Discussing the updates on the PDA Interim Guidelines

on Infection Prevention for CoVid-19 Pandemic

(Part 5)

For this week’s edition of this column, we will discuss the different layers of defense against SARS-CoV-2, the virus that causes the coronavirus disease (Covid).

The advice from the Philippine Dental Association (PDA) says that the dental team should not rely on a single precautionary strategy. It must be pointed out that a single approach or device can only minimize the risk of infection to dental personnel and other patients. One step will reduce the risk of infection by a certain degree, another step added to the first step will may be effective in reducing the remaining potential risk, until such risks have become minimal. This can be described as a layering of protective protocols.

The PDA proposes the so-called Standard Infection Control precaution which includes:

  • Washing of the hands with plain or antimicrobial soap or 70% alcohol or alcohol based sanitizers.
  • Removing of watch and jewelry.
  • Washing of hands with clean warm or cold running water with soap.
  • Lathering of the backs of hands, between fingers and under the nails.
  • Scrubbing the hands for at least 20 seconds.
  • Rinsing the hands well under clean running water.
  • Drying the hands using a clean towel or air dry.
  • Asking dental team members, patients and other people visiting the dentist’s office to wear face masks
  • Posting signages reminding people to wear face masks.
  • Making sure to provide tissues and no touch waste receptacles.
  • Making sure to provide hand washing resources or 70% alcohol to people visiting the dentist’s office.

Dentists’ offices need to guard against environmental infections and impose control protocols, too. Some of the protocols may include the following:

  • Cleaning and disinfectIon of the dentist office and equipment according to universal health protocols on airborne infections.
  • Cleaning, disinfection, or throwing away supplies, or equipment located within 6 feet of symptomatic patients.
  • Recommending 0.1% bleach solution for non porous surfaces but may damage colored fabrics.. 3% hydrogen peroxide is suitable for both porous and non porous surfaces.
  • Making sure to disinfect the light switches, cuspidor, dental radiograph equipment,  dental  chairside computer, reusable containers of dental materials, drawer handles, faucet handles, countertops, pens, telephones, doorknobs
  • Disinfecting surfaces that cannot be wrapped with a barrier or plastic.
  • Barrier protection for surfaces that are difficult to clean and these barriers include clear plastic wrap, bags, sheets, tubings and plastic- backed paper or other materials impervious to moisture.
  • Advising the dental staff to wear gloves during removal of barriers and should be thrown away after sevicing a patient. 
  • Wearing of puncture-resistant utility gloves during cleaning and disinfection.  
  • Sterilizing instead of simply disinfecting objects. If sterilization is possible, make sure to do it.
  • Always wearing gloves and masks when imaging and handling contaminated film packets for x-rays.
  • Extra oral imaging processes such as panoramic or Cone Beam Computed Tomography (CBCT), is better to avoid gag reflex that occurs during intra oral imaging
  • Using a double barrier when using intra oral imaging .
  • Using the anti-retractive valve which reduces the backflow of oral bacteria or viruses into the tubes of the handpiece, which serves as an extra preventive measure.
  • Cleaning and sterilizing handpieces and other instruments that can be removed from the air and water lines of dental units.
  • Following the manufacturer’s manual of operation for the sterilization of handpieces and other intraoral instruments.
  • Never settling for surface disinfection if a device’s internal component that cannot be disinfected.
  • Putting a barrier on equipment or objects where a barrier can be properly installed prior to every patient use.