Open instrument trays, packs, or cassettes and
leave wrapping material underneath as a barrier for
the work surface. To protect surfaces against
contamination by blood, you should cover and use
barriers for areas that are difficult to disinfect.
Infection Control During Dental Treatment
Aerosols in the work environment present a
potential health hazard for both the dental staff and
patient. The long term effect is cumulative and may be
harmful. The use of high-volume evacuators (HVEs)
and rubber dams during all dental procedures
generating aerosols will reduce the volume of aerosols
and decrease the level of micro-organisms. Aerosol
levels can also be lowered and minimize the potential
risk by employing the following procedures:
Clean cavity preparations with water, air, or an
air and water combination.
Cover ultrasonic tanks when in use.
The dental officer may direct you to have patients
brush their teeth or rinse with a mouthwash before
treatment. This will reduce the microbial con-
centration of their oral flora (saliva). Three 10-second
rinses will temporarily reduce a patients microbial
count by up to 97 percent. Many dentists are now using
a 0.12 percent chlorhexidine gluconate preoperative
rinse that also significantly decreases the amount of
microbial count of an aerosol.
The following procedures should be used with all
dental patients for infection control:
Be sure to wash your hands before donning and
after removal of gloves.
Wear sterile gloves for all invasive surgical
Use nonsterile gloves for examination and other
nonsurgical dental procedures.
Use a rubber dam whenever possible. Swab
isolated teeth with an antimicrobial mouthwash
to reduce aerosolization of oral bacteria.
Use disposable suction, saliva ejector, and
Autoclave all instruments that can withstand
Sterilize rotary cutting instruments such as burs
and diamonds before using.
Use the unit dose concept when dispensing
supplies for each treatment setup. This is
Use sterilizable cassettes, tray sets, or packs for
Place the proper amount of supplies in each
setup before sterilizing.
Store opened packages of supplies in closed
drawers or cabinets in the DTR (in a covered
container if practical).
Use clean forceps to dispense only enough
supplies for immediate use.
Never use your hands to dispense items from
bulk storage containers.
Use of bottled irrigation solution for surgical and
nonsurgical procedures is considered sterile
only for that patient if aseptic techniques are
Record expiration dates on all opened
Before leaving the DTR, all personnel will remove
and discard gloves and masks worn during patient
treatment, except when transporting contaminated
items to the CSR or to the prosthetic laboratory if
authorized by your Command Infection Control
To prevent transfer of secretion to and
contamination of a patients chart, remove gloves and
wash hands (unless cover gloves are worn) before
writing in dental records, viewing radiographs, or
Disinfecting the DTR Between Patients
You have just finished with a patient, and the
dental officer is15 minutes behind schedule and your
last patient for the morning is waiting in the reception
area. You are in a hurry to set up for the patient. Stop,
slow down, and think! Disinfecting your DTR for
your next patient takes time and must be done
correctly. Always wear gloves while handling
nonregulated waste materials and instruments or
cleaning contaminated surfaces. Place all nonregulated,
nonsharp, disposable materials in designated containers
lined with plastic bags. Use foot operated containers if
they have lids.
The ultimate goal of an aseptic technique is to
break the chain of infection and eliminate the possible
transmission of infectious disease between patients