Environmental cleaning is fundamental to keeping your practice clean and safe for you, your staff, patients, and patrons that visit. This principle consists of clinical contact and housekeeping surfaces. The dental office is full of areas that sometimes can and sometimes cannot be protected from blood, spatter, and aerosols. Understanding how to protect your workspace and office equipment is essential to reasonable housekeeping procedures. Protection often includes plastic barriers, but what are you using to clean the floors and walls? Your dental office should be equipped with different types of disinfectants and solutions to decontaminate other surfaces.
OSHA's Bloodborne Pathogen Standard 1910.1030 states that employers shall create and implement a housekeeping plan. It should address the types of surfaces and contaminants in the practice and what work tasks are performed within the office. Staff should use surface disinfectants according to the manufacturer's instructions for use (IFU). Considering the different types of surfaces in your office (e.g., countertops, flooring, cabinetry), different levels of germ-destroying solutions will need to be available.
Cleaning, disinfecting, and sterilizing are all different methods to remove or kill bacteria from surfaces. The critical act of cleaning refers to removing soil and debris from devices and instruments. Disinfecting can be a chemical or physical agent that destroys pathogenic organisms from surfaces. Sterilization is the process that eradicates microbial spores. For this purpose, we will discuss how to clean and disinfect surfaces and what solution is best used.
A clinical contact surface are surfaces that might be directly or indirectly contaminated with blood or other potentially infectious materials (OPIM) while providing dental care. These surface areas include countertops, dental chairs, handpiece hoses, and shade guides. Surface barriers should be used in every case for areas that cannot be easily decontaminated. If a surface is not barrier protected, a thorough cleaning and disinfection must occur following each and every procedure. A low-level disinfectant should be used to clean non-critical items such as blood pressure cuffs, unless otherwise grossly contaminated.
An EPA-registered hospital disinfectant with low to intermediate-level claims should be used to clean contaminated surfaces. Products with these claims are common to see in a dental practice; they can include Cavicide, Birex, and Optim. These products are broad-spectrum and labeled to kill hepatitis B, human immunodeficiency virus, and tuberculosis. Clinical contact surfaces shall be decontaminated immediately or as soon as feasible following a procedure that was conducted in that area. Spills that contain blood or OPIM shall also be addressed immediately. At the end of each workday, all surfaces must be disinfected. Barriers must be changed following each procedure.
In addition to the operatory and sterilization areas, dental offices have areas where procedures are not routinely performed. These surfaces include the breakroom, lobby, and front desk area. While blood and OPIM are not commonly transferred to these areas, germs and bacteria can settle onto these surfaces. A low-level disinfectant or multi-purpose cleaner is suitable for desks, keyboards, sinks, and tabletops. Floors should be cleaned regularly with water and detergent. Fresh preparation of detergent solutions should be made each time. Keeping the area free of visible soil, dust, and clutter helps keep the office tidy. Cloth-upholstered furnishings and carpets should not be in dental settings.
When housekeeping surfaces such as walls or floors may become contaminated with blood, sputum, or OPIM, a detergent and water or hospital-grade disinfectant can be used. Take into consideration the size of the spill and surface material. Trash bins and similar receptacles shall be inspected and decontaminated on a regular basis.
Knowing how to use the products, their intended use, and for what surface it's used can help protect your equipment and furnishings. Following the manufacturer's IFUs will provide the necessary information on how to use the product. Be sure to wear proper PPE while cleaning and disinfecting. Keeping your office clean can help protect you, your staff, and your patients.
Resources:
- (2021, January 29). A GUIDE TO DENTAL DISINFECTANTS AND STERILANTS. Noble Dental Supplies. Retrieved May 5, 2023, from https://www.nobledentalsupplies.com/a-guide-to-dental-disinfectants-and-sterilants
- Condrin, A. K. (2014, August 1). Disinfection and Sterilization in Dentistry. Texas Dental Association. Retrieved May 5, 2023, from https://tdaperks.com/disinfectionsterilization/
- Occupational Safety and Health Administration. (1991). Bloodborne Pathogens (Standard No. 1910.1030). Retrieved from https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
- Schneiderman, M. T., & Cartee, D. L. Surface Disinfection. Infection Control in the Dental Office, 169-191. https://doi.org/10.1007/978-3-030-30085-2_12
Written by Deanna Otts-Whitfield RDH, BSDH, MSHQS, CDIPC
Deanna Otts-Whitfield is a clinical consultant with Dental Compliance Specialists. She works with clients to help them successfully adhere to regulatory agencies. After high school, she served four years in the United States Marine Corps. She obtained her bachelor's degree in 2009 and executive master's in 2020. Just two years later, she decided to hang up her loupes. Her 14 years as a clinical dental hygienist have proved to be vital in the compliance sector. With experience in private and public health settings, her knowledge extends beyond the operatory. She has a passion for learning and helping people. You can contact her at Deanna@DentalCompliance.com.
Dental Compliance Specialists helps make dental offices safer for patients, dentists and their employees. We help our clients develop and maintain their compliance programs including OSHA/Infection Control, HIPAA, DEA regulations and prescribing practices, Radiation Safety, OIG/Medicaid Compliance, Record Auditing, and more by providing actionable systems, easy-to-use tools, robust training, and accountability. Most of our clients have never been in trouble and want to keep it that way. Sometimes, though, dentists call when they are in trouble. In either case, we are there to make a meaningful difference. If you need help call us at 817-755-0035.