You must clean and disinfect the previously
covered surfaces between patients only when the
integrity of the physical barriers has been com-
promised or when the surface is visibly soiled. For
example, if moisture is absorbed through the cover to
the underlying surface, then the purpose of the barrier
is defeated, and the surface must be disinfected.
Cleaning Unprotected Areas
Using the spray-wipe-spray technique, clean and
disinfect all unprotected high touch areas with an
intermediate-level, EPA-registered disinfectant.
Remove all debris and particulate matter before
disinfection. To be effective, the disinfectant must
remain in contact with the surfaces for the time
specified by the manufacturer. Do not use 2 percent
glutaraldehyde as a surface disinfectant because of its
caustic vapors and high cost.
Bringing Contaminated Items to the CSR
After completion of the above procedures, you can
now take all metal and heat stable items to the CSR for
sterilization. Ensure all instruments and equipment are
handled properly and no sharp objects are protruding
through packs or cassettes while transporting items to
Preparing for the Next Patient
When you return to the DTR from the CSR and if
your room is clean, remove your gloves and wash your
hands and other exposed skin surfaces with an
antimicrobial soap. When discarding a face mask after
removing gloves and washing hands, handle the mask
only by the elastic or cloth tie strings. Never touch the
mask itself. Plan the above process carefully for
efficient use of time. Replace clean disposable barriers
and set up clean handpieces and instruments for the
Dental personnel who sustain percutaneous
inoculation of serum or saliva by accidental puncture,
or splashing while handling contaminated
instruments, equipment, or supplies must receive
immediate medical evaluation to comply with local
military treatment facility (MTF) guidelines. Refer to
the Nosocomial Infection Control Manual for
Ambulatory Care Facilities, NEHC-TM89-2, and
report the incident as a mishap to the command safety
officer using OPNAVINST 5102.1.
SECURING THE DTR
To secure the DTR at the end of the day, follow all
steps as mentioned under the Disinfecting the DTR
Between Patients heading.
Flush the high-volume evacuator (HVE) system
with at least one quart of water. Clean the system with
an HVE system cleaner at least once each week. Use
the system cleaner more often if indicated by
Spray-wipe-spray the countertops, dental unit,
chair, and dental light. Flush each unit waterline and
hose for 30 seconds.
If unit has a self-contained water delivery system,
follow manufacturers instructions for flushing and air
purging the lines.
Although micro-organisms are normal
contaminants of walls and floors, these surfaces are
rarely associated with transmitting infection to staff
and patients; however, all facilities must remain clean.
Any infection control instruction will determine and
implement a written schedule for cleaning and a
method of disinfection based upon location within the
facility, type of surface, type of contaminant present,
and tasks or procedures performed in a given area.
The OSHA and NAVOSH requirements for
housekeeping include sections on equipment, laundry,
and infectious waste disposal.
OSHA and the Navy require that all DTFs ensure a
clean and sanitary workplace. Work surfaces,
equipment, and other reusable items must be
decontaminated with an EPA-registered disinfectant
upon completion of procedures when contamination
occurs through splashes, spills, or other contact with
blood and OPIM. Observe and perform the following
Clean uncarpeted floor and other horizontal
surfaces regularly and when spills occur. Use mops
with a detergent and an EPA-registered disinfectant or a
detergent with sodium hypochlorite (1:100 dilution).
Mops must not be used for more than 1 day without