OCCUPATIONAL HEALTH ISSUES

Personal protection covers a broad area in infection control, from immunization to barrier use. Use the following guidelines to minimize the risk to yourself, your staff, your family and your patients.

VACCINATION

Several vaccines are routinely administered during childhood and adolescence. Some of them require updating (boosters).

  1. Rubella (R)
  2. Hepatitis B
  3. Influenza
  4. Mumps (M)
  5. Measles (M)
  6. Tetanus (T)
  7. Diptheria (D)

If in doubt about your vaccination status, talk to your physician. He/she may recommend either testing you for antibodies or having a booster. Boosters are generally not required after MMR immunization. Td booster is needed every 10 years. Influenza vaccine is given yearly in October. Current recommendations are that the hepatitis B vaccination does not require boosters after the initial series of vaccines is given.

HAND WASHING

In order to reduce the likelihood of cross-contamination, hand washing facilities should be designed to minimize hand contact with inanimate objects such as water tap handles and soap dispensers. Faucets with foot controls, sensors, or any other method of water dispensing which does not require manual contact help avoid the possibility of contaminating taps.

HANDS SHOULD BE WASHED:

  • at the beginning of each day
  • prior to gloving
  • after the removal of gloves
  • if a glove is torn or punctured
  • when hands come in contact with an object or surface which may be contaminated; and
  • whenever coming back to work after a break.

Single use disposable towels should be used to dry the hands. Regular liquid soap is appropriate for the procedures of a Denturist practice. Antimicrobial soap is necessary for surgical procedures only.

GLOVES

Gloves must be worn when hand contact with bodily fluid or mucous membranes is anticipated, or when touching surfaces that may be contaminated. A latex, non-sterile glove is recommended for most non-invasive dental procedures. A well-fitting, comfortable glove which does not tear easily is recommended. Non-sterile latex, vinyl or other impervious material are acceptable alternatives.

Hands should be washed prior to gloving and must be washed after removal of gloves. Do not wash gloves with hand soap or use gloves after they have been in contact with disinfectants, as their effectiveness is diminished by exposure to chemicals. Remove and discard gloves after each and every patient. Gloves cannot be effectively disinfected and should not be re-used.

Practitioners are encouraged to try different brands to assess the comfort, strength, cost and irritability of a glove. Hypoallergenic gloves are available. Any health care worker who has exudative lesions or weeping dermatitis on their hands should refrain from all direct patient care and from handling patient-care equipment until the condition resolves. Some problems related to the wearing of gloves can be reduced by wearing the gloves only when required, changing the gloves frequently, or by using vinyl, nylon, or cotton gloves as a "liner".

Gloves should not be worn when handling charts, radiographs or telephones. Always remove and replace gloves before performing these activities. When cleaning the operatory between patients or using chemical disinfectants, utility gloves should be used.

Washing hands and donning a new pair of gloves in the presence of the patient at the beginning of each procedure will assure him or her that infection control procedures are being used in your clinic. Promote your practice by using infection control procedures.

MASKS

Routine use of masks is not necessary; rather, they should be donned for procedures in which splashing or spattering of blood or other body fluids is likely. However, due to the close proximity of the Denturist to the patient's oral cavity, many patients and Denturists feel more secure when a mask is used. Disposable masks serve as a filter and a barrier to splashes and splatter of fluids. Masks lose effectiveness if moist. In addition, as they become contaminated during any procedure, they should be replaced for each patient. When removing your mask, handle it by the strings only, to prevent potential contamination of your hands.

An important feature of a mask is its fit. It has been estimated that approximately 20% of air breathed passes around the mask and is unfiltered. Purchase masks that fit snugly against the face and meet the minimum standard of 95% filtration of particles 5 microns or smaller.

EYE PROTECTION

As with masks, eye protection is necessary only if splashing or spattering are likely. Protective eye wear prevents infection (such as by the viral infections influenza and hepatitis B) from being transmitted by spattering of the conjunctiva of the eye, by saliva, or other body fluids. Protective eye wear or prescription glasses fitted with side-shields usually offer sufficient frontal and side splash protection for the Denturist in the clinical setting.

Eye wear should be cleaned between patients. To clean glasses, wear gloves and wash the glasses under running water and dry thoroughly. Check with the individual manufacturer to see which, if any, disinfectant can be used on the glasses.

LAB COATS AND CLINIC JACKETS

Clinic coats and jackets should be worn only at the office and should not be worn to and from work, or outside of the office during the day. Both short sleeved and long sleeved jackets offer benefits. Short sleeves allow the arms of the Denturist to be washed if they should come in contact with a contaminated item. Long sleeved jackets offer protection against injury to the Denturist's arms. As both sleeve lengths offer benefits, the selection is up to the personal requirements of the wearer. Polyester-cotton blends or a tight cotton weave launder well and can be washed in hot water. Jackets should be changed daily and when they become visibly soiled. Washing clinic clothing in a normal laundry cycle is sufficient.