Dental Team Responsibilities and Safety Protocols

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Questions and Answers

What is a key duty of all members of the dental team?

To prioritize financial gain over safety

To disregard infection control protocols

To protect patients, colleagues, and themselves from harm (correct)

To focus solely on the technical aspects of dental care

Which organization oversees the registration for healthcare providers in England?

Care Quality Commission (CQC) (correct)

Public Health England (PHE)

General Dental Council (GDC)

National Health Service (NHS)

What can occur if instruments used in dentistry are not properly cleaned after use?

Contamination leading to cross-infection (correct)

Enhanced efficiency in dental procedures

No significant impact on patient health

Improved patient satisfaction

What is one potential consequence of international travel and commerce related to dental services?

Emergence of unexplained infections Signup and view all the answers

What does HTM 01-05 (2013) ensure for dental workplaces?

They meet registration requirements set by the CQC Signup and view all the answers

What is a major reason for the need for infection control in dentistry?

The mouth contains numerous microorganisms Signup and view all the answers

What does the term 'contaminated' refer to in a dental context?

Instruments that have been exposed to pathogens Signup and view all the answers

Which pathogenic microorganism is NOT a concern to the dental team?

Tuberculosis Signup and view all the answers

What is one of the immunizations dental staff should receive before working at the chair side?

Hepatitis B Signup and view all the answers

What is the purpose of wearing Personal Protective Equipment (PPE) in a dental setting?

To protect from contact with blood and other bodily fluids Signup and view all the answers

Which item of clothing is required by the UCLH Dress Code for patient-facing staff?

A uniform Signup and view all the answers

What type of footwear is required for dental staff?

Flat or low-heeled shoes Signup and view all the answers

Which jewelry restriction applies to dental staff according to the guidelines?

One small earring only per ear Signup and view all the answers

How should the nails of dental staff be maintained?

Short and unvarnished Signup and view all the answers

What is a legal requirement for dental employers regarding PPE?

They must provide PPE for their staff Signup and view all the answers

Which of the following is NOT classified as part of the personal protective equipment (PPE)?

Casual clothing Signup and view all the answers

What is the main health concern regarding water quality for immuno-suppressed individuals?

Opportunistic respiratory pathogens Signup and view all the answers

What is the recommended action to reduce the risk of suck-back in dental units?

Flush the water lines at the beginning of the day and in between patients Signup and view all the answers

How often should dental units and water lines be disinfected?

Weekly Signup and view all the answers

What is the role of Bilpron in maintaining dental water lines?

It prevents biofilm formation for up to 3 months Signup and view all the answers

What is decontamination primarily referred to in a medical context?

Reprocessing of reusable items Signup and view all the answers

What is the recommended duration for hand washing according to WHO?

40-60 seconds Signup and view all the answers

What is a limitation of alcohol-based hand rubs?

They cannot be used if hands are visibly soiled. Signup and view all the answers

Which hand washing technique helps avoid recontamination?

Foot or elbow-operated taps Signup and view all the answers

What is the purpose of disinfection?

Killing bacteria and fungi but not spores Signup and view all the answers

Why should certain lotions be avoided when using medicated soap?

Some may make the soap less effective. Signup and view all the answers

What should be avoided to prevent the breakdown of latex gloves?

Petroleum-based lotions Signup and view all the answers

Which of the following correctly describes 'social cleaning'?

Cleaning to a socially acceptable standard without disinfection. Signup and view all the answers

What is an important safety precaution for using alcohol-based hand rubs?

Store away from sources of ignition. Signup and view all the answers

Which of the following is NOT a step to follow when washing hands?

Operating taps with bare hands Signup and view all the answers

What is one benefit of alcohol-based hand rubs?

They provide rapid and effective antimicrobial action. Signup and view all the answers

What is the primary purpose of disinfecting clinical areas in dentistry?

To prevent cross-contamination Signup and view all the answers

What is meant by 'zoning' in a clinical area?

Designating areas as clean or dirty Signup and view all the answers

Which of the following actions is recommended during clean-up after a dental procedure?

Wearing protective gear Signup and view all the answers

What does biofilm consist of in the context of Dental Unit Water Lines?

A layer of micro-organisms in a slime matrix Signup and view all the answers

What is one of the major risks associated with the clean-up process in dentistry?

Needlestick injuries Signup and view all the answers

What should you do first when cleaning up after a dental procedure involving sharps?

Wear gloves and dispose of sharps Signup and view all the answers

What are needlestick injuries commonly associated with?

Needles used during medical procedures Signup and view all the answers

Which surface must be disinfected after each patient in a dental setting?

Clinical contact surfaces Signup and view all the answers

What is autoclaving primarily used for in clinical settings?

Sterilizing instruments Signup and view all the answers

Which of the following best describes the definition of asepsis?

Absence of living pathogens Signup and view all the answers

Study Notes

Infection Prevention & Control in Dentistry

Infection control is the methods and measures used in dental workplaces to prevent contamination and infection transmission from patients, staff, or instruments.
The purpose of this session is to provide relevant information relating to infection prevention and control principles in dentistry.

Learning Outcomes

Explain the importance of infection prevention and control to patients, the dental team, and the wider public.
Identify dangers in the dental surgery.
Differentiate between decontamination, disinfection, and sterilization techniques.
Describe clinician responsibilities in preventing cross-infection, the need for up-to-date immunisation, and why proper cleaning is essential.
Explain inoculation injuries and how to avoid them in the dental workplace.
Understand the zoning technique to ensure environmental infection control.
Recognise the need for proper waste disposal.

GDC Learning Outcomes (2013)

Explain potential routes of transmission of infectious agents in dental practice.
Explain mechanisms for infection prevention.
Explain the scientific principles of decontamination and disinfection.
Implement and perform effective decontamination and infection control procedures according to current guidelines.
Discuss the relevance of infection control to health and safety.

What do you understand by Infection Control?

Infection control involves methods and measures used in a dental workplace to prevent contamination and the acquisition of infections from patients, staff, or instruments.

Statistics

Seven out of every 100 patients in developed countries, and 10 out of every 100 in developing countries, acquire at least one healthcare-related infection.
Sharps injuries cause approximately 66,000 HBV, 16,000 HCV, and 200-500 HIV infections annually among healthcare workers worldwide.
This translates to 37%, 39%, and 4.4% of healthcare workers, respectively.
In 2016-2017, there were an estimated 834,000 healthcare-associated infections (HCAIs) costing the NHS £2.7 billion and causing 28,500 patient deaths.

Who is at Risk?

Dentists
Hygienists/Therapists
Dental Nurses
Technicians
Patients
Families/commuters

Why Infection Control is Important in Dentistry

All dental team members have a duty of care to protect their patients, colleagues, and themselves from harm in the dental workplace.
Importantly, infection control prevents contamination or acquiring infections from patients, staff, or dirty instruments.

Bigger Picture

Infection control is connected to ecological changes, changes in human behaviour and demographics, international travel, and commerce, and unexplained emergencies and breakdowns in public health measures.

Background

Health scares have highlighted instances of dirty dental surgeries and equipment, leading to HIV, Hepatitis B, or C concerns.
563 patients were potentially exposed due to a hygienist's actions.

Regulation

Registration for healthcare providers in England is overseen by the Care Quality Commission (CQC).
Compliance with quality requirements of HTM 01-05 (2013) ensures workplaces meet CQC and GDC standards.

Need for Infection Control in Dentistry

The mouth is teeming with microorganisms.
Dental instruments become contaminated during use.
Without proper cleaning and disinfection, contamination can spread through cross-infection.

Cycle of Infection

The goal is to break the cycle linking the pathogen, infection control hygiene, transmission mode, susceptible person, individual treatment, and colonization/infection.

Dangers in the Surgery

Different kinds of medical equipment and people present potential infection dangers.

Pathogenic Micro-organisms

Herpes Simplex type I
Hepatitis B
Hepatitis C
New-variant Creutzfeldt-Jakob disease (vCJD)
Human Immunodeficiency Virus (HIV)
COVID-19 and other emerging pathogens.

Immunizations

All dental staff should receive immunizations before chairside work.
These include Poliomyelitis, Tuberculosis, Tetanus, MMR (measles, mumps, and rubella), Diphtheria, Pertussis (whooping cough), and Hepatitis B.

Personal Protective Equipment (PPE)

PPE is worn to protect staff from contact with blood and bodily fluids.
Employers are legally obligated to provide PPE.
PPE must be worn correctly, as per the infection control policy.

Uniform

Uniform policy ensures that all patient-facing staff wear a uniform.
These uniform policies are designed for infection control purposes.

Footwear

Safe, sensible footwear, preferably flat or low-heeled, is required in clinical areas.
Comfortable materials that don't make excess noise should be worn.

Nails, Hair, Jewellery, Piercings

Nail varnish, extensions, and false nails are not allowed.
Hair must be tied back.
Long fringes should be clipped/tied.
Body piercings must be covered with plasters.
Only one small earring per ear and discreet nose studs are permissible.

Plastic Aprons

Single-use plastic aprons are worn over the uniform during procedures or cleaning when soiling can occur.

Wearing Gloves

Gloves come in varying quality, latex, and non-latex.
Glove changes are required between patients and when soiled/torn.
Wearing gloves does not replace handwashing.

Facemasks

For AGP procedures, a fit-tested facemask is essential when dealing with patients with infectious agents.
This includes patients with partly or wholly airborne or droplet-transmitted infections.

Protective Eye Wear

Visors or face shields should be worn.
Eye protection must be disinfected thoroughly between patients.

Loupes

When used to substitute for protective eye wear, loupes must be used with a facemask to prevent transmission.

Hand Hygiene

Hand hygiene covers handwashing and additional measures like hand disinfection with anti-bacterial rubs.
Clean hands are a crucial counterpart for glove use and prevent contamination.

When is Hand Hygiene Important?

Before/after treatment sessions
Before/after removing PPE
After washing dental instruments
Before contact with sterilized instruments
After decontamination
After cleaning/maintaining decontamination devices

Hand Washing

Dedicated handwashing sinks must be available in the workplace.
Taps should be operated by elbow or foot.
Nails must be short; jewelry should be removed.
Proper handwashing should last 40-60 seconds using mild liquid soap, according to WHO guidelines.

Handwashing Steps

Steps for correct handwashing, including video tutorials.

Improper Handwashing Technique

Visualization of common handwashing mistakes to highlight proper technique.

Alcohol Based Hand Rub

Alcohol-based hand rubs are beneficial for rapid and effective antimicrobial action as well as reduced disinfection time; however, they cannot replace handwashing.
Rubs must not be used on visibly soiled hands.
Follow instructions carefully.
Precautions are necessary due to flammability.

Skin Care

Use approved hand creams or lotions.
Manufacturers' compatibility must be checked.
Some lotions can affect the effectiveness of medical hygiene soap and potentially cause latex glove breakdown.
Avoid contaminating dispensers by refilling.

Cleaning and Getting Rid of Micro-organisms

Social cleaning achieves a socially acceptable standard.
Disinfection kills bacteria and fungi, but not always spores or some viruses; it usually involves chemicals.
Sterilization kills all microorganisms, such as using autoclaves.
Asepsis is the absence of all living pathogenic microorganisms.

Cleaning the Clinical Area

The entire dental area must be cleaned to an acceptable social standard.
The clinical area should be divided into 'clean' and 'dirty' zones.
This zoning prevents cross-contamination.

Preparing the Dental Chair

Regularly cleaning surfaces in contact with patients during dental procedures minimizes contamination spread.

What Needs to Be Cleaned Between Patients?

Ensure all surfaces in contact with patients are thoroughly cleaned with appropriate disinfectants between patients.

Protective Barriers

Protective barriers are essential to limit infection transmission and contamination.

Clearing and Cleaning After Each Patient

Removing sharps, cleaning trays and surfaces, disinfecting the dental chair and instruments, and using disinfection wipes are necessary.

Preventing Needlestick Injuries

Proper safety measures are required for reducing infection risks during clean-up.

Needlestick Injuries

Needlestick injuries can transmit bloodborne pathogens like HIV, hepatitis B, and hepatitis C.

Action Plan for a Sharps/Needlestick Injury

Local procedures for managing sharps injuries, including the responsibilities of those affected.

Dental Unit Water Line (DUWL) & Biofilm

Biofilms are layers of microorganisms in a matrix that form on surfaces in contact with water.
Water lines in dental units can easily develop biofilms containing potentially harmful bacteria.

Risk to Staff and Patients

Water should be free from organisms harmful to humans (WHO 2015).
Most contaminants aren't pathogenic, but immunocompromised individuals are more vulnerable.

Type of Bacteria in the DUWL

DUWL bacteria originate from mains water, forming quickly, and are generally more resilient to treatment than oral bacteria.

Reducing Biofilm

Water lines should be flushed and cleaned between patients and at the end of each day to reduce bacterial count.
Disinfect weekly as per instructions.

Flushing of Dental Units

Explains the procedure of flushing dental units for infection control purposes as a part of the day-to-day activities in the dental workplace.

Reducing Biofilm (continued)

Use sterile bottled water instead of tap water.
Prevent contamination of mains water supply through a physical air gap.
Use point-of-use filters.

Decontamination

Decontamination, also known as reprosessing, removes contamination from reusable items, ensuring safety for patients and staff.
This involves cleaning, disinfection, inspection, and sterilization.

Cleaning of Reusable Instruments

Essential quality requirements of reusable instruments cleaning must meet the standards in HTM 01-05, in order to be free of contaminants before sterilization.

Cleaning of Equipment

Three main techniques for cleaning reusable dental equipment: manual cleaning, manual cleaning with ultrasonic decontamination, and decontamination and cleaning with washer-disinfectors.

Instrument Cycle

A comprehensive cycle of steps for acquiring, transporting, using, storing, and cleaning dental instruments for patient care.

Autoclaving (Moist Heat) Sterilization

Autoclaving is necessary to kill spores and viruses.
Requires specific temperature, pressure, and cycle time guidelines.

Dry Heat Sterilization

Hot air ovens are used to sterilize instruments with sharp edges.

Chemical Disinfection

Chemical disinfectants are suitable for sterilization of instruments and surfaces.
The method's effectiveness depends on concentration, temperature, and thorough cleaning before use.

Sterile Single-Use Instruments

Sterile single-use instruments are often ready-packed for use in the dental workplace.

Waste Disposal

Clinical waste must be put into the proper containers using correct disposal methods.
Waste must be handled with appropriate PPE.
Separate bins for non-clinical/recycled waste are crucial.

Sharps Boxes

All used needles, burs, and matrices must be placed in sharps boxes and treated with care; avoid mixing reusable items with single-use items.
Follow guidelines for the disposal of sharps containers.

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Description

Test your knowledge on the key duties and safety protocols of dental professionals. This quiz covers important aspects such as infection control, proper use of Personal Protective Equipment (PPE), and guidelines for dental workplace hygiene. Ideal for students and practitioners in the dental field.