Minimising the risk of cross-infection is a key aim of every dental surgery, in order to maximise the quality of patient care, protect patients and protect dental staff. It’s also a legal requirement as part of HTM 01-05 regulations. Personal Protective Equipment (PPE) is part of Standard Precautions for infection prevention and control. In tandem with other measures (such as good ventilation, correct handling of waste, immunisation and correct working practices), PPE can help to minimise the possibility of exposure to infections.
The term PPE is used to describe all protective equipment that a dentist or dental nurse may use in the surgery. Typically, this might include the following elements:
PPE for eyes – googles, visors. Normal glasses don’t provide sufficient eye protection as they lack side protection, so goggles or visors should be worn during treatments and when manually cleaning instruments. Patients should be given eye protection prior to any examination or treatment.
PPE for hands – sterile, single-use gloves. These should be put on at the start of treatment and removed at the end. They need to be removed aseptically so that the outside of the glove isn’t touched by bare skin. Sterile gloves are needed for invasive surgery, while heavy duty gloves are required for cleaning of dental instruments.
PPE for the face – masks and respirators. Conventional single-use masks provide barrier protection against splatter, but do not generally protect the wearer effectively against aerosol inhalation. Respirator masks filter inhaled air and remove microbes.
PPE for the body – aprons, gowns. Single use aprons are often worn over the top of dental uniform to act as a barrier to fluids. Items of dental uniform and footwear themselves are not considered PPE as they do not provide a barrier to body fluids. However they are an essential part of dental wear for all surgery staff; they promote a smart, professional appearance and can form an important element of your branding.
Choosing the right dental uniform is vital! Uniforms should be short sleeved and arms should be bare. Uniforms should be changed on a daily basis and washed at a suitable temperature to help prevent cross contamination. Open-toed footwear is not suitable. Neither uniform nor surgery shoes should be worn outside of the surgery; staff should change in and out of their uniform within the practice.
Personal care – hair tied back, only stud earrings, no false nails, piercings to be removed/covered, tattoos to be covered.
There are several aspects to be aware of concerning the use of PPE. The order of putting on and removing PPE is vital in order to prevent the spread of infection. NHS England advise the following sequences:
For putting on PPE, the order is uniform, apron, mask, eye protection then gloves.
For removing PPE, the order is gloves, apron, eye protection, mask, uniform.
Throughout the process, it’s important to keep hands away from the face and limit any surfaces touched in the patient environment. Gloves should be changed if they become torn or heavily contaminated, and always between patients. Hands should be cleaned after disposing of gloves.
Single use items should be disposed of as hazardous clinical waste, and managed according to practice waste management policy.