SURFACE CLEANING AND DISINFECTION

The need for surface cleaning can be reduced somewhat by the use of "barriers" and disposable items. Any surface that can be covered and will be in contact with the Denturist's hands or the patient's head should be covered. Whenever possible, foot controls should be used to operate taps and chairs. Plastic wrap or disposable covers having an impermeable plastic layer should be used to cover head rests, light handles, light control switches, and manual chair switches.

Surface cleaning and disinfection should take place after treatment of each patient and at the completion of daily work activities. Acceptable surface disinfectants must have documented evidence of bactericidal, tuberculocidal and virucidal activity. Products whose labels state only “hospital-level disinfectant” are not acceptable for use in a Denturist office. Check the label and product enclosure to ensure that a disinfectant will kill Staphylococcus aureus, Salmonella cholernesuis & Pseudomonas aeruginosa. The disinfectant must be tuberculocidal and must be effective on both lipophilic viruses (e.g. HIV) and hydrophilic viruses (e.g. Polio and Coxsackie) in 10 minutes or less.

Just as it is important to clean an instrument before it is sterilized, it is equally important to clean a surface before it is disinfected. As all disinfectants are inactivated by protein and blood, surfaces should be cleaned before they are disinfected. For surfaces which are not obviously dirty or contaminated, the "spray-wipe-spray" technique is adequate. A disinfectant is first sprayed on and the damp surface wiped with a paper towel to remove any debris (the cleaning stage), then disinfectant is sprayed on again as the disinfectant step. This spray is left on to allow for time for disinfection.

Chlorines - corrosive; damages clothes, plastic, rubber, metal and steel. Usually must be prepared daily
Iodophores - stains (removable), must be prepared daily
Synthetic phenols - film accumulation, damages plastics and rubber
In addition, 6% hydrogen peroxide and 70% isopropyl alcohol are adequate disinfectants. Hydrogen peroxide may corrode certain metals.

Water-based products in a pump spray/squirt bottle are preferable to alcohol-based or aerosol products. Alcohol makes the proteins in blood and saliva more difficult to remove from a surface and tends to evaporate quickly, thus reducing the contact time on the contaminated surface. Because alcohol makes the proteins in blood and saliva more difficult to remove, alcohol or alcohol based solutions should not be used for the first spray and clean phase, or to clean any obviously contaminated surfaces.

Sodium hypochlorite (household bleach) can be used in a 1:10 to a 1:100 dilution, depending on the amount of organic matter (blood and mucous) present on the surface to be disinfected. A fresh mix of sodium hypochlorite must be made daily (every 24 hours). Spray the disinfectant onto the surface to be cleaned, not onto disposable towel.