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2.4 Principle III: Limit the Spread of Blood and Saliva

Spatter

Program staff should use the air/water syringe carefully to avoid creating backsplash or spatter. The high-velocity evacuation (HVE) tubing and container should also be used in such a way as to limit potential spatter. One manufacturer advises keeping the on/off button depressed before the HVE tubing is placed inside the patient’s mouth and until the hose end has been removed from the mouth to avoid waste flowback.

Cure light-barrierBarriers and Disinfection of Surfaces

Treatment area surfaces can be divided into those with potential for clinical contact (e.g., tabletops, instrument tray, light handles) and housekeeping surfaces (e.g., floors, walls). Clinical-contact surfaces must either be cleaned and disinfected with a hospital disinfectant or a disinfectant wipe product that is registered with the Environmental Protection Agency (EPA) between patients or be covered with barriers that are discarded and replaced between patients. The decision about which approach to use depends on factors such as time, cost, chemical-waste-disposal considerations, and the ability to place barriers. Surfaces must be cleaned before they are disinfected.

Barrier use, compared with cleaning and disinfecting, minimizes wait time between patients and also decreases handling of and exposure to disinfectants. If a surface is not barrier-protected or if contact is made under a barrier, the surface must be cleaned and disinfected.6 Maryland school-based dental sealant programs use a combination of barriers (e.g., for curing lights, head rests) and disinfection (e.g., for trays, counters).

Use the following procedures to clean and disinfect clinical contact surfaces:

  • Spray surface with a proper anti-microbial agent.
  • Wipe surface to clean it, and remove any debris.
  • Spray surface with disinfectant again.
  • Follow manufacturer’s directions for the amount of contact time required to allow the product to achieve disinfection.

If disinfectant wipes are used, clean the surface and discard the wipe, then use a fresh wipe for disinfection. Follow the manufacturer’s directions.6

The HVE tubing and container should be disinfected. One manufacturer recommends thoroughly rinsing the HVE tubing and container by evacuating clean water through the hose end after each patient, followed with air to clear water from the tubing. The entire system should be cleaned and disinfected by evacuating a cleaner/disinfectant through the entire hose assembly and waste bottle each time it is emptied. The tubing should be flushed for at least 2 minutes each morning and for 30 seconds between patients. Thorough scrubbing of the entire assembly is also recommended each time the bottle is emptied.