Infection Control In The Dental Office

Back when I first wrote this (sometime between 2013 and 2018) as many as 7,000 dental patients in Oklahoma had been recommended to have blood tests as a precaution, after state health officials discovered violations that included questionable instrument sterilization procedures. More recently, COVID brought up the question of whether infection would spread in the dental office during the course of dental treatment.

You might be wondering “could that happen to me?”

It’s very unlikely. There are many measures in place, that are designed to prevent this from happening. But this is a good time to review key points that your dental office should be doing. If you have questions about specifics of what your dental office does, your dentist or one of her or his staff should be able to show you their machines and procedures.

Just like when you sneeze or cough, when you have dental care, your oral bacteria transfers to items used during that care. Your own bacteria often are not harmful to you but can cause problems for someone else. Our goal with infection control is to prevent the spread of bacteria (and viruses) from one patient to another (also called cross-contamination).

There are several types of items used during your dental care. Let’s discuss them, what we do with them, and why we do it.

Some items are designed for single use only and are thrown out after being used to prevent cross-contamination. We call these disposables. Examples include the rubber cups used for polishing your teeth during your cleaning and the plastic cup that holds the water you use to rinse. Our gloves and masks are also disposable items, as are a number of other things. It is important to note that the disposable item might be used more than once during your visit without being replaced--for example, if the dental hygienist polishes your lower teeth then lets you rinse out the polishing paste before she polishes your upper teeth, she does not have to get a new rubber cup for your upper teeth. You can also refill your water cup if you need more water to rinse without needing to get a new one each time. Once your appointment is finished, we will discard these disposable items, clean the areas surrounding them, and replace them with new ones for the next patient.

For hard surfaces, there are two option--disinfection or barriers. Surfaces deemed easier to clean and disinfect or ones that are too large or inconvenient to cover with a barrier surface, like countertops and the dental chair, are treated with a high-level disinfectant following the manufacturer’s directions. Plastic or foil may cover surfaces that can’t be disinfected or ones that the dental office determines would be hard to disinfect. These materials are used because they are nonporous and don’t easily let contaminants get through them to the surface underneath. At the end of your appointment, the plastic or foil is removed (thrown out) and new put on when the room is cleaned between patients. In other words, the barriers are considered disposable.

Other items, such as metal instruments used during your care, are cleaned and sterilized in an autoclave between uses. An autoclave is a machine that uses heat and pressure or chemicals to destroy disease causing organisms like bacteria. In Ohio, dentists are required to test each autoclave weekly to make sure that it is doing its job properly. We also need to keep a log of these test results for a minimum of the two previous years.

These are just a few of the things that I and your dentist do to prevent scenarios like the one in Oklahoma. If you have concerns about this occurrence, please discuss them with your dental office. If you do not have a dentist, please consider making my office your dental home by calling 440-960-1940. 

*NOTE: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.