Environmental Infection Control in Dentistry

We had seen NABH, CDC guidelines. We learnt how to protect ourselves. How could we protect ourselves from disease like TB and how could we handle sharp instruments.

Today we will talk about how we can protect ourselves from the disease which occurs from environment. Here, environment means air and water. Quality control to prevent infection and how to clean table tops, your chair, laptop, mouse, utility trays etc.

Firstly, let’s talk about air borne diseases. Before starting, I would like to share an incident of mine.

After my wedding, my wife Dr. Sucheta Sharma joined our clinic in 2013. But soon she began to feel nauseous.

We consulted physician and pulmonary specialist, a lot of test had been done and everyone had the symptom of bronchitis and there was no treatment for bronchitis. Patients had to take medicines continuously.

Doctor told that in cities like Delhi, this is common. Then, we met young physician who recently passed MD and he asked us to get some test done on staphylococcus. And yes we found the culprit.

This staphylococcus is an air borne disease which we get in the hospitals. Those doctors told us that due to poor air quality, your clinic can suffer from this.

At that time I firstly got to know about the importance of air quality.

Before proceeding further, let us see which microbes can be in our clinics.

These could be of the following types:-

Staphylococcus, exterococcus species, mycobacterium, tuberculosis, varicella, zoster, rubella, aspergillums, hegionella species and now the huge one is corona virus.

Now let’s see some tips on how we could protect ourselves from these airborne diseases.

If possible, design your clinic in such a way that can give proper sunlight and natural ventilation. But the clinic is done in a commercial place and the shop cannot design such.
The clinic should have ventilation system and it should be on all the times.
If possible, room air purifier should be made available in the clinic.
There should be space between two working operatory.
If there is curtain in the clinic then it should be cleaned regularly.
Regular cleaning of non- visible areas should be done like windows, corner, inside of fall ceiling, etc.
If air cleaning of AC is done then only use AC.
As I told you in the respiratory etiquette, use mask wherever necessary.
Air quality should be monitored in every three months.

Now, let’s see water infection control.

According to WHO, there are about 2 million deaths due to water every year. And as you know, the quality of water is becoming useless day by day in India. Most of us drink the water of R.O. only. Then how can we ignore water quality in our clinic.

We all know that we cannot practice without water. We use water in almost every case. And if there are microbes in the water, then there are the chances that we are spreading infection.
So, I am going to tell some of the tips by doing that you can monitor the water quality in your clinic.

Always use distal water in chair neither R.O. water, nor tap water. Distal water is very cheap or you can take the machine of making distal water. If the water contains microbes, then there is chances that it starts multiplying itself by hiding in air-rotor pipes and chair pipes.
Clean your water tanks in every two months and after cleaning don’t forget to write the dates on the water tank.
Before starting the clinic in the morning, flush your water lines for two minutes at least and at least 30 seconds between two patients.
Flush your spittoon water pipe and suction pipe daily, with cleaning ascent and in between patient with clean water.

Kavo and 3m’s products suction cleaning products comes, you have to dilute it in 2l solution and make it suck.

If you don’t have these products then u can also use 1% hypo.

If possible, take distilled water only for rinsing also.

Now, let’s see how we can clean those environmental surfaces.

Now, we are talking about that surface where you can touch or water droplets from patient’s mouth can come upon you.

For ex –

Mouse and keyboard to view RUG.

Utility trays.

TV screen, if it is mounted on the chair.

Your chair fable, where you write prescription.

Chair control and dental chair itself.

Now, let’s see how we can take care of these.

We can cover dental chair head and back – rest.
We can cover dental chair light handle.
We can cover dental chair control.
We can cover keyboard and mouse.
We can cover TV screen.
We can cover air- rotor and suction.

Remember all there barriers must be discarded by the doctor or assistant before removing the gloves.
Then the surfaces which are not completely barrier proof should be disinfectant. You can buy any disinfectant which are EPA approved. Most of these disinfectant are bactericidal.
There is a method of using every disinfectant which is told to you by the manufacturer in its guidelines. Most of times it is seen that as the assistant sprays, he wipes it. You have to take care that the spray stays for two to four minutes so that it can act.

Thank you

SOLUTIONS FOR DENTIST

We had seen NABH, CDC guidelines. We learnt how to protect ourselves. How could we protect ourselves from disease like TB and how could we handle sharp instruments.

Today we will talk about how we can protect ourselves from the disease which occurs from environment. Here, environment means air and water. Quality control to prevent infection and how to clean table tops, your chair, laptop, mouse, utility trays etc.

Firstly, let’s talk about air borne diseases. Before starting, I would like to share an incident of mine.

After my wedding, my wife Dr. Sucheta Sharma joined our clinic in 2013. But soon she began to feel nauseous.

We consulted physician and pulmonary specialist, a lot of test had been done and everyone had the symptom of bronchitis and there was no treatment for bronchitis. Patients had to take medicines continuously.

Doctor told that in cities like Delhi, this is common. Then, we met young physician who recently passed MD and he asked us to get some test done on staphylococcus. And yes we found the culprit.

This staphylococcus is an air borne disease which we get in the hospitals. Those doctors told us that due to poor air quality, your clinic can suffer from this.

At that time I firstly got to know about the importance of air quality.

Before proceeding further, let us see which microbes can be in our clinics.

These could be of the following types:-

Staphylococcus, exterococcus species, mycobacterium, tuberculosis, varicella, zoster, rubella, aspergillums, hegionella species and now the huge one is corona virus.

Now let’s see some tips on how we could protect ourselves from these airborne diseases.

If possible, design your clinic in such a way that can give proper sunlight and natural ventilation. But the clinic is done in a commercial place and the shop cannot design such.

The clinic should have ventilation system and it should be on all the times.

If possible, room air purifier should be made available in the clinic.

There should be space between two working operatory.

If there is curtain in the clinic then it should be cleaned regularly.

Regular cleaning of non- visible areas should be done like windows, corner, inside of fall ceiling, etc.

If air cleaning of AC is done then only use AC.

As I told you in the respiratory etiquette, use mask wherever necessary.

Air quality should be monitored in every three months.

Now, let’s see water infection control.

According to WHO, there are about 2 million deaths due to water every year. And as you know, the quality of water is becoming useless day by day in India. Most of us drink the water of R.O. only. Then how can we ignore water quality in our clinic.

We all know that we cannot practice without water. We use water in almost every case. And if there are microbes in the water, then there are the chances that we are spreading infection.

So, I am going to tell some of the tips by doing that you can monitor the water quality in your clinic.

Always use distal water in chair neither R.O. water, nor tap water. Distal water is very cheap or you can take the machine of making distal water. If the water contains microbes, then there is chances that it starts multiplying itself by hiding in air-rotor pipes and chair pipes.

Clean your water tanks in every two months and after cleaning don’t forget to write the dates on the water tank.

Before starting the clinic in the morning, flush your water lines for two minutes at least and at least 30 seconds between two patients.

Flush your spittoon water pipe and suction pipe daily, with cleaning ascent and in between patient with clean water.

Kavo and 3m’s products suction cleaning products comes, you have to dilute it in 2l solution and make it suck.

If you don’t have these products then u can also use 1% hypo.

If possible, take distilled water only for rinsing also.

Now, let’s see how we can clean those environmental surfaces.

Now, we are talking about that surface where you can touch or water droplets from patient’s mouth can come upon you.

For ex –

Mouse and keyboard to view RUG.

Utility trays.

TV screen, if it is mounted on the chair.

Your chair fable, where you write prescription.

Chair control and dental chair itself.

Now, let’s see how we can take care of these.

We can cover dental chair head and back – rest.

We can cover dental chair light handle.

We can cover dental chair control.

We can cover keyboard and mouse.

We can cover TV screen.

We can cover air- rotor and suction.

Remember all there barriers must be discarded by the doctor or assistant before removing the gloves.

Then the surfaces which are not completely barrier proof should be disinfectant. You can buy any disinfectant which are EPA approved. Most of these disinfectant are bactericidal.

There is a method of using every disinfectant which is told to you by the manufacturer in its guidelines. Most of times it is seen that as the assistant sprays, he wipes it. You have to take care that the spray stays for two to four minutes so that it can act.

Thank you