Is My Dental Office Really Safe From Infection?

Has the Coronavirus (COVID-19) made you ask, “Is it safe for me to go to the dentist office?”

This post explains the many steps a dental office takes to make the office safe from infection. Use this as a guide to discuss infection control with your dentist.

At Cranford Dental a top priority is patient and staff safety. Thus we trust that this post will make patients fees safe and secure when visiting the dentist.

Here we review the steps our dental office takes to ensure safety for  patients and employees.

Personal Protective Equipment

We follow the recommendations of the Center for Disease Control and the American Dental Association in selecting and wearing personal protective equipment (PPE).

Accordingly, dentists, assistants, and hygienists wear the recommended PPE when treating patients.

Mask, Gloves, Gown, Glasses

PPE includes wearing gloves, a mask, a gown, and protective eyeglasses. This equipment protects not only ourselves, but also our patients.

We follow safety protocol in putting on and taking off our PPE. This includes thorough hand washing before putting on gloves. And washing again (or using hand sanitizer) when we remove them.

To understand our office protocol for PPE use, read the post we wrote to guide the public during the Coronavirus Quarantine: Face Masks & Gloves: In-Depth Guide for Public

Surface Covers

Personal protective equipment also includes the “barriers” we use on our dental equipment and tools. This gives each patient and staff member assurance that the places they touch are clean.

We put plastic covers over:

• Dental chair – to protect clothing and exposed skin of patients
• Trays – to help keep instruments sterile
• Air/water syringe, suction – extra protection for patients and staff
• Light handles – Protect staff when moving light
• Computer equipment – Prevent infection from staff hands and aerosols

Clean Rooms Between Patients

The dental assistants and hygienists disinfect every surface in the operatory after the patient leaves the room. And this includes surfaces that we cover with plastic for even more protection.

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This is how we clean after every patient leaves our dental operatory:

• After every patient, we remove protective bags and place them into the trash. Then we take all dirty instruments from the room to the sterilization area.
• Next we spray surfaces of our cabinets and equipment with “Discide” disinfecting spray.
• After sitting on surfaces for one minute, this spray will kill major viruses and bacteria including:
  • Avian Influenza
  • Human Coronavirus
  • Candid Albicans
• Then we wipe counters and equipment with an approved disinfectant wipe.
• After disinfecting the room, we cover the chair and equipment with clean protective bags.

Sterilization of Dental Instruments

As a dental hygienist, I am sure that each instrument I use is sterile before I begin using it. Of course, I want my patient to also have confidence in our sterilization process. I wrote this to explain all that we do to make sure our dental instruments are safe.

Hannah Hopper, RDH

Here are the steps we use to clean each dental instrument:

The hygienist (or assistant) takes used instruments to sterilization room.

We remove instruments immediately after the patient leaves the room. Then we place them on the “dirty” side of our sterilization area.

Disposable air/water and suction tips and other disposable items do not come into sterilization room. Rather they go in trash in treatment room.

Next we put instruments into an Ultrasonic Cleaner.

The Ultrasonic Cleaner removes dirt and particles from the instruments:

• The Ultrasonic Cleaner is a receptacle that contains disinfectant and water.
•  A cavitation motion cleans off any debris from the instrument.
• Cavitation-The high frequency pressure or sound waves produce bubbles to agitate liquids.
• This agitation produces high forces on contaminants that are stuck to the instruments. This cleans out small cracks, holes and divots.
• Instruments stay in the ultrasonic cleaner for 15 minutes to assure proper debridement.

Office staff rinses off instruments

Once the Ultrasonic process is complete, a staff member rinses instruments (in cassettes) and then checks to make sure all residue is gone.

Then we place instrument cassettes on a rack to dry. 

Staff member puts cassettes and loose instruments into sterilization bags.

The assistants and hygienists use metal cassettes to separate instruments based on type of dental procedures. This assures that no one touches an instrument until the staff is ready to use it on a patient.

Next we place each cassette into a bag and seal the bag.

We put bagged instruments into an Autoclave.

The Autoclave works by using heat, pressure and steam to achieve sterilization.

• It uses 15 lbs. of pressure per square inch and achieves 250 degrees Fahrenheit for 20-30 minutes
• At this level, the autoclave kills fungi, bacteria, viruses, spores, etc.
• Once pressure and heat are right, the indicator on the bags turn from pink to brown. This is one of the ways we know with certainty that the instruments are sterile.

Instruments remain in bags/pouches until used.

We first check to see that the bag indicator is brown. Then we take the wrapped instruments directly to patient rooms.

Assistants and hygienists open the wrapped package in front of the patient. This gives assurance that no one touched the instruments after they came from the sterilizing process.

Office tests Autoclaves every week.

The Center for Disease Control requires weekly testing of autoclaves.

A designated staff member runs tabs that are encrypted with different microorganisms through the autoclave. Then she sends tabs to a testing facility.

She checks the reports each week to verify that autoclave is working to keep patients and employees safe.

Staff cleans and checks Sterilization Equipment

We clean all surfaces of the sterilization room intermittently throughout the day as well as at the end of the day. This is achieved by wiping down all surfaces with “DisCide” disinfecting wipes and spray.

Monthly we clean autoclaves by running an approved cleaning solution and distilled water through it.

The autoclave requires frequent repairs due to the high heat and pressure it uses to sterilize the instruments. We send ours off the minute we sense a problem.

Water Sterilization Procedures

We follow a strict protocol to make sure only pure water goes into a patient’s mouth from dental instruments.

Each day we flush water lines which lead to dental handpieces. Thus we know that water going through the dental equipment piping is pure.

Water runs into the tubing from a bottle of purified water. This bottle is changed out at least weekly.

Cranford Dental and Sterilization

We follow very strict procedures for office sterilization. As head of infection control at Cranford Dental, I can assure that our protocol works to keep staff and patients safe. We constantly train staff and monitor infection control safety procedures based on CDC recommendations.

Nan Katherine Gallis, RDH

Our office follows the guidelines of the Center for Disease Control and the South Carolina Department of Health and Environmental Control.

Designated staff members are responsible for keeping up with regulations and making sure that our office complies.

Our entire staff completes training at least annually to assure that we follow current guidelines.

Cranford Dental and COVID-19

During the COVID19 Pandemic dentists joined other healthcare professionals in reviewing infection control procedures. Our goal: to make the dental office safe.

Safety Measures Following Coronavirus Pandemic

The dentists and staff at Cranford Dental make office safety a top priority. Therefore we train in making a patient feel safe during every minute of her dental visit. Of course, helping the staff know they are safe is a big part of making this work.

Dr. Elizabeth Cranford Robinson

When you visit our office, you will note the changes we made to help patients avoid infection in our public areas.

• We wipe down all surfaces in the office including the waiting room chairs, keyboards, door handles, bathrooms and all areas that patients and employees come in contact with.
• To minimize the traffic in our office, patients can wait in their cars until appointment time.
• Also, family members will wait outside rather than in the waiting room.
• We ask patients to use hand sanitizer upon entering the office.
• Patients review safety information before getting treatment.

We want to give you confidence in visiting the dental office.

Thank you to Hannah Hopper, RDH and Nan Katherine Gallis, RDH for reassuring our patients by writing this blog article. Also thanks for all you do to help keep our office safe.

Dr. Bill Cranford

Understandably, the Coronavirus Pandemic makes the public aware of the importance of infection control.

We trust that reading the details of exactly what protocols we follow in infection control will help you understand why you should feel safe.

 Please contact Cranford Dental or call 803-324-7670 if you have concerns about dental office infection control procedures.

We will be happy to give you an office tour and explain all our infection control practices in greater detail.