Personal Protective Equipment for Oral Health Care Practitioners





By Rebecca Stone February 8, 2019

Some of us can recall the days of wet-fingered dentistry, when the wearing of gloves was practically unheard of in general practice. But with today’s infection-control awareness in the stratosphere, performing dentistry barehanded or without surgical masks is unthinkable.

To discover the best options in personal protective equipment (PPE) for your practice, it’s wise to consult the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. There you’ll find that recommended attire includes gloves, surgical masks or face shields, eye protection and long-sleeved gowns or lab coats.1–3

Gotta Love Gloves

Gloves provide a barrier between the practitioner and the oral mucosa, blood and saliva of the patient. They include nonmedical gloves used in housekeeping; examination gloves, which may or may not be sterile; and surgical gloves, which are always sterile.2

Gloves are designed for single use with ergonomics and safety in mind as far as texture, thickness, puncture resistance, comfort and fit, and whether they are ambidextrous or hand specific. This is especially pertinent with surgical gloves, which are designed three-dimensionally to accommodate a broad range of sizes.1,4,5

In response to the emergence of natural rubber latex (NRL) allergies, gloves are now made of other materials such as nitrile, polyvinyl chloride, polyurethane and other blends. But because a number of clinicians value the characteristics of NRL gloves, low-protein NRL gloves that do not elicit allergic responses have been developed.5

Gloves used to be powdered to make them easier to put on and take off. But the powder also resulted in allergic reactions. Such complications led to the 2016 U.S. Food and Drug Administration (FDA) banning of the use of powdered gloves.5

Mask Wear

Dust or utility masks are used as barriers for procedures in which no fluid, spray or aerosols will be produced. But to meet the performance standards established by the American Society for Testing Materials (ASTM) for barrier protection from typical procedural byproducts, clinicians need more, depending on what is anticipated during a procedure.4,5

ASTM level 1 masks offer bacterial filtration efficiency (BFE) and particulate filtration efficiency (PFE) equal to or more than 95%, but score low in fluid resistance. ASTM level 2 masks provide BFE and PFE equal to or more than 98%, with moderate fluid resistance. ASTM level 3 masks offer the same BFE and PFE as level 2, and score high in fluid resistance.1,5

N95 respirators are capable of filtering more than 95% of airborne particles as small as 1-μm. These offer maximum filtration and protection from such airborne viruses as tuberculosis and H1N1 influenza.6

Further Protection

Protective eyewear shields both practitioners and patients from any debris or spatter that goes airborne. Glasses with impact- and scratch-resistant, antifog lenses, and with side shields or wraparound designs; goggles and loupes designed to create a seal against the face; and full face shields are part of this category.4,6

To further enhance protection against cross-contamination, long-sleeved gowns or lab coats are advised. But the Centers for Disease Control and Prevention and OSHA agree that there is no need to change gowns and lab coats between patients as long as there is no visible soiling.3-6

When you are dressing for success, it only makes sense to complete the ensemble with an effective isolation system. Systems such as Isolite 3, Isodry and Isovac offer not only isolation via soft-tissue retraction and continuous suction, but the mouthpiece also provides a throat shield that prevents accidental ingestion of foreign objects. And, in the case of the Isolite 3, shadowless illumination is an added benefit. With the help of such systems, both you and your patient are covered for pretty much any procedure.

 

REFERENCES

  1. Cuny EJ. Gear up for infection battles. Mentor. 2017;8(4):30–32,34,36.
  2. Centers for Disease Control and Prevention. Personal Protective Equipment. 2016. Available at: https://www.cdc.gov/oralhealth/infectioncontrol/questions/personal-protective-equipment.html. Accessed January 7, 2019.
  3. Occupational Safety and Health Administration. OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030(d). United States Department of Labor. Available at: https://osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=10051. Accessed January 7, 2019.