lotions are recommended for repeated use over the course of the clinical workday. All hand hygiene products specifically manufactured for healthcare practitioners are generally compatible with glove usage and contain fewer scents that may be offensive or allergenic to dental clinicians and patients. DHCPs should consult with lotion manufacturers regarding compatibility and interactions between lotions, gloves, dental materials, and antimicrobial products. Lotions that contain petroleum or other oil-based emollients can weaken gloves and increase the porosities in gloves. Using a water-based lotion is a better option (CDC, n.d.a.). they are visibly contaminated with blood or other potentially infectious materials. Protective apparel Protective apparel or gowns are required to shield all clinical personnel from infectious or harmful substances while in the dental office. Protective gowns should cover all personal clothing and skin that is likely to be soiled with blood, saliva, or other potentially infectious material. These garments should be worn during patient care, instrument processing, disinfection of environmental surfaces, and when harmful or toxic substances are handled. Protective gowns may be disposable or reusable and should be changed when they become visibly soiled and at the end of the workday. Soiled apparel should be placed into a designated container for contaminated laundry. No personal protective equipment of any type should be worn outside the dental clinic. Gloves Protective medical gloves should be worn when a potential exists for contact with blood or saliva, items contaminated by blood or saliva, or mucous membranes. Medical and sterile surgical gloves can be made of latex, nitrile, vinyl, or other synthetic materials. Sterile surgeon’s gloves must meet standards for sterility assurance established by the FDA and are less likely than patient examination gloves to harbor pathogens that could contaminate an operative wound. Nonlatex gloves should be provided for patients and dental workers with latex allergies. Ambidextrous and hand-specific medical gloves are available. Ambidextrous gloves are less expensive than hand- specific gloves, but they may contribute to hand and wrist fatigue. Although hand-specific gloves may be more expensive, they offer better fit, greater comfort, and less hand and wrist strain. Fresh patient examination gloves should be worn when performing any patient care procedure and should be removed immediately after use followed by hand hygiene. Many studies from a global perspective have demonstrated a lower frequency of inner glove perforation and visible blood on surgeon’s hands when double gloves are worn; however, the effectiveness of wearing two pairs of gloves in preventing disease transmission has not been demonstrated (Oosthuysen et al., 2014). Utility gloves have increased puncture and chemical resistance and should be worn when handling contaminated instruments and during housekeeping procedures such as environmental surface disinfection. Utility gloves should be routinely checked for punctures, tears, or any other signs of deterioration. If such signs are evident, the gloves should be discarded. However, if they are still intact, utility gloves may be disinfected with Environmental Protection Agency (EPA) registered intermediate-level surface disinfectants. Some utility gloves may also be autoclaved; consult the manufacturer’s instructions. Irritation contact dermatitis and latex allergies are often associated with glove use and are very common among DHCPs. Table 3 illustrates the comparison of these conditions. Although some symptoms of irritation contact dermatitis and allergic contact dermatitis may seem insignificant, any condition that compromises healthy skin increases the risk of exposure to
dental treatment is strongly discouraged and it is prohibited during surgical procedures. When choosing products for hand hygiene in the dental office, it is recommended to select products that are commercially available for healthcare personnel. These products generally contain emollients, such as glycerin or aloe, to soften hands and protect the epidermal integrity. The use of lotions in hand hygiene is recommended for healthcare workers to help prevent skin dryness associated with frequent hand washing. Petroleum- and oil-based products can weaken latex gloves and increase permeability; therefore, they should be used only at the end of the workday. Water-based Personal protective equipment Splashing and spattering of blood and other body fluids commonly occurs during dental hygiene procedures. All DHCPs at risk for exposure to potentially infectious materials must wear personal protective equipment (PPE), including protective eyewear, surgical masks, protective apparel, and gloves. Dental facilities must ensure that sufficient and appropriate PPE is available and accessible to dental personnel. Dental personnel should be educated on proper selection and use of PPE and should remove all PPE prior to leaving the work area. Protective eyewear Protective eyewear protects the eyes from exposure to microorganisms caused by spatter and from physical injury from particulate debris. Proper eyewear should be impact- resistant and have side coverage around the eyes. It may be disposable or reusable. Personal eyeglasses generally do not provide adequate coverage and do not have side shields, so they cannot be considered PPE. Chin- length full-face shields may be more comfortable and effective against large amounts of spatter and debris. Eye protection is required for all dental hygiene patient care procedures, including oral exams, scaling, suctioning, taking impressions, and polishing teeth and for non-clinical functions such as instrument pre-cleaning and cleaning, disinfecting environmental surfaces, and performing certain laboratory procedures. Protective eyewear for patient use is also recommended to protect the patient’s eyes from spatter or debris generated during dental procedures. Reusable eye protection should be decontaminated between patients by washing with soap and water. However, if clinician and patient eyewear is contaminated with blood, intermediate-level disinfectants should be used. Surgical masks Surgical masks protect the mucous membranes of the nose and mouth during dental procedures that are likely to generate splashes or spattering of blood or other body fluids. Masks must fit the face and create a light seal over the nose and mouth. The formfitting of the mask over the bridge of the nose minimizes eyewear fogging. Several acceptable types of masks are available, including dome/cone and flat masks with ear loops or tiebacks. Masks for dental procedures should have a filtration capacity of at least 95% (i.e., filter leakage of less than 5%). An intermediate- to high- filtration mask is recommended during procedures in which spatter and splashes are anticipated, whereas a lower filtration mask may be used for dental examinations and procedures that do not produce aerosolization. Surgical N-95 respirators are available for maximum filtration and should be used with patients who have suspected respiratory infections. Masks should also be worn while cleaning and disinfecting environmental surfaces and while performing other functions that may generate splashes and spatter such as placing instruments in a holding solution, loading the ultrasonic cleaner or instrument washer, and hand scrubbing instruments. Masks should be changed between patients and when they become damp from external contamination or from condensation of moist exhaled air. After use, masks may be disposed of in the regular trash unless
Page 36
EliteLearning.com/Dental
Powered by FlippingBook