Infection Control: “Clean” Fun for Pedodontic Practices and Patients
Nancy Andrews, RDH, BS
Not all microorganisms are harmful and cause infection and disease; in fact, many are protective. In pedodontic practices, there is an opportunity to play up this concept of “clean” by providing children and their parents with “take-home” guidelines or infection control products and including them in hand hygiene activities. In addition, publicizing office asepsis practices and sending reminders home with patients market the office commitment to high personal and professional standards and focuses the dental team on consistent personal hygiene and safety.
Hand contamination is responsible for over 85% of infections, and should be foremost in dental asepsis programs. Combining handwashing (to remove debris and microorganisms) with alcohol waterless hand sanitizers (to destroy skin microorganisms) is not just a dental regimen. With the growing popularity of alcohol hand rubs used by the public, patients can benefit from understanding the differences between handwashing and the use of alcohol hand rubs for their personal use. Dental professionals should maximize the opportunity to demonstrate model asepsis practices.
- When washing hands before treating patients, explain the need to remove germs before putting your hands into their mouth.
- When lathering, sing “Twinkle-Twinkle-Little-Star,” then explain the 15-second length of lathering time necessary to sufficiently clean hands, and how every surface of the hands should be rubbed to lift off germs.
- Rinse hands well, describing how loosened germs are being washed away.
- When hands are not visibly soiled and an alcohol rub is appropriate, demonstrate how it is done: apply enough solution to cover hands and rub continuously for 15 seconds until hands are dry.
- Explain that germs may hide around and under jewelry and fancy fingernail decorations and extensions. Sharp nails and jewelry can also tear gloves, which are important to protect hands from touching saliva and germs. Reiterate that short, smoothly filed fingernails promote asepsis and prevent glove damage.
- Place alcohol hand sanitizer dispensers where patients and their parents might try them. The front desk is an ideal location that is shared by dental workers who handle charts and may touch patients and potentially contaminated items or surfaces.
Respiratory Hygiene/Cough Etiquette is recommended for dental workers and patients to control transmission of droplet infections. For additional information, visit http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm.
Reestablishing a Patient Connection With Personal Protective Equipment (PPE)
Relating to and connecting with children when they are “out of their comfort zone”, perhaps fearful and confused, and possibly experiencing pain, presents a challenge. Accomplishing this with your face mostly covered by a mask, eyewear, or a shield removes the expressiveness of one’s face, except for the eyes. In addition, “plasticky” gloves that touch their mouths may result in the patient focusing on the feel and smell of the “inhuman” hands, the look of the “paper face,” and the distant sound of the voice from behind the shield.
PPE is not only required, but is essential to protect patients and workers. An important message for pediatric dental patients is that masks, goggles, and face shields protect them from the operator’s coughs, sneezes, and germs while they have their mouth open. Aesthetic masks should be selected that enhance the expressiveness of eyes, since eyes are the only facial feature visible to patients. Plain or diffusely blended complimentary soft mask colors can communicate comfort, calmness, and caring, and infuse the eyes with richness. There are patterned masks, but these may visually compete with patterned uniforms more than nongraphic masks. Flat, soft masks flex when the wearer speaks, adding some animation to the face, even while covered. Coned masks are rigid and move less when the clinician is speaking, and may also muffle the voice to a greater extent than softer masks. Masks are available in a wide variety of colors; several colors within the levels of protection should be selected. Hygienists may even consider asking the patient to choose the mask.
Selection of Gloves
Many gloves are now available in several colors and in different flavors; however, flavoring may be offensive for some patients. Color variety may be an option as long as the gloves provide the optimal protection.
Infection Control Reminders
Children may enjoy selecting their favorite color of disposable goggles, masks, or other items that can be sent home with them. Patient protection masks are also available that the patient can wear during the appointment and take home. This mask has a shield to protect the patient’s eyes from splatter, dust, or flying objects. The “take-home” message to the parents and the patient will be that the office cares about them. Individual tissue packs with the office name and phone number can be very useful during the appointment and given to the patient with a copy of the Respiratory Hygiene/Cough Etiquette printout “Cover Your Cough”. For more information, visit http://www.cdc.gov/flu/protect/covercough.htm.
*OSAP member and consultant on infection control.
1. Guidelines for Infection Control in Dental Health Care Settings---2003, Centers for Disease Control MMWR Dec. 19, 2003 / 52(RR17):1-61.