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.