Infection prevention and control is coming under increasing scrutiny, yet has always been considered important to the medical and healthcare professions. Recent outbreaks of MRSA and C Diff demonstrate the need for strict and effective decontamination methods has never been so significant. There has been an increasing awareness of the hazards associated with poor cleaning techniques among those in the profession as well as the public. This indicates an urgent need for every member in the dental team to be vigilant in applying correct decontamination protocols, such as one plan outlined below:
After treating each patient:
- Discard all disposable protection, such as the surgical light and head rest
- Discard and remove disposable end fittings from the suction unit
- Disinfect the chair and hand controls
- Clean and disinfect surfaces, chairs, spittoons and other risk areas
- Add new disposable protections and fittings.
After treating your last patient:
- Clean and disinfect all work surfaces, especially those not visibly contaminated
- Clean and disinfect surgery floors
- Always clean from the cleanest to the dirtiest areas.
In addition, to aid in this hygiene maintenance, all work surfaces and floor coverings should be continuous, jointless (where feasible) and non-slip. It is well known such surfaces are susceptible to contamination from microorganisms and therefore need a stringent decontamination process to reduce the risk of infection for patients and staff.
It would also be advisable to undertake the technique referred to as 'zoning'. It is the most effective way of ensuring decontamination is performed as efficiently as possible and the first step in successful surface disinfection as it focuses on those specific areas most frequently contaminated. Zoning involves the division of contaminated areas from clean as well as allocating areas for placing 'dirty' and 'clean' instruments.
The most important areas involved in zoning include: dental chair and spittoon, controls and switches, work surfaces and floor.
Appropriate training should be be provided to all members of staff in every practice, and documented as evidence. Though it is important dental nurses deal with the treatment areas, hiring a cleaner is acceptable for the upkeep of floors and public areas but they too must be trained and fully conversant with practice cleaning protocols.
The latest research demonstrates that regular use of commercial bacterial cleaning agents and wipes are successful in preserving sanitation as well as reducing surface contamination through viral means.
To this end, many companies are producing products to aid in waging this worldwide war against contamination. Yet, in the dental profession, it is particularly important the proper products are used to certify that those areas most vulnerable are effectively sterilised.
Those in the profession should look out for a microbiological disinfectant particularly effective against bacteria (including TB), fungi, hepatitis B viruses, HIV, HCV, adenoviruses, rotaviruses, papoviruses and polioviruses. For example, the mikrozid AF wipes are an aldehyde-free rapid cleaner with an alcohol base, which are particularly useful on glass, Corian, ceramic and laminate work surfaces.
Some surfaces require a quicker and gentler, alcohol-free solution to prevent cracking and smearing, for instance natural and artificial leather, Perspex/Plexiglas and soft PVC. The mikrozid Sensitive wipes are handy in this way as a disinfectant for all work surfaces, including dental chairs.
For large surface areas, a powerful disinfectant with strong soil loosening properties should be used. One such product is Terralin protect as it eradicates bacteria like MRSA, fungi and viruses making it extremely efficient. It is also effective on all types of surgery floors such as metal, plastic and rubber and offers exceptional material compatibility. In addition, as a 0.5 per cent concentration makes a 400l in-use solution, it is incredibly cost effective.
It is not possible to overemphasise how essential effective cleaning and decontamination is to the dental profession. As such it should be a duty undertaken by all staff members and strictly adhered to.