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HOW DO I KNOW IF THE DENTAL OFFICE I GO TO IS SAFE?
When visiting a dental office, it's crucial to maintain awareness of your environment beyond basic cleanliness. While visual inspections can offer initial insights, ensuring the cleanliness of instruments and the efficacy of sterilization protocols is equally vital. Given the complexity of dental office operations, identifying key questions to ask can be challenging without guidance. To assist in this process, we have developed a simple checklist for your convenience during your next dental appointment. Additionally, the Centers for Disease Control and Prevention (CDC) offers a comprehensive checklist for those seeking a more detailed assessment. Utilizing either checklist will provide valuable insights into the standards upheld by your dental office. Taking the time to familiarize yourself with these considerations is essential when selecting a dental office for your treatment needs.
DENTAL OFFICE SAFETY CHECKLIST
When going to a dental office, there are questions you should pose to your dental care professionals to ensure you are being treated safely while under their care.
General Questions You Should Observe When You First Arrive at the Dental Office
- Does the office look clean? (Office looks organized, no trash laying around, countertops are clean, no foul odor)
- Does the equipment/instruments look old? (Is there rust on equipment/instruments, yellowing of instruments)
- Do the dental staff use personal protective equipment? (Face masks, eye protection, gloves)
Below we have focused the checklist questions on
seven specific categories:
Dental Unit Waterlines
(Again don’t be surprised, but definitely be concerned if no testing is done! Ask why?)
What are Dental Unit Waterlines?
Dental unit waterlines are the tubing and plumbing systems within dental chairs and units that deliver water to various instruments.
- When was the last time the dental unit waterlines were tested?
- Does the office keep testing records showing dates when dental unit waterlines were last tested?
- What was the last reading tested? Was it below <500 cfu (colony forming units) That is the max allowed. Europe is less than <100 cfu
- If they don't test. Red Flag!
Air Water Syringe
(A lot of offices are non-compliant, so you need to verify) This is a common example on not being up-to-date with CDC recommendations.
What is an air/water syringe?
The air/water syringe is a tool used in dental procedures to spray water and air into a patient's mouth. It assists in rinsing away debris, maintaining a clean treatment area, and drying teeth or gums as needed.
- You have to ask if they are sterilized or just bagged. There is a good chance you will be surprised with this one!
- Does the office use high-level disinfectants to clean the air/water syringe after each use?
- If they claim they wipe it, then they are admitting its never been sterilized. - RED FLAG!
Air Water Syringe Tip
(We hate to say it, but yes, there are still a lot of DHCPs using and reusing an item that should be mandated for single use only.) We don’t re-sterilize our needles, so why are we attempting to re-sterilize micro- lumen tubing?
What is an air water syringe tip?
The air water syringe tip is inserted into the air/water syringe that is used for channeling air and water into the mouth during dental treatments.
- Plastic disposable air water syringe tip - Excellent, they have adopted best practice for this item.
- If they don't test. Red Flag!
Personal Protective Equipment
- Does the dentist/hygienist/assistant wash hands prior to performing the dental procedure?
- Does the dentist/hygienist/assistant already have gloves on prior to performing the dental procedure?
- Did they put them on infront of you, or were they all ready on when they entered the room?
Make sure a fresh pair of gloves are placed on infront of you to ensure they have not been worn, for setup, touching handles, doorknobs or any switches. Fresh pair before they enter your mouth. Don’t be afraid to ask for a new pair.
- If the dentist/hygienist/assistant leaves the treatment, and return do they remove and replace their gloves?
- Does the dentist/hygienist/assistant give you protective eyewear for the dental procedure?
Eyewear is a standard recommendation, some use eyewear and a face shield.
- Does the dentist/hygienist/assistant put on a mask prior to performing the dental procedure?
It is a CDC recommendation that all DHCPs wear a mask while working on the patient or while in the operator with the patient. If the patient is considered a high risk then all DHCP’s should be wearing a n95 respirator instead of a mask. New studies are coming our regarding aerosolization of infectious diseases, and extra precautions should be taken to minimize any potential transmission.
Dental Instruments
What are dental instruments?
Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures.
- Is the dental tray covered with barrier protection or left on the tray with no cover?
- Are the instruments in a sealed bag on the tray?
Barrier Protection
What are dental instruments?
Dental barriers for clinical contact surfaces control the spread of infection by preventing the exchange of saliva, blood, and other body fluids. You will notice barrier protection by seeing a thin plastic cover or barrier between the contact surface/device/instrument from the outside environment.
- Is there a barrier protection on the headrest of the dental chair?
- Are the instruments to be used in the procedure sealed in a pouch prior to use?
- Is there barrier protection on the handles of the overhead light?
- Is there a barrier protection on all of the devices attached to the dental chair?
- Is there a covering on the computer keyboard and mouse in the operatory room?
- Does the tray where the instruments are placed have a barrier protection?
Sterilization and Disinfection
What does sterilization mean?
Sterilization involves the complete eradication of all microbial life forms, including bacteria, viruses, fungi, and spores, from surfaces, objects, or environments.
What does disinfection mean?
Disinfection involves reducing the population of viable microorganisms to a level considered safe according to prevailing public health standards, although complete elimination may not always be achievable.
- Does the office have a designated central processing area where all instrument cleaning, disinfecting, and sterilization occur?
You should always ask to see the dentist / hygienist sterilization room. They should be ecstatic to show you and tell you how each and every patient is protected. You should be able to see a clean, organized and well managed room, if not, ask questions, never assume.
- Ask how often they test their autoclave?
Its supposed to be done weekly. Both mechanical and chemical indicators should be used to detect any procedural errors or machine malfunctions. Biological testing (spore testing) will actually test sterilization, the other two don’t. However biological testing usually takes days before results are known. See if your office has a log of when it was last tested.
- Does the office heat-sterilize every device that is attached to the dental chair?
- Are the instruments on the tray heat-sterilized prior to be used on you?
If so they should be kept in the sterilization pouch and opened in front of you to show they were sterilized and now just opened. They have not been on that tray for the past 5 hours in an environment that has aerosolization issues.
- Do countertop surfaces look like they have been disinfected? Free of trash and soiled areas.
- Does the dental chair look disinfected? Wiped down and cleaned? Free of stains, dirt and debris. Is it covered in a chair cover (barrier film) or are you sitting on a prewired chair?