Understanding Infection Control

Introduction to PPE for Dental Technologists

• PPE's vital role is exploring safeguarding dental technologists and ensuring a safe working environment.
• By Heba Rashed

Role of PPE in Infection Control

• PPE refers to protective clothing, equipment, and devices.
• They minimize exposure to hazards in the workplace.
• Dental procedures that handle blood, saliva, or bodily fluids require strict PPE use.

Benefits of Proper PPE Use

• PPE serves as a barrier, reducing the risk of transmitting infectious elements between patients, staff, and the environment, preventing cross-infection.
• Proper PPE protects dental professionals from potential exposure to hazardous substances, ensuring their health and well-being and enhancing safety.

PPE for Dental Technologists

• Dental technologists play a crucial role in infection control.
• Their PPE requirements are essential for protecting both themselves and patients.

Face Shields

• Offers protection to dental workers

Gloves: Overview and Types

• Types include the following:
• Latex
• Nitrile
• Chloroprene
• Latex gloves are known for their sensitivity and dexterity.
• They can cause allergies in some individuals.
• Nitrile gloves are a good alternative to latex.
• Provides excellent barrier protection
• Resistance to punctures.
• Chloroprene gloves offer superior chemical resistance.
• Often used for handling certain hazardous materials.

Masks: Surgical vs. Respirator Masks

• Surgical masks provide a barrier against large droplets and splashes.
• Surgical Masks do not filter out small particles.
• N95 respirators filter at least 95% of airborne particles.
• A N95 respirator protects from viruses, bacteria, and other contaminants.

Eye and Face Protection

• Goggles provide protection for the eyes from splashes, droplets, and debris.
• Face shields offer broader protection.
• Covers the entire face
• Protects the eyes, nose, and mouth.

Surgical Gowns and Lab Coats

• Gowns and lab coats should be made of fluid-resistant materials.
• This prevents the penetration of liquids.
• Common materials include:
  • Non-woven fabrics
  • Cotton
  • Polyester blends
• Varying levels of fluid resistance.

Surgical Caps, Bouffants, and Shoe Covers

• Surgical caps prevent hair from falling into the work area.
• This minimizes contamination risks.
• Bouffants serve a similar purpose to surgical caps but are often preferred for longer hair.
• Shoe covers protect the floor and minimize the spread of contaminants from shoes.

Respiratory Protection Equipment

• NIOSH certification ensures respirators meet safety standards.
• It also provides adequate protection.
• Fit testing verifies the respirator's seal on the face.
• Ensuring a proper fit to provide maximum protection.

PPE for Special Procedures

• Procedures involving high-speed drills or ultrasonic scalers produce aerosols.
• Aerosols require special PPE.
• The use of ultrasonic scalers necessitates a full-face shield and a respirator mask.
• Procedures involving drills also require a full-face shield and a respirator mask for adequate protection.

Preventing Aerosol Spread

• Suction devices like high-volume evacuation systems are essential for capturing aerosols and minimizing their spread.
• Strict protocols should be in place to control aerosol production during procedures.
• Use high-volume evacuation systems and rubber dams.
• Employ rubber dams to isolate the treatment area
• Reduce aerosol generation.

PPE Maintenance and Storage

• Reusable PPE items should be cleaned, disinfected, and stored properly.
• This prevents contamination and ensures their effectiveness.
• Used PPE should be disposed of properly in designated containers.
• This prevents the the spread of infectious agents.

Factors Influencing PPE Selection

• Consider the nature of potential hazards in the dental environment when selecting PPE in relation to the exposure type.
• Choose PPE that can withstand the specific tasks and procedures, in relation to the durability and suitability required.
• Ensure proper fit for maximum protection and comfort.

Gloves in Dental Settings

• Gloves provide a barrier and protect hands from exposure to infectious materials, chemicals, or other hazards during patient care and environmental services.
• Sterile gloves are for surgical procedures.
• Non-sterile gloves are for other patient care activities.
• Materials include vinyl, latex, and nitrile.

Do's and Don'ts of Glove Use

• Work from clean to dirty areas.
• Change gloves if torn or heavily soiled.
• Also, change gloves after use on each patient.
• Avoid touch contamination.
• Never wash or reuse disposable gloves.
• Do not touch your face or adjust PPE with contaminated gloves.

Gowns and Aprons in Dental Settings

• Protect the wearer's body and clothing from contamination with blood, body fluids, and other potentially infectious materials.
• Gowns and aprons can be made from natural or synthetic materials, reusable or disposable.
• Key factors are fluid resistance and cleanliness.
• Correct donning, use, and removal procedures are crucial for maintaining worker and patient safety.

Face Protection in Dental Settings

• Masks protect the nose and mouth from fluid penetration and should fully cover these areas and create a seal.
• Goggles protect eyes from splashes and sprays and should fit snugly around the eyes.
• Face shields protect the entire face from splashes and respiratory droplets.
• A shield should cover from the forehead to the chin and wrap around the sides.

Respiratory Protection in Dental Settings

• Protects healthcare workers from inhalation of infectious aerosols.
• Aerosols include those containing Mycobacterium tuberculosis.
• Types of repiratory protection include particulate respirators, half- or full-face elastomeric respirators, and powered air-purifying respirators (PAPRs).

Respiratory Protection Program

• Medical evaluation ensures workers can safely use respirators without health risks.
• Fit testing determines the right size and model for each user, ensuring a tight seal.
• Training instructs on proper use, limitations, and maintenance of respirators.

Key Points About PPE Use

• Don PPE before patient contact: put on PPE before entering the patient's room or area to prevent contamination spread.
• Remove PPE carefully: take off PPE at the doorway or immediately outside the patient's room to avoid contamination.
• Wash hands or use alcohol-based sanitizer immediately after removing PPE.

Sequence for Donning PPE

• Gown first: start with the gown to create a barrier and prevent contamination.
• Mask or respirator: protect the nose and mouth from exposure to potential airborne pathogens.
• Goggles or face shield: safeguard the eyes from splashes or sprays containing infectious materials.
• Gloves last: create a barrier to protect hands and prevent the spread of contaminants.

How to Don PPE

• Sequence is important.
• After the isolation gown gloves were donned.
• Fit testing for respirators is required and never unnecessary.

How to Don a Gown

• Select the appropriate type and size: choose a gown that fits properly and provides adequate coverage.
• Secure at the neck and waist: ensure the gown fully covers the torso from neck to knees and arms to wrists.
• Use two gowns if necessary: if the gown is too small, use one that ties in front and another in back.
• Make sure to fully cover your torso from neck to knees and arms to the wrist.

How to Don a Mask

• Place over the nose, mouth, and chin: ensure the mask fits snugly over these areas.
• Secure on the head using ties or elastic bands to secure the mask firmly.
• Adjust the nose piece by molding the flexible nose piece to create a tight seal over the bridge of the nose.

How to Don a Particulate Respirator

• Select a respirator that has been properly fit-tested for your face.
• Position and secure by placing over nose, mouth, and chin and securing place with elastic straps.
• Perform a user seal check by inhaling to check for collapse and exhaling to check for leaks.

How to Don Eye and Face Protection

• Position Goggles: Place the goggles over eyes and secure them with earpieces or a headband.
• Adjust Face Shield: Position the face shield over the face and secure it on the brow with a headband.
• Ensure Proper Fit: Adjust for comfort and maximum protection.

How to Don Gloves

• Select Correct Type and Size: Choose gloves that fit snugly and comfortably.
• Insert Hands: Carefully put on gloves, avoiding contamination.
• Extend Over Cuffs: Pull gloves over the cuffs of the isolation gown for complete coverage.

Contaminated and Clean Areas of PPE

• The outside front of PPE is considered contaminated.
• This area likely has come into having contact with infectious materials.
• The inside, outside back, and tie areas are considered clean and not likely to have contacted infectious agents.

Sequence for Removing PPE

• Remove gloves carefully by peeling off gloves and turning them inside out.
• Remove face shield or goggles by grasping by clean areas and lift away from the face.
• Remove the Gown by untying and peel away from the body and rolling inside-out.
• Remove mask or respirator by grasping ties or bands at the back of the head and remove carefully.

Answer PPE Question

• Remove the gloves is done first.

Where to Remove PPE

• The patient room: remove PPE at the doorway before leaving the patient's room.
• AnteRoom usage for removing PPE.
• Hand Hygiene: ensure hand hygiene facilities are available at the point of PPE removal.

How to Remove Gloves

• Grasp the outside edge: pinch the outside of one glove near the wrist.
• Peel away by pulling the glove inside-out as you remove it.
• Remove the second glove by sliding an ungloved finger under the wrist of the remaining glove and peel off.

Removing Eye and Face Protection

• Grasp Clean Areas: Hold ear or head pieces with ungloved hands.
• Lift Away: Gently remove eye protection without touching the front surface.
• Dispose or Reprocess: Place used items in designated receptacle for disposal or cleaning.

Removing Isolation Gown

• Unfasten ties and undo the gown's fasteners, being careful to avoid contamination.
• Peel away and pull the gown away from the neck and shoulders, turning the contaminated face inward.
• Roll into a bundle and fold or roll the gown into a bundle, containing the contaminated surface inside.
• Discard properly by placing the gown in the appropriate waste container following facility protocols.

Removing Masks and Respirators

• Masks: Untie bottom tie, then top tie; lift away from face, avoiding touching the front.
• Respirators: Lift bottom elastic strap over head, then top strap; remove carefully without touching the front.

Hand Hygiene Practices

• Handwashing with antimicrobial soap is crucial for removing microbes and reducing infection risk.
• Alcohol-based sanitizers: convenient alternative when handwashing is not possible and is effective against many pathogens.

Conclusion

• PPE is crucial for protecting dental professionals and ensuring a safe work environment.
• Proper PPE use significantly reduces the risk of cross-infection and enhances overall safety.
• Prioritizing safety and investing in comprehensive PPE protocols creates a culture of well-being for all stakeholders.