Infection Control Manual

Section V: Maintaining the Chain of Asepsis and Limiting Contamination

1. Only items and surfaces that have been properly disinfected and/or sterilized constitute the patient's "chain of asepsis." Contact with other items or surfaces during or prior to treatment constitutes contamination and requires changing of disposable treatment gloves before proceeding with treatment.

2. Dental personnel should minimize the field of contamination by avoiding contact with objects such as patient records, telephones and cabinets during treatment procedures.

3. One area of the operatory should be considered clean and kept separate for the placement of patient records, radiographs, paperwork and writing instruments. Items in this area should only be handled without gloves or with clean gloves. Radiographs and material needed for viewing during treatment should be retrieved from the patient's record prior to patient contact, or removed with clean gloves after patient contact. Gloves should be removed prior to handling telephones or making chart entries. Care must be taken and plans must be made in making chart entries to avoid contamination. Entries may be made when gloves are contaminated by using aluminum foil covering the pen and a clean towel over the chart page upon which to rest the hand when writing. Notes may be made on a piece of paper separate from the chart and later transcribed onto the chart when hands are clean.

4. Remove gloves, wash hands, and put on clean gloves if the chain of asepsis is broken for any reason.

5. Instruments and materials that have fallen outside the "chain of asepsis" during treatment should be placed in the operatory sink for later scrubbing and disinfection.

6. To remove contaminated gloves, mask, and eye covering, the following technique should be followed:

1. To avoid skin contamination when removing gloves, with gloved fingers of the right hand, pinch a large enough area of the left glove near the inner wrist to pull off and invert the glove. Then, insert a bare finger inside the other cuff without touching the soiled surface of the glove, to pull it off, inverting it also. Discard into the operatory trash receptacle.

NOTE: (NEVER discard gloves or masks on the operatory floor, or outside the operatory/treatment area.)

2. After discarding gloves, wash hands thoroughly with antiseptic hand soap, rinse, and dry with paper towel.

3. Then, remove mask by the rubber band at the sides (facial portion may be contaminated) and discard in the operatory trash receptacle.

4. Masks should be changed every hour when treating the same patient and between the treatment of patients. Soiled masks should be removed and discarded rather than worn around the neck where contamination may spread to neck and clothes.

5. Protective eye covering with solid side shields should be removed, sprayed with disinfectant, and wiped dry with a clean towel.

7. Eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses are prohibited in patient care areas, dental laboratories, sterilization areas, and in other areas where there is a potential for occupational exposure to bloodborne pathogens.

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