Dental professionals are in a unique position to prevent the spread of infection.
The very nature of invasive dental work means there is an increased risk of infection and biological contamination. In addition to contamination caused by touching surfaces and equipment, dental procedures themselves can also generate contamination, both in the form of airborne aerosols and micro-organisms entering waste systems whilst remaining viable.
These factors create a constant need to maintain high standards of hygiene even ‘behind the scenes’ to protect patients, staff and visitors. It is these perhaps unseen areas we will focus on in this blog post.
So, how do you ensure that the highest standards of disinfection are achieved?
As you’d expect with a subject as complex as infection prevention, the answer is not simple!
One size doesn’t fit all.
There are many areas and workflows within the dental practice which require infection control processes to be regularly and comprehensively employed, from the reprocessing of dental instruments, to all the surfaces in clinical areas, including the dental chair and diagnostic equipment, to the basic hand hygiene of each and every person entering your dental environment.
Cleaning or disinfection?
Before we get our teeth into how to keep those pesky bugs at bay, let’s get one, often confused, fact put to bed: the difference between cleaning and disinfection…
Although often terms used in unison, they are not the same thing.
Cleaning is the removal of dirt and debris, usually in the presence of a detergent. In a dental environment this could well include bodily fluids released as the result of dental treatments, like blood, tissue, tooth and bone fragments or pus.
Disinfection is the inactivation or killing of micro-organisms on a surface, using a disinfectant agent which is known to have antimicrobial properties.
Disinfection can only occur on a clean surface, so it is vital that the cleaning step takes place prior to disinfection (although, there are, of course, combination products available, which combine both steps).
So, now that’s sorted, let’s concentrate on disinfection. We’re just going to look at three areas here:
- Preventing contamination in dental water lines
- Removing contamination from suctions lines and amalgam separators
- Disinfection of dental Impressions
We’ll leave instrument reprocessing and decontamination for another day, as it’s a big topic in its own right.
Decontamination and disinfection in the dental practice
But, whichever area you’re looking at, rest assured that we’ve got bags of experience in at Blueprint Dental and are always here to help you out with which product you need for which application, to strike that important balance between efficacy and material compatibility.
A little more on that too…
Efficacy v Material Compatibility
There needs to be a balance between the ability of the disinfectant to inactivate micro-organisms and its effect on the environment around it. It needs to be safe to use in the presence of humans, not leave potentially toxic residues around after use and leave the surfaces and equipment on which it is used unharmed.
Disinfection of non patient-facing areas of the dental practice
Infection control is a critical activity in every dental practice. It’s important to make sure that all areas of the practice are clean and decontaminated regularly. This includes areas and equipment which is not necessarily patient facing, but nonetheless could present a serious biohazard if not incorporated into your decon processes.
The importance of ensuring dental water lines are decontaminated regularly
You’ve probably heard that dental water lines need to be decontaminated on a regular basis.
But what does that actually mean?
Left to their own devices there are a number of potential hazards which can be associated with water lines in and around the dental treatment centre. In this article, we’ll concentrate on the removal and prevention of biofilms and biological decontamination, but process water quality and the prevention of limescale deposits are also areas which need addressing. Again, perhaps another blog post for another day.
A broad spectrum anti-microbial agent, such as Hydrogen peroxide (H2O2) offers long lasting protection against the build up of a biofilm and microbial contamination in water lines, whether these are associated with hand piece operation and cooling or bottle systems and spittoon operation. Some will even act as a limescale inhibitor too, which is an added benefit.
Some disinfectants are specifically tuned for continuous dosing of water lines in specific manufacturer’s treatment centres, some are used at regular interval according to your own decontamination protocols and others can be used as a biofilm removal agent. These are often slightly more concentrated solutions used in situations where a biofilm has built up within the water lines, following some maintenance procedures or before the treatment centre is first commissioned for patient use.
What about contamination in suction lines and amalgam separators?
Equipment which creates contamination as a result of particles and biological debris from the patient poses an immediate and constant contamination threat if left untreated.
Suction lines and amalgam separators should be decontaminated on an at least daily basis with a broad spectrum disinfectant effective against bacteria, fungi, viruses and mycoplasma (tuberculosis).
A word here also about disinfectant rotation…
As with many anti-microbial treatments, both inside and outside of the patient, consistent dosing with just one product can lead to the emergence of microbial resistance, which in turn increases the risk of contamination and/or decreased efficacy of your chosen disinfectant. For this reason, it is considered best practice to rotate the products used for disinfecting. For example on a weekly rotational basis. This will significantly reduce the risk of microbial resistance to the products used. Often the two rotational products will differ in pH. Look out for a manufacturer who can provide you will both products which are clearly labelled to show which rotational product is which in your regime.
These areas are also prone to the build up of odours, so a product with an integral deodoriser is also advantageous, as is one with enzymatic properties to break down proteinaceous material removed from the patient.
That said, care should also be taken to ensure that any disinfectant used in these areas and then discharged to drain are environmentally friendly and do not cause ecological damage after their release.
Some products used in this area can also be used to decontaminate spittoons, although specialist products are also available for this purpose.
Disinfecting dental impressions
Dental impressions remain an important part of many patient procedures still carried out using non-digital technologies. Every day, dentists take impressions to create dental prosthetics such as crowns and bridges. However, these impressions can also be a breeding ground for micro-organisms if not disinfected correctly. In order to ensure the safety of patients, staff and technicians at the dental laboratory, it is important to properly disinfect these impressions before they are sent out for fabrication.
Ideally find yourself a ready-to-use solution with a short action time, which can be used on alginates, silicones and poly-ether rubber, as well as the impression trays themselves. That way you’ll be able to disinfect a wide range prosthetics, worn dentures and dental impressions.
Choose a formaldehyde-free and phenol-free product which is bactericidal, fungicidal, virucidal and, ideally, tuberculocidal too.
So, in summary, it’s clear to see that maintaining consistent and robust disinfection protocols are of utmost importance for all dental professionals. In this post, we’ve explored areas which are often not in direct patient contact, but which still form a vital part of the practice’s overall infection prevention and decontamination routines. Not only is this crucial for patient safety and that of your staff, but it also helps maintain the quality, reputation and longevity of your practice as a whole.
We’d love to help you ensure you have the highest possible standards of hygiene in your practice and we’re pretty confident that we can sort you out with the right disinfection product for the right application.
You can get in touch to discuss further using the form below….