing, sneezing, or talking
d. Inhalation of airborne microorganisms that can remain suspended in the air for long periods.

Below are of the ways infection control can be undertaken:

1. Instrument and Equipment Cleaning- dental instruments and equipment should be cleaned and disinfected unless there are disposable alternatives.
   Critical instruments are used to penetrate soft tissue or bone, and they can also encounter blood. Instruments under this classification include scalers, scalpels, forceps, and bone chisels. Critical instruments should be sterilized after each use.
   Semi-critical instruments come into contact with mucous membranes (such as the inside of your cheeks) or non-dry skin. These instruments include mirrors, reusable impression trays, and amalgam condensers. They should be sterilized with dry heat after each use.
   Non-critical instruments are those that touch only intact skin. They include blood pressure cuffs, X-ray heads, and pulse oximeters. These instruments can be reused between patients after receiving intermediate-level disinfection.
2. Hand Hygiene- As we’ve learned, hand washing is imperative in preventing the spread of disease. A dental professional with visibly soiled hands must wash thoroughly with antimicrobial or plain soap and water. In addition to washing dirty hands, the CDC recommends performing hand hygiene under these other three conditions: After the dental professional uses bare hands to touch equipment contaminated by blood, saliva, and other secretions; before and after the treatment of each patient; before putting on gloves and immediately upon glove removal.
3. Surface Contamination and Office Cleanliness- a dental office contains two types of surfaces: clinical contact surfaces and housekeeping surfaces. Clinical contact surfaces include light handles, drawer handles, faucet handles, countertops, chairs, and other items you or your dental pro would touch during a procedure.
   Clinical contact surfaces, if not protected with barriers such as a clear plastic wrap, bags, and sheets, should be cleaned between patients with an EPAregistered hospital or List N disinfectant. Those surfaces should also be cleaned after every workday. Floors and sinks are examples of housekeeping surfaces to be cleaned and disinfected periodically throughout the day. Walls, chairs, and other surfaces should be cleaned regularly.
4. Education and Training- Dental offices should offer ongoing education and training to their employees to ensure policies and procedures are practiced correctly.
5. Patient Screening- Initial patient screening is accomplished by the dentist during history-taking interactions before entering the operatory. The dentist’s review of the patient’s medical history is mandatory at the onset of every clinical appointment.
6. Personal Hygiene- The dentist’s personal hygiene is an absolute necessity. As patients become more aware of the potential danger to themselves from materials and instruments that are not disinfected or sterilized. (i) Hair is cleared away from the face. (ii) Jewellery is removed from the hands, arms, or facial area during patient treatment. (iii) Fingernails are kept clean and short to prevent perforation of gloves and accumulation of debris. (iv)Thorough forearm and hand washing are mandatory before and after treatment.
7. Instrument Processing-Make sure instruments processing is done with- Presoaking and cleaning; proper Packaging of the instruments and then undertake Sterilization.
8. Protective coverings: Uniforms should be changed regularly and whenever soiled. Gowns or aprons should be worn during procedures that are likely to cause spattering or splashing of blood. Hand protection Gloves must be worn for procedures involving contact with blood, saliva or mucous membrane. A new pair of gloves should be used for each patient. If a glove is damaged, it must be replaced immediately. Protective glasses, masks or face shields Protective glasses, masks or face shields should be worn by operators and close-support dental surgery assistants to protect the eyes.