Safe Dentistry: Infection Prevention and Control

Infection prevention and control measures are paramount to safe dentistry. For patients, the safety of dentistry is, of course, the most important prerequisite for confidence in it and for calm procedures. Whether it is teeth cleaning , tooth extraction, or any other dental service, the dentist must serve the patient with the highest hygiene standards.

In Georgia, there are a number of legal norms and the obligation to have medical protocols, which regulate the issues of safe operation of dental activities. Among them, the order of the Minister of Labor, Health and Social Protection of Georgia dated March 19, 2002 No. 64/N on the improvement of medical and preventive disinfection activities in the country. Also, there is a supervisory body in this field – the Agency for Regulation of Medical and Pharmaceutical Activities. There is also a technical regulation of high-risk medical activities, which also applies to dental activities.

Importance of disinfection and sterilization

During dental consultations or services, there is a risk of transmission of infection from patient to patient, from patient to medical staff, and from staff to patient. In addition, there is a significant growth rate of chronic viral pathologies in the world. In proportion to the mentioned growth, safe dentistry requires the introduction of more and more modern safe technologies. This is a necessary prerequisite for a clean and hygienic environment in the dental clinic. For this, we apply disinfection and sterilization, both for preventive and anti-epidemic purposes.

Safety dentistry standards in dental practice include following:

1. Immunization of service personnel;
2. Cleaning-disinfection of environmental surfaces;
3. Disinfection-sterilization of instruments;
4. Safe injection practices;
5. Safety of handling sharp objects;
6. The use of individual protection means;
7. Hand hygiene;
8. Treatment of medical waste;
9. Post-exposure behavior and others.

Below we will address some key issues, but keep in mind that this overview isn’t comprehensive and doesn’t include everything. In safe dentistry you will definitely find detailed protocols for safety procedures.

Immunization of service personnel for safe dentistry

In 2023, an important change was introduced in the relevant regulations, according to which:
The personnel employed in the institution – doctor/assistant/nurse, as well as the personnel employed in sterilization and disinfection, collection/assembly/removal of medical waste must have preventive immunization against hepatitis B, in the manner and periodicity established by the law.

It is mentioned that all dentists and persons involved in this activity are required to be immunized against hepatitis B.

And for hepatitis C , screening of personnel is mandatory twice a year.

Cleaning-disinfection of environmental surfaces

Dental clinic should have floors, walls and work surfaces that are easy to clean and maintain and resistant to liquids, chemicals and disinfectants. The surfaces of the walls and floor of the sterilization room should be resistant to washing and disinfection.

Sterilization-disinfection of instruments

Surfaces and dental equipment are disinfected multiple times with appropriate disinfectants.

In order to ensure proper disinfection and sterilization regime and accounting, dental clinic should have a sterilization department, where it produces disinfection/sterilization of instruments/medical items.

A dental clinic should choose one person who will be responsible for sterilization/disinfection of instruments/medical items. Sterilization should be divided into “dirty” or decontamination, “clean” or packaging and “sterile” zones. In sterilization, it’s important to keep clean and dirty items moving in one direction without crossing paths.

After each use, the bottles and ejectors are sterilized. Also, to ensure infection safety, ventilation pipes and systems are disinfected.

Disinfection, sterilization stages for safe dentistry:

1. Sorting of tools.
Start with an initial cleaning, using both ultrasonic devices and hand washing. Instruments are submerged in a 1% Gigazim rinse solution.
3. Passing the instruments in running water and cleaning them.
4. Placing instruments in 1% disinfectant solution of Gigacept AF.
Rinse and dry the instruments under flowing water.
6. Compilation and packing of instruments.
7. Place in an autoclave and sterilize at 134 degrees.
8. Dating and placing in a dry cabinet.

If the instrument is delicate or cannot be sterilized in an autoclave, high-level cold chemical disinfection and sterilization are also done. Dry instruments are placed in a 2% solution of Gigasept PEARL.

Safety of handling sharp objects

Waste containers, including sharps containers, should not be more than three-quarters full.

At the site where waste is produced, within facilities providing medical services, waste must be sorted and disposed of in specific containers for non-hazardous (regular medical waste), infectious waste, and sharp objects. This is known as the ‘three-container system’.

Use of personal protective equipment

The personnel employed at each stage of medical waste management in safe dentistry must be equipped with gloves and personal protective equipment (mask, disposable gloves/agricultural gloves, special clothing, special apron, safe protective glasses/face shield, waterproof closed shoes, etc.).

It should be noted that the Agency for the Regulation of Medical and Pharmaceutical Activities conducts very detailed and careful inspections of dental clinics and uses a fairly high standard. Due to recent legislative updates, compliance with specific regulations has become mandatory for dental practices. Failure to adhere to these requirements may result in the closure of the practice.

Summary

At Richter’s Dental Clinic, we understand how important it is for patients to be safe and aware of the clinic’s adherence to standards. We have passed the inspection of the supervisory authority, received the relevant confirmation document and are constantly monitoring all the news. Thanks to our strict adherence to disinfection rules, you can safely receive any dental service, starting with solving a common problem such as tooth decay , ending with complex dental and surgical procedures.

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