As far as cleaning and disinfecting the operatory, what tips and suggestions do you have to make it efficient, yet effective?

First and foremost, apply a basic premise of aseptic technique: clean it first. The importance of initial cleaning cannot be overemphasized and is included in all infection-control recommendations. Initial cleaning and subsequent disinfection are important because together they minimize the potential for cross-infection from environmental surfaces. It also must be mentioned that manufacturers are required to state on the product label that the disinfectant should be applied onto pre-cleaned surfaces. Although separate cleaners and disinfectants may be applied, chemical agents that accomplish both functions offer a more efficient approach.

A few other suggestions are:

  • Cover surfaces that are difficult to disinfect (i.e., chair buttons, control buttons on the air-water syringe, switches on the unit, light handles, hoses, and handpiece and air-water syringe holders) with a material impervious to water. Replace these covers between each patient.
  • Use an EPA-registered hospital disinfectant for both the cleaning step and the disinfecting step for uncovered surfaces. Using an agent with both cleaning and disinfecting properties provides some protection during the cleaning step, helps sanitize any debris spattered by the cleaning procedure, and helps keep the number of different products that need to be ordered at a minimum.
  • Personnel must follow the manufacturer’s directions on the disinfectant product label.
  • Use water, rather than alcohol, to dilute agents that require dilution before use.
  • Use heavy, puncture-resistant, utility gloves during surface cleaning and disinfection to reduce the potential for direct contamination on hands and development of irritation dermatitis.
  • Use protective eyeglasses to protect eyes from splashes or spatter created during procedures.
  • Wear a mask when cleaning and disinfecting to prevent inhalation or direct mucous-membrane contamination from spatter.
  • Using separate cleaning and disinfectant products is acceptable; however, choosing a product that accomplishes both offers a more efficient approach.
  • When performing spray-wipe-spray technique, use pump dispensers versus aerosol sprays to decrease the amount of chemicals sprayed in the environment.
  • Hold a paper towel behind the surface when spraying the disinfectant to reduce excess spray.
  • Disposable cloths or towelettes pre-saturated with disinfectants are becoming an increasingly popular option. One reason their use is increasing is that they decrease the amount of chemical sprayed into the environment.
  • Keep countertops uncluttered by removing unnecessary items – this facilitates cleaning and disinfection procedures.
  • Selecting one appropriate product with a higher degree of potency (i.e., intermediate-level disinfectant) to cover all situations might be more practical than maintaining both low- and intermediate-level disinfecting products in the dental office.

Unfortunately, misuse or overuse of chemical disinfectants can create problems for both a person’s health and equipment integrity. In addition to discoloring or compromising the integrity of treated operatory surfaces, practice personnel can exhibit a variety of clinical manifestations from long-term unwanted exposure to chemicals. Respiratory problems, such as wheezing or sneezing, development of allergies, ocular irritation, and headaches can occur as a result of excessive spraying of a disinfectant. Review and reevaluate written protocols for environmental asepsis if personnel in the practice develop these types of symptoms. The review should include consideration for implementing routine use of disinfectant wipes as a replacement for spray formulations.

Reference

Molinari JA, Harte JA. Cottone’s Practical Infection Control in Dentistry. 3rd ed. Baltimore, MD. Lippincott Williams & Wilkins (Wolters Kluwer Health);2009.