Tuesday, February 27, 2024

Infection Control In Dental Laboratory

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Infection Control In Clinics And Laboratories: Correct Device Disinfection

Inside Dental Technology – Infection Control

Just like the dental surgery, the dental laboratory is a place in which it is essential to follow the procedures for correct disinfection and sterilisation of surfaces, devices and instruments.

The aim is to reduce considerably the risk oftransmitting pathogen micro-organisms to healthcare operators, patients,visitors and to objects themselves. Putting into practice correct and strictprocedures for disinfection and sterilisation constitutes a clinical excellenceon a par with the quality of care delivered in the manufactured product and/orprosthodontic/orthodontic device.

Recent and numerous studies haveshown that surfaces, worktops, devices and/or dental impressions are importantmeans of transmission of diseases or infections.

Decontamination and the correct disinfection of all devices that containbiological material, whether incoming or outgoing from the dental surgeryare of crucial importance.

Below is a guide that highlightsall the fundamental steps for the correct hygiene protocol fordevices/impressions on the part of both the dental surgery staff and the dentallab professional.

Universal Masking By Staff Patients And Visitors

Universal masking ) to prevent the transmission of SARS-CoV-2 and other respiratory infectious agents in dental settings should continue to be applied for all staff, patients and visitors.

For patients on the non-respiratory pathway face coverings are acceptable. Surgical facemasks should continue to be worn during the winter period 2021 to 2022 by staff in all areas within dental settings, except in staff areas when eating and drinking.

Patients with confirmed or suspected respiratory infection should be provided with a surgical facemask . The patient requirement to wear a surgical facemask must never compromise their clinical care.

Organisations in NHS Scotland should refer to Coronavirus : Guidance on the extended use of facemasks and face coverings in hospitals, primary care and wider community care settings.

How The Dental Laboratory Provides Infection Control

Following infection control measures is essential for the laboratory, as well as the dental team

The use of appropriate infection control precautions is important for dental laboratory technicians, as it is for the dental team. Improper handling of contaminated items, such as impressions, casts, and other prosthetic appliances, can result in cross-contamination and possible cross-infection to personnel. When used together, routine use of recommended infection control procedures and protocols, along with effective communication between the dental practice and the dental laboratory, can provide a safe working environment for those with potential occupational risks.

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Protocol For The Decontamination Of The Dental Laboratory Staff

  • Before castingthe impression or working on devices that have been in a patients mouth, washyour hands thoroughly, disinfect the laboratory worktops and make sure thedevice was previously disinfected by the surgery
  • After workingon the device or prosthodontic product, it needs to be disinfected and insertedin a new bag suitable for its transportation.
  • It is good practice for thedental surgery and the dental laboratory jointly to agree on scrupulousprocedures for the disinfection and sterilisation of manufactured productsand/or prosthodontic and orthodontic devices.

    We therefore recommend you buy the same line of disinfectant products toimplement the correct protocol, in perfect antiseptic consistency amongcooperating facilities.

    Article by Stefania Barbieri

    Standard Infection Control Precautions

    Infection control in dental lab 1

    All health and social care providers should be familiar with SICPs and TBPs.

    SICPs are the basic IPC measures necessary to reduce the risk of transmission of infectious agents from both recognised and unrecognised sources of infection. Sources of potential infection include blood and other body fluids secretions or excretions , non-intact skin or mucous membranes, and any equipment or items in the care environment that could have become contaminated. SICPs are to be used by all staff, in all care settings, at all times, for all patients.

    SICPs should be used in treatment of patients in all healthcare settings. For patients on the respiratory pathway TBPs should applied in addition to SICPs.

    National policy for SICPs is available for Wales, Northern Ireland, and Scotland. NHS England is developing a national IPC Manual for England as set out in the UK 5-year Tackling Antimicrobial Resistance National Action Plan .

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    Infection Control In The Dental Office

    The risk of infectious disease transmission is an inherent part of dental practice. Fortunately, such risks can be greatly reduced through modern infection control practices. Such practices include the use of various measures, including administrative, engineering, and work practice controls. Such measures should be codified in an office infection control plan, which should form the basis for the daily infection control activities of the staff. This article discusses some of the measures that should be taken to safeguard the health of dental healthcare workers and patients.

    • Previous article in issue

    Simple Steps For Dental Impressions

  • Rinse under tap water to remove as much debris as possible.
  • Disinfect the impression using an intermediate level hospital grade disinfectant following the contact time that is recommended.
  • Rinse under tap water to remove the residual chemicals.
  • Shake in the sink to remove adherent water.
  • NOEL BRANDON KELSCH, RDHAP,, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists Association.


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    General Dentists Knowledge About Infection Control Of Dental Impressions Between Clinic And Laboratory In South Khorasan Province

    1Assistant Professor, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

    2Dentist, Birjand, Iran

    3Dental Student, Dental School, Tehran University of Medical Sciences, Tehran, Iran

    How to Cite:MostafaviA S, Motahhary MoghadamG, HajianiN. General Dentistsâ Knowledge About Infection Control of Dental Impressions Between Clinic and Laboratory in South Khorasan Province,Zahedan J Res Med Sci.2018 20:e22031. doi: 10.5812/zjrms.22031.


    Zahedan Journal of Research in Medical Sciences:Article Type:

    Asepsis In The Dental Office Lab

    Dental Lab Basics & Orientation | How to Work | Safety | Infection Control [Subtitles/CC]

    By , CDA, RDA, RDH, MBA

    The laboratory in the dental office is an area often overlooked for infection-control protocols, yet there are many opportunities for cross-contamination and potential disease transmission. Ideally, the lab should be a separate location from the instrument sterilization area. But in some facilities space limitations require the lab and sterilization areas to be located in the same room. If this is the case, the lab functions should not be located in the area where instruments are removed from the sterilizer and placed into storage.

    The key cross-contamination challenges in the lab are: safe handling of impressions for pouring in the office or sending to the outside lab disinfection of prostheses that are sent to the outside lab, such as dentures, partials, crowns and bridges and preventing cross-contamination through the use of polishing wheels and other devices.

    Arbor bands and polishing wheels should be disposed of after use since they cannot be effectively cleaned and sterilized. Burs, such as acrylic trimming burs, should be sterilized between uses since they too may be contaminated with saliva or blood from contact with items that have been in a patient’s mouth. Some lab burs have steel shanks and may rust when processed in a steam sterilizer. Dry heat may be more appropriate for these items.

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    Dental Laboratories And Infection Control

    When I was an assistant, I used to wonder about the dental lab that our office used to create dentures, partials, and crowns. There were a couple of times when a crown arrived and the box was empty, and then there was the time that we received a denture for a patient not in our practice.More columns from Noel KelschA patient’s perspective

    One morning a patient arrived to have his crown seated and his crown was not in the office. The lab had promised to have it there the day before but the driver for the lab was off work due to illness. I drove to the lab to pick up the crown. No one was in the front of the lab so I walked into the back. A man in overalls stood at a lathe with a denture in one bare hand and a banana in the other bare hand. On the lab bench there was a mix of dentures, burs, crackers, notes, impressions, melted wax with a spatula stuck in it, chips of impression material mixed with chunks of stone, and a cup half full of coffee. I stood there and thought, We should have visited here before we trusted our patients health to this lab.

    Studies have shown that microorganisms can be harbored in dental impression materials, including fungi and viruses. Then the impression materials are manipulated to create castings with gypsum. These microorganisms can thrive in this environment for up to seven days. The material, the processes of manufacturing, and transportation and storage make the process of producing prostheses a possible area for cross contamination.

    Protocol For Decontamination Of Dental Impressions And Prosthodontic Devices In A Dental Surgery

  • Insert thesterile impression tray with the impression material which will help record thepatients condition
  • Once theimpression has been taken, rinse the impression thoroughly to remove anyresidue and traces of saliva. Next, remove any excess water
  • Disinfect theimpression using a disinfectant specifically for impression material, dippingthe impression in the solution or spraying it directly if using a spraydisinfectant. Follow the chosen disinfectant manufacturers instructionsfor contact time
  • Where envisagedby the disinfectant, after disinfection rinse thoroughly under running water. Lastly, insert the impressions in a transparent bag suitable fortransporting the device.
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    Occupational Health And Vaccination

    Prompt recognition of cases of respiratory infection among health and care staff is essential to limit transmission. Staff testing negative for SARS-CoV-2 by polymerase chain reaction who remain symptomatic of another respiratory infection should consider the risk to service users before returning to work. Once medically fit to return to work, if staff are in doubt about any risk they may pose to service users or colleagues, this should be discussed with their line manager in the first instance. Bank, agency and locum staff should follow the same deployment advice as permanent staff.

    Staff should be vaccinated against respiratory infections, for example influenza and COVID-19, in line with country specific requirements.

    Staff who are fully vaccinated against COVID-19 and are a close contact of a case of COVID-19 may be allowed to return to work without the need to self-isolate. There are country-specific variations on the requirements for PCR and lateral flow device antigen testing and these policies are under continual review and subject to change.

    Refer to country specific policy for:

    Guidance on carrying out risk assessments is available.

    As part of an employers duty of care, they have a role to play in ensuring that staff understand and are adequately trained in safe systems of working, including donning and doffing of PPE. A fit testing programme should be in place for those who may need to wear respiratory protection.

    Diagram Summarising Pathways: Plain Text Description

    Infection control in dental lab 1

    Left top of chart begins with statement: Patient or carer has answered yes to one or more screening questions?

    Move to: Can appointment be re-scheduled until resolution of symptoms, end of isolation, negative test results or setting is able to administer the screening questions?

    Answer no: Transmission-based precautions should be applied in addition to SICPs. Post-AGP downtime applies.

    Answer yes: Reschedule the appointment

    Right top of the chart begins with statement: Patient or carer has answered no to all screening questions

    Move to: Complete appointment applying standard infection control precautions

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    Cleaning And Disinfection Procedures

    The first step in any infection control procedure is cleaning. With regard to dental laboratories, impressions may be cleaned by scrubbing gently and rinsing to reduce bioburden, and subsequently disinfected with an antimicrobial agent .10 Dental impressions may be disinfected by spraying, dipping, or immersing. The advantages of the spray method are that less of the disinfectant product is used, and often the same product may be used to disinfect environmental surfaces. However, the spray method may not be as effective as immersion due to the potential for pooling of the disinfectant in some areas, while other areas may remain dry secondary to undercuts in the impression. The spray method also releases chemicals into the air, increasing the potential for occupational exposures. The dipping or immersion technique requires complete coverage of the impression in the disinfectant. Shorter exposure times minimize possible distortion and deterioration of the surface quality of the resulting stone casts. However, the manufacturers instructions should always be consulted for their recommended procedures.

    Dental prostheses should not be stored in disinfectants prior to insertion. If a manufacturers recommended contact time is exceeded, there are potential corrosion risks for metal components. Dental prostheses may be stored in diluted mouthwash or water if desired.

    Infection Control In The Dental Laboratory

    This course will provide laboratory owners, department managers and dental technicians with the skills and knowledge to comply with OSHA standards related to infection control procedures necessary in a dental laboratory setting.

    Participants will be given the opportunity to evaluate the course and to comment on how they perceive they might incorporate any suggested strategies into their practice.

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    Safe Management Of The Care Environment And Equipment

    Frequently touched sites and points in waiting rooms and surgeries, for example dental chairs, should be cleaned between patients and:

    • equipment used for cleaning, for example cloths, should preferably be disposable however, reusable items such as mops/buckets should be stored clean and dry between use
    • medical devices and equipment should be managed as per manufacturers instructions. Decontamination of equipment and the environment following dental treatment should follow country specific guidance for England, Scotland, Wales or Northern Ireland

    Reusable equipment should be decontaminated:

    • between each patient
    • after blood and body fluid contamination
    • at regular intervals as part of equipment cleaning

    Other reusable dental equipment should be decontaminated in accordance with manufacturers advice and in line with decontamination guidance.

    An increased frequency of decontamination and cleaning should be incorporated into the environmental decontamination schedules for areas where there may be higher environmental contamination rates for example:

    • toilets
    • frequently touched surfaces such as door and toilet handles
    • staff room equipment, for example kettles

    Algorithm For Post Agp Downtime: Plain Text Description

    Dental Lab Work Infection Control

    Top of chart begins with question: What is the ventilation rate?

    1) If 0 ACH, do not carry out AGPs if there is no natural or mechanical ventilation

    2) If 1 to 5 ACH or unknown, then question: Is high volume suction used?

    2a) If Yes, then question: Is rubber dam used?

    • If Yes, then question: What is the length of procedure?

    • If 5 minutes or greater then post AGP down time = 20 minutes
    • If less than 5 minutes then post AGP down time = 15 minutes
  • If No, then question: What is the length of procedure?

  • If 5 minutes or greater then post AGP down time = 25 minutes
  • If less than 5 minutes then post AGP down time = 20 minutes
  • 2b) If No, then question: What is the length of procedure?

    • If 5 minutes or greater then post AGP down time = 30 minutes
    • If less than 5 minutes then post AGP down time = 25 minutes

    3) If 6 to 9 ACH, then question: Is high volume suction used?

    3a) If Yes, then question: Is rubber dam used?

    • If Yes, then question: What is the length of procedure?

    • If 5 minutes or greater then post AGP down time = 10 minutes
    • If less than 5 minutes then post AGP down time = 10 minutes
  • If No, then question: What is the length of procedure?

  • If 5 minutes or greater then post AGP down time = 15 minutes
  • If less than 5 minutes then post AGP down time = 10 minutes
  • 3b)If No, then question: What is the length of procedure?

    4) If 10 or greater ACH, then question: Is high volume suction used?

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