Beruflich Dokumente
Kultur Dokumente
: AIPH/IPC/IPP/036
Title: Infection prevention & control Guide Classification:
lines in Dental Department □CPP □APP □OPP □IPP □New □Revised □Renewal
Applicability: Dental Staff Effective date: 06 Feb 2017
Infection prevention & control Staff High Risk: □yes □No Expiry date: 05 Feb 2019
1. Purpose
1.1. To provide policies and procedures to ensure that all personnel involved in patient care develop an
awareness of the following:
1.1.1. Sources and method of transmission of infectious diseases from dental patients to dental
employees and vice versa.
1.1.2. The level of cleanliness and contamination of gloved hands.
1.1.3. The instruments and equipment being used and objects that may be touched and maintain that
awareness.
2. Definition
3. Responsibilities
3.2.1. Observe the implementation of the Dental department on the Infection prevention & control
guidelines.
3.2.2. Educate the Department if necessary.
4. Policy
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4.1.2. Adhere to the Infection prevention & control policies and procedures relative to their work
areas.
4.1.3. Adhere to Standard Precautions in all of the dental facilities.
4.1.4. Adhere to the Dental Services Department Dress Code.
4.1.5. Attend documented annual Infection prevention & control In-service and when Changes such as
modification of tasks or procedures, or institution of new tasks or procedures affect the
employee’s occupational exposure.
4.1.6. Report all blood and body fluid exposures (needle sticks, puncture wounds, etc.) to immediate
supervisor and the employee health clinic and follow the protocol for blood and body fluid
exposure.
5. Procedure:
Procedure steps Responsibility
5.1 Clinic Attire: Dental staff
5.1.1. All staff involved in direct patient care (dentists and support
staff) must wear high-necked, long-cuffed, sleeved cover
gowns when clothing or skin is likely to be exposed to body
fluid. This condition is not dependent upon an aerosol being
contact produced by rotary instruments. It applies during all
procedures involving patients. Cover gowns should be worn
by all personnel involved in the treatment regardless of their
role in patient care.
5.1.2. These gowns must be changed daily or when visibly soiled.
Gowns shall not be worn in cafeteria, or places that are a
great distance from the treatment rooms, including out of the
building. Other protective garb such as gloves and masks
should not be worn outside of the treatment rooms.
5.1.3. Use water resistant (plastic) aprons underneath the gown to
protect the trunk from blood & fluid exposure.
5.1.4. The clinic clothing may not be taken home and washed by
the employee, but must be discarded into the clinic laundry.
5.1.5. Personal clothing (sweaters, etc.) shall not be worn during
patient treatment.
5.2 Other:
5.2.1 Long hair must be either covered or restrained, away from the
face and uniform collar. When hair contamination is anticipated
due to spray and splatter a hair, cover must be worn. (Long hair
is defined as hair which extends below collar level).
5.2.2 Uncovered jewelry must not be worn during dental procedures.
A watch worn under the cuff of the cover gown, and thus
protected by it is acceptable.
5.2.3 Food or beverages must not be present in patient care,
laboratory, and decontamination and sterilization areas.
5.2.4 All disposable protective barriers shall be discarded prior to
leaving the operatory or work area.
5.2.5 Pens/pencils shall be protected with plastic barriers, and shall be
cleaned and disinfected with an approved disinfectant solution,
if contamination has occurred.
5.2.6 Non-sterile items such as hand mirrors, timers, pencils, patient
record, audio-visual aids, toothbrush kits, etc. must never be
placed on the bracket table. When performing charting, a
convenient location should be chosen and the surface must be
cleaned and disinfected before being used as a writing table. The
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cabinet top should never be used as a writing table if it is also
being used as an auxiliary bracket table.
5.2.7 Hepatitis B Vaccination - All susceptible DHCWs should be
vaccinated against Hepatitis B.
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approved disinfectant solution. Eyewear is not
heat sterilizable.
5.3.6.5 The patient should never be allowed to handle
instruments from the bracket table or instrument
tray.
5.3.6.6 The following procedures should be performed in
the patient’s presence:
5.3.6.6.1 Sterile trays and the hand piece
opened.
5.3.6.6.2 Suction tips and saliva ejectors
placed on the hose.
5.3.6.6.3 Paper cup placed on its stand.
5.4 Cleaning and Disinfecting Dental Operatory and Environmental Surfaces: Dental staff
5.4.3 Any area covered with a surface barrier does not need to be
disinfected between patients. Contaminated barriers shall be
discarded and replace with new clean barriers at the end of each
case.
5.4.4 Precautions shall be taken to prevent cross-contamination from
patient to drawers, counters, instruments and other items located
in a clean area of the operatory.
5.4.5 Disinfectants used must be selected from the Hospital approved
list.
5.4.6 The manufacturer’s directions on disinfectant’s label should be
followed.
5.4.7 Dentists and specialists, dental hygienists, dental nurses and
assistants are responsible for the cleaning and disinfection of
their assigned areas.
5.4.8 Heavy duty puncture-resistant rubber gloves face masks and
protective eyewear must be worn during surface cleaning and
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disinfection.
5.4.9 Sweet water must be used to dilute disinfecting agents requiring
dilution.
5.4.10 Protective eyeglasses must be worn when mixing solutions.
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5.7.3 All gross soil, i.e. cement, bone fragments, sponges must be
removed from instruments and trays with gauze sponge (while
wearing gloves) before they are returned to the Central
Sterilization Supply Department.
5.7.4 Soiled burs shall be placed on the used bur block or in a
specimen cup prior to sending to the Central Sterilization Supply
Department.
5.7.5 Used instruments shall be returned to the Central Sterilization
Supply Department in plastic, impervious bags or in a container
with lid and soaked in antiseptic solution or water and detergent.
Gloves must be worn to transport contaminated instruments –
not those gloves worn during patient treatment, but a new pair
donned for the transport. This is the only time that gloves are
worn outside the operatory.
5.7.6 All burs, hand pieces and other instruments not being used on
the seated patient shall be sent back to CSSD for re autoclaving.
5.7.7 During procedure all drawers and cabinets shall remain closed.
They may be opened only if necessary, using over gloves or a
paper towel. Alternatively, the gloves may be removed to open
drawers before proceeding after re-gloving.
5.7.8 Anesthesia shall be prepared only after need is established.
5.7.9 Gauze squares, cotton rolls and other disposables must be sterile
for use.
5.7.10 Matrix bands should be selected and pre-positioned on tray
before beginning of the procedure.
5.7.11 Sterile pliers should be used to select items pre-packaged from
the manufacturers, e.g. stainless steel crowns, temporary crowns,
wedges, etc.
5.7.12 All equipment shall be cleaned and maintained according to the
manufacturer’s instructions. Any sterile item dropped on the
floor must be considered contaminated and returned to the
Central Sterilization Supply Department for sterilization.
5.7.13 Hand pieces, air and water syringes, chuck keys, ultrasonic
scalers and dental units shall be sterilized between patients.
5.7.14 All impressions and prosthetic appliances shall be treated as
follows:
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5.7.18 Sterile pouches and trays containing instruments should be
opened just prior to patient use. Only those instruments, burs,
etc. needed for the present patient should be opened. Other
sterile instruments must remain in the packages until needed.
When applicable, the instrument trays should be re-wrapped
with the original wrapping and placed into impervious plastic
bags before being returned to the Central Sterilization Supply
Department.
5.7.19 Contaminated dental and laboratory burs that are in need of
replacement may be disposed of in the operatory or the Central
Sterilization Supply Department in sharp containers. Old
diamond burs must be sent to the Central Stores for exchange or
replacement.
5.10 Dental staff should do prevention of Sharp Injuries and refer to Prevention and Dental staff
Handling Sharp Injuries.
5.11 Dental staff should have a strict compliance on sharp disposal. Refer to Sharp
Disposal..
5.12 Dental staff should use the Transmission based precautions, refer to Isolation /
Transmission Based Precaution, if the patient is positive with communicable
diseases.
5.13 Dental Staff should follow the Medical Waste Management. Refer to Medical
Waste Management.
5.14 Dental Staff should follow the Blood and Body Fluid Spill Cleaning if there is
any spill happens. Refer to Blood and Body Fluid Spill Cleaning.
5.15 Dental Staff should know when to send the White Coat of the Physician for
Laundry. Refer to Laundry Functions / Laundry Management
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5.16 For Dental Procedures in Operating room the staff should know how to gowning
and gloving. Refer to Gloving & Gowning.
5.17 Dental Staff should use appropriate PPE for every procedure. Refer to Personal
Protective Equipment.
5.18 Dental Staff should do Hand hygiene before and after every patient. Refer to
Hand Hygiene.
5.19 If being exposed by any occupational exposure the dental staff should follow the
post exposure prophylaxis. Refer to Post Exposure Prophylaxis
5.20 Dental Staff should follow standard precautions for all the patients and consider
any potential fluid as infectious. Refer to standard precautions.
5.23 Dental Radiography Asepsis - Wear gloves when taking radiographs and when Dental staff
handling contaminated film packets. Other PPE (e.g., mask, protective eyewear,
protective clothing) is required when spatter or splashes of blood
or other potentially infectious materials is anticipated.
6. Cross Reference
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7. Forms / Attachments
7.1. Attachment 1: Modified CDC/Spaulding Classification of Contaminated Patient care items
and Environmental Surfaces
7.2. Attachment 2: Guide for the Selection of Appropriate Disinfection Methods for Items
Transported to or from the Dental Laboratory
8. Materials / Equipment
9.1. DN.6.
10. Reference
10.1. Dental Infection Prevention Guidelines for Infection prevention & control in Dental Health-Care
Settings www.cdc.gov/mmwr/PDF/rr/rr5217.pdf
10.2. Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental
Settings: Basic Expectations for Safe Care. Atlanta, GA: Centers for Disease Control and Prevention,
US Dept of Health and Human Services; October 2016.
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Attachment 1: Modified CDC/Spaulding Classification of Contaminated Patient Care
Items and Environmental Surfaces
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Attachment 2: Guide for the Selection of Appropriate Disinfection Methods for Items
Transported to or from the Dental Laboratory
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Name Title Signature Date
Prepared By
Reviewed By
Approved By
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