Infection Control Manual

Section IV: Preparation and Disinfection of Operatories

1. Clean-up and aseptic preparation of operatory is required according to the protocol outlined below, immediately following each patient encounter. Adherence to these procedures will insure that all operatories will be left in an aseptic and sanitary condition and that minimal preparation of the operatory will be required before seating a new patient.

2. Use plastic covers for the bracket tray, dental chair, air/water syringes, handpieces, and suction hose handles and accessory arm. These covers provide the most effective protection from chemicals and microbes. Items so covered do not require surface disinfection after patient treatment unless the integrity of the cover has been compromised.

3. Preparation of operatories shall be performed in accordance with the following sequence of activities.

1. Each operatory shall be stocked with the following items:

1. paper towels
2. liquid antiseptic hand soap

3. bottle of disinfectant

2. Within each clinical area, the following items are available:

1. plastic covers for bracket tables, dental chairs, air/water syringes, handpieces, suction hose handles and accessory arm.
2. foil for lamp handles
3. disposable treatment gloves and masks
4. patient napkins
5. disposable tray covers
6. disposable saliva ejectors and suction tips
7. cotton rolls, gauze, etc.
8. protective needle shields

9. leak-proof, puncture-resistant container for sharps disposal

3. Upon entering the operatory, place the foot pedal on the floor, place full water bottle on unit, turn on the main switch and lower the dental chair.

4. Wash hands with antiseptic soap, lather and rinse; repeat. Use a paper towel to avoid direct contact with the faucet handles. Put on disposable treatment gloves.

5. Push suction tip, air/water syringe and saliva ejector through the small plastic cover so that the tips protrude through the cover.

6. Test air/water syringe and suction to ensure unit activates. If plastic cover blocks activator switch in holder, simply pull plastic away from switch. Flush water through air/water syringe and handpiece for 30 seconds.

7. Re-hang handpiece hoses and air/water syringe in their supports.

8. Place disposable napkin on surface of mobile cabinet. Set out sealed instrument cassette and supplies for the entire treatment procedure on the covered bracket table and covered mobile cabinet. Remove disposable gloves. Remove radiographs and information from the patient chart. Place in appropriate location in the operatory.

9. Seat the patient in the operatory. Patient use of an antiseptic mouthwash is recommended prior to treatment for reduction in patient oral bacterial count.

10. Review medical history and check blood pressure.

11. Put on mask and eye covering in accordance with Section 3, I. Wash hands, put on disposable treatment gloves. Open sealed instrument cassette without contaminating instruments. Leave slow, color-change sterilization indicator strip on the tray with instruments. Retain paper instrument cassette wrap.

4. Clean-up and disinfecting of the operatory shall be performed according to the following sequence of activities after dismissing the patient from the operatory. Do not disinfect surfaces and items covered with plastic drape unless the plastic cover was torn during treatment.

1. Wash hands with antiseptic hand soap. Rinse, dry, and put on disposable treatment gloves. With needle shield in place, remove covered needle from anesthetic syringe. Discard needle, anesthetic carpules, and all other sharp disposable items into leak-proof, puncture-resistant container. Place cotton rolls, air/water syringe tip, and other disposable items from the bracket table into the inverted plastic covering the dental chair and discard.

2. Account for all instruments originally found on the cassette. Write the patient’s chart number on the blue wrapping paper so that it is readily visible. If a secondary tray has been checked out, write your student ID number on the blue wrapping paper for that tray. Re-wrap instrument cassette(s) and set aside.

3. Dispense disinfectant into a paper towel, wipe any used bottles and containers. Wipe dry with paper towel.

4. Remove hoses. Remove handpiece and follow protocol in Section VII, H. Remove and discard plastic covers from air/water syringe, handpiece hoses, and suction hose from the supports on the unit. Discard suction and saliva ejector tips. Place three towels in the seat of the dental chair. Lay air/water syringe, handpiece hose, and suction hose ends on paper towel on the dental chair and wipe with disinfectant.

5. Invert, remove, and discard plastic drape from bracket table. Remove and discard the lamp handle foil and the patient napkin covering mobile cabinet.

6. Remove handpiece and follow protocol in Section 4, H.

7. Wet paper towel with disinfectant and wipe lamp switch, lamp face, and controls that were not covered with plastic drape. Wipe surface of the mobile cabinet, uncovered arms of dental chair, exposed drawer handles, radiographic view box and switch. Discard wet paper towels.

8. Wipe faucet handles, sink counter top, and trash disposal openings with disinfectant and wipe dry with paper towel. Discard towel, wipe areas with disinfectant, and leave damp.

9. Wipe items of clinical equipment to be returned to the dispensary with disinfectant. Let stand for 3 minutes, then wipe dry.

10. Remove treatment gloves according to technique described in Section 5, F. Discard in operatory trash bin. Wash hands with antiseptic hand soap, rinse, and dry with paper towel.

11. Place a clean saliva ejector, air/water syringe tip and suction tip into their hoses and cover with plastic drapes.

12. Re-bag the accessory arm.

13. Re-hang the hoses in their supports.

14. Cover the back of the dental chair with plastic drape. Cover lamp handles with foil. Cover the bracket table with plastic drape and place paper tray cover on top.

15. Raise the dental chair to its highest position. Hang up the foot pedal on the dental unit or lay in patient chair on paper towel. Turn off the main switch.

16. Empty water bottle and invert (turn upside-down) on paper towel.

17. Return disinfected items to the dispensary with gloved hands. Submit instruments to the dispensary for sterilization. See Section 7.

5. Contaminated equipment will be decontaminated, if possible, prior to being returned to storage servicing or shipping for service. Equipment that cannot be adequately decontaminated will be tagged as a Biohazard.

6. Housekeeping workers will wear appropriate personal protective equipment during cleaning of areas potentially contaminated with infectious materials.

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