A Deep-Dive into Infection Prevention and Control: Because Safety Never Takes a Holiday

While it’s a phrase straight from the mouth of Paul Blart: Mall Cop, it holds true. Safety never takes a holiday, and the safety of your staff and patients should be first and foremost in your mind. Dental professionals need to be educated on proper procedures for cleaning and sterilizing the tools that they’re using every day so they’re not exposing people to pathogens. 

Over the course of this next quarter, I’m dispatching to different dental offices that we work with to conduct a series of experiments. The goal is to find out if the most stringent infection control procedures that we utilize are doing enough. If they aren’t, then it’s time to make some changes to our checklists and procedures as well as in the dental industry as a whole. 

Outline of This Episode

• [1:30] Infection prevention and control and my upcoming project
• [11:09] The importance of sterilizing your equipment
• [17:59] Learn how to read and follow IFUs
• [26:36] Addressing lack of formal infection control training
• [32:22] Learn how to properly use your ultrasonic
• [41:01] Make sure you’re receiving the proper vaccinations
• [42:48] Wear proper protective gear: gloves
• [46:56] The alarming biofilm being found in dental waterlines
• [1:02:49] How does infection control apply to ortho?

Texas—and all states—should require infection prevention and control training 

There is no infection control training in Texas and quite honestly, they’re behind the times. Admittedly, they aren’t as forward-thinking as other states. I believe that very few schools—and not just in Texas—are teaching current standards in their curriculum. It begs the question, are our dental assistants getting the proper training? 

What about dentists? I’ve found that some schools of dentistry have their dental students go through a rotation where they learn how to process and sterilize their instruments. But most instrument processing is done by a paid staff and dentists are never educated on the proper procedure for cleaning their tools. 

This has got to change. There is a gross lack of knowledge and a whole lot of misunderstanding in the industry. Many dentists and their assistants are learning techniques and procedures from sales reps who don’t know what they’re talking about. They’re often the only outside contact that dentists have which is a problem in and of itself.

Very few dental offices properly use their ultrasonic  

Dental staff often overlook one simple thing that will give them the answers to proper sterilization procedures—Instructions For Use (IFUs). It’s a user manual for your instruments that lays out the exact procedure to properly use, clean, and sterilize your tools. It’s pretty idiot-proof. 

There’s an amazing product called SonoCheck—it’s a tablet that you drop into your ultrasonic to test if it’s working properly. You drop it in green and it should come out yellow. If there are major problems with your Ultrasonic cleaner, it won’t change colors at all.

I’ve seen time and time again that offices just crank the dial on the ultrasonic to whatever time it lands on and expect it to clean their instruments. Most are only doing half the time required in their instruments IFUs. Dental offices NEED to start using them for the correct amount of time. They also should use critical water, the right amount of water at the right temperature, and enough of the right kinds of enzymes.

The bottom line is if the instruments aren’t processed long enough and in the proper manner, they won’t be clean. You’ll be using dirty instruments on your patients. 

The often overlooked tactic to protect your staff

It’s simple and highly effective: wear the right kind of protective gloves. Most dentists, hygienists, assistants, etc. are required to get a Hepatitis B vaccine. Most do it before they finish school but some don’t finish the series. They don’t get tested to make sure they have the antibodies if they’re exposed. It’s currently the only required vaccination.

But if you’re not wearing protective gloves and get stuck by an instrument used on a patient, you’re exposing yourself to other pathogens as well. It could be hepatitis B, Syphilis, Malaria—anything bloodborne. You must assume that everyone is sick and that every instrument is trying to kill you until proven otherwise.

Gloves are inconvenient, sure. But you CAN learn how to process instruments with gloves. Train until you get comfortable with them, but for heaven’s sake wear the dang gloves!

Treat your water lines regularly and monitor them for biofilm

We’ve talked about this before, but biofilm is a buildup of bacteria (both good and bad) that can adhere to water lines. They’re terribly difficult to kill and the longer they go unnoticed the more difficult it becomes. I believe states will start mandating water line testing. My advice? Don’t wait until it’s mandated. 

In 2016, a dental unit water line in Anaheim, CA was contaminated with a mycobacterium. It was discovered when dozens of children showed up complaining of facial swelling and pain. Their faces and jawbones were infected with this bacteria. One child had the bacteria progress so severely that she had to have part of her jaw bone removed—all because of an untested waterline in a dental office.

The hassle it may cost you is not worth the PR nightmare. It’s not worth losing your license, your practice, and perhaps your freedom. Test your water lines, treat them with shock treatments, and replace them if necessary. You must know how to monitor and maintain control of your water quality. 

Jacque and I discuss in-depth testing and cleaning of water lines, proper use of ultrasonic equipment, how these strategies apply to ortho, and much more. Be sure to listen to the whole episode to learn how to better protect your practice!

Resources & People Mentioned 

• OSAP
• OSHA
• AAMI ST79:2017
• Sonocheck
• Brandmax Triple Enzyme Cleaner
• ProEdge Dental Water Labs
• Aquasept

Connect With Duane

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• toothcop(at)dentalcompliance.com
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