CHAPTER 6 Infection Control in the Dental Office
Over the past several years there has been significant controversy and lack of understanding about the possibility of contracting disease while in a dental office: Investigational reporters have produced and presented television programs that have been negative about dentists and their ability to control transmission of disease from one patient to another.
About 50 years ago, the diseases that were prevalent in the general population were different from the diseases present today. Over that time, AIDS has become a major health threat in some countries. Hepatitis B has become commonplace. Herpes has also been more prevalent. On the positive side, other diseases, such as tuberculosis, smallpox, and polio, have been greatly reduced or nearly eliminated worldwide. There are still numerous concerns among health practitioners and patients relative to the potential for transmission of disease in dental offices.
What is the current situation in most dental offices relative to infection control? Dentistry has taken on the infection control challenge with enthusiasm, backed with scientific research. The result is outstanding! Most dental offices are very safe, and you do not have to worry about contracting a disease from another patient while visiting your dentist. What has dentistry done? The following information will help you to understand the various areas of infection control now present in most dental offices. It will also provide information for you to have a discussion with your dentist about this very important topic.
A dental handpiece is the rotary cutting instrument used by dentists to remove decay from your teeth and shape them to allow adequate restoration (FIG. 6.1). A few years ago the lay press severely criticized the dental profession, alleging that dental handpieces were not properly sterilized. The same argument could be used about dishes, knives, forks, and spoons in restaurants. Dentistry has now progressed to the point that dental handpieces are sterilized by heat before being used in your mouth. The many moving parts in handpieces break down during sterilization because of this heat. The continual replacement of dental handpieces is one of the major overhead costs your dentist incurs to provide safe treatment for you. On the positive side, sterilized dental handpieces are not a risk for you.
Countertops, drawers, handles, chairs, tables, etc. collect airborne particles as well as debris from actual physical contact with contaminated materials. Similarly, such surfaces in restaurants, public restrooms, and other areas are contaminated but seldom cleaned. What has happened to these surfaces in dental offices? Employees in most dental offices wipe environmental surfaces with strong disinfectants (FIG. 6.2). It is interesting that the disinfectants that are used are available in your grocery store. Lysol sprays containing 79% alcohol are very good surface disinfectants. When the solution is sprayed into a towel and then wiped onto the surface and allowed to dry, the surface is well disinfected. Most dental offices clean environmental surfaces after the completion of each patient.