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    6 overlooked areas in your office that can improve infection control

    Minimizing infection risk is vital to you, your patients and your practice.

    There are plenty of no-brainers when it comes to infection control. Everyone knows to wear protective gloves and surgical masks; everyone knows to disinfect surfaces. But there are also common precautions and places within the practice that might not seem obvious, and these mistakes have occurred either because of bad habits or trying to take short cuts.

    Read on to learn about six commonly overlooked areas in the dental office that can help improve infection control.

    Sterilization area

    For Karen Daw, an infection control consultant and former clinic health and safety director for The Ohio State University College of Dentistry, the practice’s sterilization area is often misused.

    “That’s an area where we have the potential to do the greatest amount of harm, and yet we are assigning people, who in some cases have no experience, to be in charge of instrument processing,” she says. “There are several states where dental assistants do not need any formal training before they go into an office and many times they receive on-the-job training, as far as instrument processing. We are not giving them the training and tools to be successful.”

    Clinicians must follow cleaning and disinfecting guidelines both from the Centers for Disease Control and Prevention (CDC) and product manufacturers, but the rules are not always cut-and-dried.

    “Another challenge is getting clear-cut instructions from some of the manufacturers about proper instrument reprocessing,” Daw says. “You’ll see some IFUs state, ‘Clean this instrument with detergent and water.’ Well, is there a certain type of detergent we need to use? Can this be submerged completely in water?”


    Pouches are sometimes mishandled, Doug Braendle, product manager at SciCan, says. Following the proper protocol will ensure safety and compliance.

    “Once they are wet, if you put them in a contaminated area, like putting them down in their area where an ultrasonic is running and we don’t have a lid on it, then we run the risk of reinfecting the contents of the package,” Braendle says. “It’s something we call ‘wicking.’ Because if you put a wet pouch down on top of a contaminated surface, the pores on the package are open and it allows the bacteria and the microbes in. It’s like wind through a screen door.

    More from the author: 10 questions you need to ask about infection control

    “All the manufacturers will say, in their protocol, that packages must be dry coming out of the sterilizer,” he continues. “But we understand the reality. The reality is that the office is working fast and there’s a lot of stuff being processed. And when you tell an office that is notorious for taking wet stuff out and you say, ‘They have to stay in there until everything is dry,’ the reaction we get, 99 percent of the time, is, ‘Oh, we just don’t have time for that.’ They kind of know, sometimes, that’s the wrong thing to do, but they just do it anyway.”

    Ultrasonic cleaners

    A major concern for infection control is not only having the right equipment, but using it properly. For example, Braendle says something his staff sees often is the lid not being on the ultrasonic cleaner.

    “A good percentage of the time our reps will walk into the sterilization area, the ultrasonic unit is running and there’s no lid on top,” Braendle says. “And then when you ask, almost the universal answer is, ‘I don’t know.’ And the minute you get, ‘I don’t know,’ this is not a one-time offense where somebody forgot to put the lid on. If they don’t know where the lid is, this has been going on for along time. These are instruments that had literally just been taken out of the operatory, they’ve been in people’s mouths, there is blood, there’s all kind of contamination on these instruments.”

    Leaving the lid off of the ultrasonic can lead to some pretty disturbing results.

    “The thing that happens is what is called ‘aerosolization,’” Braendle explains. “When we have an ultrasonic cleaner trying to do its job, there’s this aerosolization mist that comes out.”

    Practice consultant Noel Kelsch studied aerosolization by placing Petri dishes at varying distances from an open-topped ultrasonic.

    “She was actually getting growth on the Petri dishes 12 to 15 feet away,” Braendle says. “That tells us that with what we call the ‘dirty soup,’ that stuff is going everywhere.”

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    Robert Elsenpeter
    Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author ...


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