Infection control and compliance: The importance of personal protective equipment in the dental office

Personal protective equipment (PPE) has been integral to the dental office’s success for decades. Even before SARS-CoV-2, dental health care personnel (DHCP) donned face masks, gloves, and lab coats for patient care. Following the COVID pandemic, PPE is just as or more important than ever. Rules and regulations govern what and when protection should be worn, but why are some dental professionals not adhering to the principles?

Dental employees are exposed to many hazards in the workplace. Blood, saliva, aerosols, hazardous cleaning agents, and other potentially infectious materials (OPIM) are common in our everyday practice as dental care professionals. But it’s as if we’ve become immune to the danger of our jobs. DHCP should be more inclined to adhere to personal and patient protection.

In 2023, a study revealed that more than 57% of dentists needed to comply more with PPE.¹ Protective measures can directly impact our health and the health of our patients.

Several different regulatory agencies create specifications for the use of PPE. The Centers for Disease Control and Prevention (CDC) released its Guidelines for Infection Control in Dental Settings in 2003, stating what and when to use PPE in the dental setting. While these recommendations are more than 20 years old (the CDC is currently updating its policies), they are still relevant, yet some DHCP are still not following the guidelines.

What are employers required to provide?

Many dental professionals need to be made aware of the significance of the Occupational Safety and Health Administration (OSHA) in the industry. Several standards specify PPE requirements for patient care, decontamination, and instrument reprocessing. Furthermore, employers are required to provide adequate PPE to employees at no cost. This includes gowns, patient care and heavy-duty gloves, face masks and shields, eye protection, and emergency equipment such as ventilation devices.² OSHA’s Bloodborne Pathogen Standard and Exposure Control Plan dictate many of the regulations that apply to dentistry.

The task determines the PPE

Selecting appropriate protective attire is determined by the task at hand. It must be emphasized that scrubs are not PPE and are not considered protection against hazards in the workplace.³ Engineering controls and work practice controls—such as sharps containers, handwashing, and PPE—are essential to the safety of DHCP. Changing how a task is performed, introducing a safety device into the workflow, and proper training can reduce or eliminate occupational hazards.

PPE can be disposable or nondisposable. Both are designed to keep the skin, clothing, mouth, eyes, and nose protected during procedures where blood, saliva, and OPIM are present. Furthermore, decontamination procedures also require PPE such as heavy-duty gloves for instrument reprocessing and cleaning spills.

“If Saliva Were Red”

If you have not seen the updated “If Saliva Were Red” video from the Association for Dental Safety (ADS), I recommend you do so. The educational video represents the hazards of everyday dental practice. Health-care-associated infections (HAIs) are common in the dental industry. The exposure and management of HAIs can be directly attributed to the proper use of PPE. Protecting DHCP and patients is essential to the overall health and safety of the dental practice. Simple protocols for the donning and doffing of PPE can keep clinicians safe and healthy while protecting patients from the hazards of dentistry.

Following the CDC’s recommended guidelines and OSHA standards can help improve infection control standards for the well-being of the dental office staff and patients. Staying abreast of the rules and regulations enables employees to provide a safe dental visit for patients.

Editor’s note: This article first appeared in Clinical Insights newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

References

1. Wan Q, Han L, Yang X, Yu S, Zheng X. Dental professionals’ use of personal protective equipment during COVID-19: a cross-sectional study in China. Front Public Health. 2023;11:1183580. doi:10.3389/fpubh.2023.1183580
2. Occupational safety and health standards: bloodborne pathogens. Standard number 1910.1030. U.S. Department of Labor. Occupational Safety and Health Administration. 1992. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
3. Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM; Centers for Disease Control and Prevention. Guidelines for infection control in dental health-care settings – 2003. MMWR Recomm Rep. 2003;52(RR-17):1-61.