Gloves, Handrubs and HAIs in the Dental Setting

staphylococcus aureus in the dental setting

Health care associated infections, or HAIs, can be acquired anywhere health care is delivered, including the dental office.  As a dental clinician or dentist, you know that proper hand hygiene and gloving is essential to your patient’s safety as well as your own.

But how prevalent are infectious agents such as bacteria, fungi and viruses in the dental setting?  And is your current hand hygiene routine enough to prevent HAIs?

Dental Staph

A recent study conducted by the Department of Public Health and Infectious Diseases at Sapienza University, in Rome, Italy, investigated staphylococci contamination on disposable gloves and clinical surfaces in the dental setting.

Environmental samples were collected from the tray and gloved dominant hand soon after dental therapy of the second or third patient at 136 general dental practitioners’ offices.  Staphylococci were detected in 41% of the trays and 57% of the gloves.  Specifically, S. aureus was found in 5% of both tray and glove samples, and MRSA was detected on 1.5% of the glove and tray samples.

The study concluded that contact surfaces and gloves in the dental setting are “frequently contaminated.”

Studies like this underscore the importance of proper hand hygiene and proper donning and doffing of exam gloves.  But even if you are using the manufacturer’s recommended amount of alcohol-based handrub, another recent study warns that it may not be enough.

Pump Up the Volume

The Bode Science Center in Hamburg, Germany evaluated the effectiveness of different volumes of alcohol-based handrubs.  They used the manufacturer recommended product volumes of 1.1 mL, 2 mL, and 2.4 mL, as well as 1 and 2 pump dispenser pushes for foams and gels.

They discovered that 70% ethanol (v/v) handrubs at the recommended volume of 1.1 mL per application “did not ensure complete coverage of both hands and do not achieve current ASTM efficacy standards.”  Whereas an application of 2 mL of 85% w/w ethanol rub reduces contamination sufficiently to fulfill the US FDA efficacy requirement.

Proper Gloving and Handrub Guidelines

To provide the safest environment possible for yourself and your patients, diligently follow proper gloving and hand hygiene guidelines to reduce HAIs.  This includes handwashing or handrubbing before donning gloves, and immediately after careful removal of gloves.  And when using an alcohol-based handrub, use enough to completely cover all surfaces of your hands.

Share Your Experience – How is your office’s hand hygiene compliance?  What have you done to improve it?  Post your comments below.

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