Dirty Little Secrets
Infection control expert Nancy Andrews answers your questions
By Nancy Andrews, RDH, BS
Editor’s Note: Are your customers asking tough hygiene questions? Here is your chance to ask someone "In the Know." Nancy Andrews, RDH, BS, will take your questions and tell your tales. Pulling from centuries of experience, endless education, lots of research, and occasional consultation with other experts, Nancy invites your e-mails at Infectioncontrol@mdsi.org. The best question or tale at the end of the year gets $100.
A story with a point!
Q: I have a good relationship with an office manager and recently asked her what they were doing with their Sharps disposals. At first, she just smiled. After a little prodding, she informed me that the dentist has the staff throw their sharps containers in dumpsters. She knows this isn’t the right thing to do, but she does her job and doesn’t question the boss. She also said the staff probably doesn’t know any better because they have been doing it for years. This is how they train their employees. I’m in shock.
A: I’m afraid it may not be as rare as we hope. They are lucky to have you helping them BEFORE the health department, EPA, the State Dental Board or OSHA get involved. Worse yet would be the personal tragedy and possible legal issues of an accidental exposure. Waste disposal laws are plainly written in OSHA’s Bloodborne Pathogen standard, and each office should have a written Injury and Illness Manual that directs the legal and safe disposal of sharps and other hazardous waste. If the office is not attending annual OSHA training and other infection control continuing education courses, I’d strongly encourage them to do so. I trust you to hook this office up with a compliance program and all the supplies they need to put it into place.
The right approach
Q: I see a vast array of methods and products used in offices to disinfect cases going out to labs. I usually recommend a leading intermediate level surface disinfectant for impressions, but what about partial and full denture re-makes?
A: Indeed, there are many approaches in the field. To add to the confusion, even some manufacturers of disinfectant products do not address this issue. Dentures may absorb disinfectants. The disinfectant can later irritate the patient and cause a serious reaction when the denture is placed in the mouth. Denture cleaning solutions in ultrasonic baths may be used to physically clean the cases. Highly diluted bleach solutions may be used also, if left for a limited time and rinsed well. Worn dentures can, over time, also be infiltrated with microorganisms beneath the surface. Therefore, they may remain contaminated after being treated with a surface disinfectant. When lab technicians work on cases, they must anticipate exposure to contaminated material in spite of pre-treatment, and take reasonable precautions.
Labs should routinely remove any cleaners, abrasives, or products they use before returning the case. Often cases will come back soaking in mouthwash with small amounts of alcohol. This "freshens" the taste of the denture, retains moisture, and may dilute remaining chemicals. P.S. No red mouthwash: it looks like blood and grosses people out.
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