Policy Title: Clinical Asepsis Policy Policy Number :19 6.4.9. Take/send instruments and handpieces to the decontamination/sterilization area. 6.4.10. Remove and dispose of the disposable gown (if used) in the plastic lined waste container. 6.4.11. Remove gloves and discard them in the plastic lined waste container. 6.4.12. Wash, rinse and dry hands or use an alcohol-based hand rub. 7. REFERENCES: 7.1. Infection Control and Management of Hazardous Materials for the Dental Team, (2013). Page 87 of 120
Special considerations of infection control in dentistry 1. POLICY STATEMENT 1.1. Applies to what is the best practice in the infection control aspects of Dental Hand-pieces, Pre-procedural Mouth Rinses, Oral Surgical Procedures and Handling Biopsy Specimens. 2. PURPOSE 2.1. To prevent/minimize the risk of infection in dental settings. 2.2. To promote awareness for each dental personnel in the importance of the infection control aspects of Dental Hand-pieces, Pre-procedural Mouth Rinses, Oral Surgical Procedures and Handling Biopsy Specimens 2.3. To provide a framework for the education of dental healthcare personnel in the infection control aspects of the special considerations. 3. SCOPE 3.1. This policy applies to all dental healthcare personnel. 4. DEFINITIONS 4.1. Handpiece is a small, high-speed drill used during dental procedures. 4.2. Mouthwash or mouth rinse is a chemotherapeutic agent used as an effective home care system by the patient to enhance oral hygiene. 4.3. Pre-procedural Mouth Rinse is a mouth rinse used by patients before a dental procedure. 4.4. Oral Surgery is a specialty in dentistry. It includes the diagnosis, surgical and related treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the head, mouth, teeth, gums, jaws and neck. Page 88 of 120
4.5. A biopsy is a medical test commonly performed by a surgeon or an interventional radiologist involving sampling of cells or tissues for examination. 4.6. A specimen is a portion/quantity of material for use in testing, examination, or study. 5. ROLES AND RESPONSIBILITIES 5.1. All dental healthcare personnel have responsibility to conform and respect all aspects of this policy. 5.2. Managers/ department s heads have a key responsibility to ensure their department functions within the parameters of the policy and that staff are trained and assessed by the infection control team in these issues. 6. PROCEDURE 6.1. Dental Hand-pieces and Other Devices Attached to Air and Waterlines 6.1.1. Clean and heat-sterilize handpieces and other intraoral instruments that can be removed from the air and waterlines of dental units between patients. 6.1.2. Follow the manufacturer's instructions for cleaning, lubrication, and sterilization of handpieces and other intraoral instruments that can be removed from the air and waterlines of dental units. 6.1.3. Do not surface-disinfect, use liquid chemical sterilants on handpieces and other intraoral instruments that can be removed from the air and waterlines of dental units. 6.1.4. Do not advise patients to close their lips tightly around the tip of the saliva ejector to evacuate oral fluids. Page 89 of 120
6.2. Pre-procedural Mouth Rinses 6.2.1. A pre-procedural antimicrobial rinse (e.g., chlorhexidine gluconate, essential oils, or povidone-iodine) can reduce the level of oral microorganisms in aerosols and spatter generated during routine dental procedures and can decrease the number of microorganisms introduced in the patient's bloodstream during invasive dental procedures. However no recommendation is offered regarding use of pre-procedural antimicrobial mouth rinses to prevent clinical infections among DHCP or patients. 6.3. Oral Surgical Procedures : 6.3.1. The following apply when performing oral surgical procedures: o Perform surgical hand antisepsis by using an antimicrobial product (e.g., antimicrobial soap and water, or soap and water followed by alcohol-based hand scrub with persistent activity) before donning sterile surgeon's gloves. o Use sterile surgeon's gloves. o Use sterile saline or sterile water as a coolant/irrigant when performing oral surgical procedures. Use devices specifically designed for delivering sterile irrigating fluids (e.g., bulb syringe, single-use disposable products, and sterilizable tubing). 6.4. Handling Biopsy Specimens: 6.4.1. During transport, place biopsy specimens in a sturdy, leak-proof container labeled with the biohazard symbol. 6.4.2. Care must be taken when collecting specimens to avoid contaminating the outside of the container and the laboratory form accompanying the specimen. Page 90 of 120
6.4.3. If a biopsy specimen container is visibly contaminated, clean and disinfect the outside of a container or place it in an impervious bag labeled with the biohazard symbol. 7. REFERENCES 7.1. Guidelines for Infection Control in Dental Health-Care Settings 2003. (Department of health and human services Centers for Disease Control and Prevention). Page 91 of 120