Although infection control is making headlines these days, it has always been a standard part of dentistry. Limiting the spread of germs keeps patients and staff safe. It’s good for both health and business. But it takes teamwork to stay ahead of the microorganisms that cause disease, and whether it’s sterilizing instruments or getting an annual flu shot, dental assistants play a key role.
What is Infection Control?
The term “infection control” refers to procedures that minimize the risk of infections in healthcare settings. Only three things are required for infections to occur, a source, a host and a mode of transmission.
A Source
A reservoir for germs exists wherever conditions are favorable for their growth. Examples in a dental office include bathrooms, dental instruments, sinks, human mouths, and skin.
A Host
A host is a person vulnerable to infection. In a dental office, that includes patients, staff and guests.
A Mode of Transmission
For germs to cause infections, they need to move from the reservoir to the host. Pathogens in a dental office can travel via instruments, skin and body fluids, including saliva and respiratory droplets.
How to Control Infections?
Universal infection control protocols prevent the spread of disease by creating barriers between sources and hosts and by eliminating modes of transmission. Standard practices in a dental office include handwashing, cough etiquette, personal protective equipment, environmental sanitation, health screenings, and immunizations.
Handwashing
Handwashing for 20 seconds with soap and water removes almost all bacteria from the skin. Dental assistants should wash their hands, scrubbing vigorously, before donning gloves and after removing them to keep pathogens on their hands at the lowest level possible.
Cough Etiquette
Cough etiquette limits the spread of germs through respiratory secretions. All dental staff should cover their mouths with a tissue when they cough, disposing of it immediately after use. Handwashing then prevents the spread of bacteria that may have contaminated skin.
Personal Protective Equipment
Personal Protective Equipment (PPE) creates a physical barrier between staff and patients, decreasing the transmission of germs. A dental assistant uses gear such as masks, gloves, gowns and face shields to protect themselves against contaminated body fluids. PPE must be changed between each patient and before leaving the room to prevent cross-contamination of other surfaces.
Environmental Sanitation
Regular use of chemical cleansers to sanitize hard surfaces and equipment from chairs and countertops to tools and instruments limits the growth of surface bacteria. Non-disposable instruments must be sterilized.
Health Screenings
If a patient with influenza sits with nine others in a waiting area, that individual is likely to infect at least one additional patient. Policies that prevent sick staff or patients from coming to the office eliminate potential reservoirs of infection.
Immunizations
As an oral care provider, it’s a dental assistant’s professional responsibility to protect patients from contagious diseases whenever possible. Vaccinations can protect staff from infection by patients and vice versa.
The Importance of Infection Control in a Dental Office
Germs are a part of life, millions of species exist naturally in the air, water and soil. Up to 500 types of beneficial bacteria live in the body, aiding with metabolism and digestion. Only a small number of microorganisms are known to be pathogens; bacteria, viruses or fungi that cause disease.
But because healthcare settings, such as dental offices, treat high volumes of patients, they harbor a greater number of potentially harmful germs, including those that are resistant to treatment. Healthcare-associated infections are a leading cause of illness in the United States, making pathogen control a must for the safe treatment of patients and protection of staff.
The Dental Assistant’s Role in Infection Control
One of the dental assistant’s primary and arguably most important roles in a dental practice is infection control, patient’s lives depend on it. Their responsibilities include sanitation, patient screening, and PPE Use.
Infection Control Through Sanitation
There are three levels of chemical cleaning done in healthcare settings, each has a unique purpose.
Level #1: Sanitation – kills some bacteria and viruses, less than half in some cases. Solutions are effective but comparatively mild, making them suitable for sensitive and low-risk surfaces. Examples include desks, restrooms, doorknobs, office equipment and floors.
Level #2: Disinfection – eliminates a higher percentage of potential pathogens. Chemicals are more potent and best used to clean the surfaces and equipment patients touch. Exam chairs, sinks and nearby surfaces are disinfected between visits for safety. Particular attention should be paid to moist surfaces because they’re more hospitable to bacterial growth.
Level #3: Sterilization – kills or inactivates all pathogens, but the process is harsh, involving high heat or powerful chemicals. Dental assistants sterilize all instruments used in patients’ mouths plus linens, fluids and other equipment used during oral surgery.
Patient Screening for Infection Control
It’s a dental assistant’s duty to protect high-risk patients but knowing which are vulnerable and need additional precautions requires understanding their medical history. What medical issues do they have? What prescription drugs are they taking? Do they have allergies to medicine?
High-risk patients include:
- Smokers
- Diabetics
- Pregnant women
- Those with artificial heart valves or joint prosthetics
- People with allergies to antibiotics and dental anesthetics
- Chemotherapy patients
Before an exam, a dental assistant helps patients complete or update medical history forms, clarifying responses and identifying concerns for the dentist to review before providing care. Those at high-risk for infection may require antibiotics before treatment or special precautions to limit their exposure to bacteria.
PPE Use for Infection Control
Humans are reservoirs for infection, but PPE serves as a roadblock. Gloves, masks and face shields prevent contaminated body fluids from contacting a dental assistant’s skin during procedures. PPE must be donned, removed and disposed of carefully between procedures to avoid contact with contaminants on the outside of the equipment. It’s not foolproof, but when worn consistently, it’s one more pathogen barrier a dental assistant has between themselves and their patients.
Skills for Success at Infection Control
Infection control is more than a set of procedures; it’s a philosophy. It’s critical to know the rules, but not every infection control situation is obvious. These skills help dental assistants see the big picture. They include attention to detail, communication skills, clinical judgement, consistency and leadership skills.
Skill #1: Attention to Detail
Infection control is a meticulous process. Everything from mixing disinfectants and sterilizing instruments to donning and doffing PPE must be done according to strict standards. Attention to detail prevents the complacency that comes with doing repetitive tasks.
Skill #2: Communication Skills
Experts blame most infection control breeches on poor communication. One incidence of infection in a hospital, for example, could be linked to a malfunctioning heat sterilizer. A technician noted the problem over a weekend and stopped using it, but maintenance was never notified, and the unit was never tagged. Weekday staff continued to use the device without knowing it didn’t reach proper sterilization temperatures, resulting in infections. Mechanical safeguards have since been added to prevent future issues, yet the incidence could have been averted with communication.
Communication is also critical when interacting with patients. The Center for Disease Control (CDC) suggests reaching patients through signage and social media improves their awareness of infection and how to prevent it. During cold season, a notice at the door, by a hand sanitizer dispenser, cues patients to think about their behavior. Dental assistants play an important part in planning these infection control interventions.
Skill #3: Clinical Judgement
Dental assistants use their knowledge of pathogens to make infection control decisions. Some feel automatic, like putting gloves on before handling a patient’s dental appliance. Others are less obvious, such as questioning if patient bathrooms are being cleaned as often as they should during flu season.
Sound clinical judgment empowers dental assistants to question infection control protocols and suggest improvements. It’s the definition of proactive, front line care.
Skill #4: Consistency
Infection control is an everyday practice, but bacteria are invisible, there are no obvious cues to remind staff that a surface or instrument could be contaminated. People can have infections or be colonized with germs and not show symptoms.
Research cited by the CDC pinpoints consistency as the key to effective infection control. Following policies and procedures is essential.
Skill #5: Leadership Skills
Infection control begins with knowledge, non-clinical staff and patients depend on dental assistants to spread the word, not the germs, by exemplifying good work habits and sharing valuable know-how. What they learn in school and through continuing education governs their personal practice, but it’s leaderships skills that help them guide others.
Final Thoughts
Dental assistants minimize the risk of illness to their patients and staff by following infection control procedures and helping others do the same. It’s an everyday responsibility with a profound impact. As oral care professionals, keeping people safe is always the top priority.
Are you concerned with infection control and keeping your dental patients healthy? Are you ready to become a dental assistant? The Dental Assistant training program at Meridian College provides extensive hands-on training including a school externship at a dental office where you will assist the dentist in treating actual patients.
Contact Meridian College today to learn more about becoming a dental assistant.