Containing the Spread of Infection

A growing awareness in the dental community has led to greater compliance with infection control protocols.

Due to the nature of dental procedures, both patients and dental healthcare providers are at a high risk of exposure to pathogens through various possible entries, according to Yatao Liu, PhD, director of strategy, innovation and clinical affairs, Kavo Kerr. The good news is that, thanks to epidemiological studies, the Centers for Disease Control and Prevention’s (CDC) infection control guidelines and product innovations, people are better informed and more compliant when it comes to following infection control protocols.

Infection control responsibilities
“The exposure risk includes direct contact with blood, oral and respiratory secretions, contaminated surfaces and equipment, aerosol transmissible pathogens, dental waterlines and more,” he says. As such, “a highly trained staff member with in-depth knowledge of infection prevention would be very helpful in preventing infections among both patients and dental healthcare professionals.”

A staff member tasked with infection control responsibilities must stay current with CDC guidelines and recent epidemiological studies, track and report infection prevention records, and educate and train other staff, Liu points out. Additionally, this person must have the ability to review existing infection prevention policies to identify gaps and out-of-date information. Particularly in multi-office practices, he or she must “observe current practices in different offices and understand the current gap between practices and policies, and develop engaging and effective training programs based on the identified gaps,” he says. “In the early stage of product screening and trial phasing, it may be beneficial to use different products in different offices, and then do a cross-over switch to compare the products for the best fit.” Once the right products are identified, standardizing across all offices could lead to a few advantages, he adds, including:

• A consistent set of procedures to follow means offices are less prone to errors associated with different product instructions for use.
• Standardization could lead to more convenient training programs.
• There is a potential cost savings due to larger purchase quantities.

Protocols and products
Education and training are key to encouraging dental clinicians to adhere to an infection control program, notes Liu. He outlines several key protocols that should be followed in every dental practice, regardless of its size or number of locations:

• Sterilization. Sterilization is mainly done by FDA-cleared devices or FDA-cleared chemicals with sterilization process validation mechanisms (e.g. chemical indicators). However, point-of-use cleaning and thorough cleaning, which is sometimes overlooked, is a necessary prerequisite to ensure effective sterilization.
• Hand hygiene. Education and increased awareness of the risks associated with the spread of infection have led to better hand hygiene compliance. Still, there is always room for improvement.
• Surface disinfection. Inanimate surfaces can harbor various pathogens. Most pathogens, including virus, bacteria and fungi, can survive on dry surfaces from hours to weeks. Compared to other infection prevention measures, compliance with surface disinfection has taken longer to catch on.

Dental clinicians today have more options than ever before to help them adhere to infection control protocols. Advances in technology have led to better, more effective solutions, and products such as the following – at one time seen only in a physician’s office – have become commonplace in both solo and multi-office dental practices:

• Personal protective equipment (gloves, gowns/aprons, masks, goggles and face shields).
• Hand hygiene products (antimicrobial soaps, no-rinse sprays/gels, antiseptic towelettes).
• Surface cleaners and disinfectants. (Disinfectants must be appropriate for blood and saliva and offer broad-spectrum antimicrobial efficacy.)
• Single-use products (disposable prophy angles, disposable air/water syringe tips, barriers, etc.).
• Instrument cleaners (enzymatic detergent, alkaline detergent, etc.).
• Cold sterilants.
• High-level disinfection equipment.
• Sterilization equipment and accessories.
• Dental line maintenance products.

Armed with the right tools, clinicians have become increasingly vigilant in complying with infection control protocols, notes Liu. It’s a trend he hopes will continue.