As dentists, we want every patient’s visit to be safe, effective and pleasant. During the annual spring cleaning of your practice, consider these infection control improvements that can help you make the patient’s experience the safest it can be.

Organize Your Infection Control

The first way to start improving your current infection control protocols is to use the “Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.” This 2016 Centers for Disease Control and Prevention (CDC) publication is an update to the “Guidelines for Infection Control in Dental Health-Care Settings — 2003.” While the infection control guidelines remained the same in the 2016 publication, the update expanded the resource to provide a summary of effective infection control procedures as well as a simplified checklist for the dental office.

The impetus for the update was the documentation of infectious transmissions in dental practices from 2003 to 2015, including patient-to-patient transmissions. Investigators reported that “breakdowns in basic infection prevention procedures included unsafe injection practices, failure to heat sterilize dental handpieces between patients, and failure to monitor autoclaves (e.g., conduct spore testing).”¹ This led the CDC to create an easy-to-use checklist for infection control procedures that includes both office administrative policies as well as direct observation of infection control procedures in the practice. Dentists and staff can download or order free print copies of this resource at cdc.gov/pubs/CDCInfoOnDemand.

Another key improvement to any practice would be to designate an infection control/prevention coordinator (ICPC).² The Organization for Safety, Asepsis and Prevention (OSAP) has created a thorough guide that defines the basic responsibilities of the ICPC, such as:

• Update written policies, standard operating procedures and other documents for the practice.
• Use up-to-date resources from governmental agencies such as the CDC, Occupational Safety and Health Administration (OSHA) and Environmental Protection Agency (EPA) as well as act as an informational resource for the office.
• Keep all certificates current and training records available for employees.
• Maintain and monitor logs for medical waste, sterilization, etc.
• Coordinate office training for infection control and other pertinent areas (i.e., OSHA-mandated training).

The above ICPC guidance will be effective in addressing the infection control deficiencies noted by the CDC. As the leaders of our practices, we cannot afford to allow such lapses in infection control. The ICPC is an important addition to any practice that does not already have such a role in place.

Consider the Patient’s Perspective

Another improvement that I highly recommend comes from taking the patient’s perspective. In my years of practice, I would often start the day by following the path the patient took to my operatory, and then I would sit in my dental chair to see what the patient saw. Here are some things to look for when evaluating the patient’s perspective of your practice:

• Is the waiting room welcoming? Are the floors, walls and furniture clean? Are the furnishings and decorations up to date?
• What does the patient see when they enter the treatment room? Is the room a pleasant place to receive treatment?
• Where are your instruments? They should be in sterilized packages and not opened until the patient is seated for care. All items should be neat and well organized.
• Is the treatment room cluttered? A cluttered room can be claustrophobic to some people and may be considered unclean.

Another practice resource OSAP offers is The Safest Dental Visit campaign. This campaign is designed to provide your practice with guidelines and ideas that will enable you to foster the safest patient visit. It will also help increase patient loyalty by helping patients recognize how safe and effective your practice is. Remember that image and perception are everything, and word-of-mouth is the best advertisement your practice can have. The campaign comes with a toolkit that gives you step-by-step guidance in creating the “safest dental visit” for each patient.³ Offices that comply with The Safest Dental Visit campaign pledge to follow current CDC guidelines, have an ICPC and foster a culture of infection prevention and safety.

Additional Resources

Finally, each practice owner should ensure that they are using the most up-to-date infection control equipment and materials. Regardless of where you buy your materials, make sure they meet OSHA and EPA guidelines for safety and effectiveness and come from reputable sources. You can find additional information on the CDC website at cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/index.html and at osap.org/page/SDVDentalPractices.

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Author Information
Larry N. Williams, DDS, MPH, MAGD, ABGD, is an associate professor at the Midwestern University College of Dental Medicine. To comment on this article, email impact@agd.org.

References

1. Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Centers for Disease Control and Prevention; U.S. Department of Health and Human Services, October 2016. www.cdc.gov/oralhealth/infectioncontrol/pdf/safe-care2.pdf. Accessed 3 Jan. 2020.

2. The Organization for Safety, Asepsis and Prevention. “The Role of the ICPC.” OSAP, www.osap.org/page/RoleofICPC. Accessed 3 Jan. 2020.

3. The Organization for Safety, Asepsis and Prevention. “Safest Dental Visit for Dental Practices.” OSAP, www.osap.org/page/SDVDentalPractices. Accessed 3 Jan. 2020.