Disinfection and environmental safety: Dental assisting

Disinfection of environmental surfaces in the dental setting is essential to help eliminate pathogenic microorganisms on contaminated surfaces.

Even though a surface looks clean, it can serve as a reservoir for microorganisms. Proper cleaning and disinfection interrupts disease transmission and protects patients, dental team members, and the community.

As a dental assistant, understanding how to prevent transmission of infection is essential for maintaining environmental safety.

OK, first, let's look at the main types of environmental surfaces in dentistry, clinical contact surfaces and housekeeping surfaces.

Clinical contact surfaces include touch surfaces that are directly touched during patient care, like dental light handles, drawer handles, and chair side computer keyboards.

And transfer surfaces that are not directly touched, but come in contact with contaminated instruments or materials, such as instrument trays, intra-oral X-ray equipment, or handpiece holders.

On the other hand, housekeeping surfaces include floors, walls, sinks, and other surfaces that don't typically come into direct contact with the dental team, patients, or contaminated dental instruments.

These surfaces carry a lower risk of disease transmission. Now, surface contamination is expected in dental settings.

It primarily results from aerosols, spatters, and droplets generated during procedures, especially when using rotary or ultrasonic instruments.

Surfaces can also become contaminated through contact with contaminated gloves, instruments, equipment, or other materials.

Because surface contamination is an everyday occurrence in dental settings, management of surface contamination must be systematic and consistent.

The two primary methods to manage surface contamination include the use of surface barriers and pre-cleaning and disinfecting between patients.

Surface barriers are single-use disposable fluid resistant materials placed on surfaces that are difficult to clean, such as knobs, switches, and handles.

When cleaning between patients, carefully remove and discard the contaminated barriers and apply a clean surface barrier, taking care to avoid accidentally touching the clean surfaces with the contaminated barrier.

Keep in mind that even though the surfaces have been covered with barriers, they will need to be cleaned and disinfected at the end of each workday.

The process of pre-cleaning and disinfecting has two steps. First, pre-cleaning involves removing debris, blood, saliva, and other body fluids from the surface.

This reduces the bio burden, which is a number of microorganisms on the surface. This step is critical because if a surface isn't clean, it can't be disinfected.

Once you have cleaned the surface, the next step is to apply an appropriate disinfectant to inactivate or kill the pathogenic microorganisms that remain on the surface.

The only disinfectants that can be used for clinical contact surfaces in dental settings are those that are registered with the Environmental Protection Agency or EPA as hospital disinfectants with tuberculosidal claims.

These disinfectants are used on surfaces visibly contaminated with blood to provide immediate level disinfection. Finally, two additional dental assistant responsibilities involve maintaining high volume evacuation or HVE systems and dental water lines.

Use of HVE systems greatly reduces contamination of saliva, spatter, and aerosols during patient treatment. You'll maintain the HVE by flushing a detergent or water-based disinfectant through the system at the end of each working day and clean the traps on a regular basis.

Also, because microbial biofilm can form on the inner surface of dental water lines, you'll need to take steps to ensure water quality meets the EPA standards by following your unit's dental water line protocols.

This can include regular flushing of water lines at the start of each day and between patients, using appropriate cleaning agents and disinfectants, and routine testing and documentation of water quality.

OK, let's take a look at how disinfectants are classified according to their level of disinfection. Low-level disinfectants destroy most bacteria, fungi, and viruses, but not mycobacterium tuberculosis or bacterial spores, and are typically used on housekeeping surfaces, such as floors and sinks.

Intermediate level disinfectants also destroy most bacteria, fungi, and viruses, and inactivate microbacterium tuberculosis, but do not destroy bacterial spores.

This level of disinfection is used on clinical contact surfaces contaminated with blood and other infectious materials such as dental light handles and countertops in the operatory.

Lastly, high-level disinfectants destroy all microorganisms, including Mycobacterium tuberculosis, but not all bacterial spores, and are typically used for heat sensitive instruments that can't be sterilized.

As a dental assistant, you play a key role in ensuring environmental surfaces in the dental setting are cleaned and disinfected.

You'll implement measures to prevent transmission of microorganisms from contaminated surfaces by applying the correct level of disinfection required to eliminate microorganisms on contaminated surfaces and using surface barriers.

Your efforts to maintain scrupulous infection control will help prevent transmission of infection and promote environmental safety in the dental setting.

All right, as a quick recap, disinfection of environmental surfaces in the dental setting is essential to eliminate microorganisms on contaminated surfaces.

Always keep in mind that even though a surface looks clean, it can also serve as a reservoir for pathogens. Proper cleaning and disinfection interrupts disease transmission and protects patients, members of the dental team, and the community.

As a dental assistant, understanding how to apply methods of cleaning and disinfection to prevent transmission of infection, is essential for maintaining environmental safety.