By Noel Brandon Kelsch, RDHAP
Sometimes it is the little details that have the greatest impact on an outcome. Having a quality dental lathe and applying infection control measures to its use directly impacts not only the person using the lathe, but all those involved in the process, from the patient to the community.
A dental lathe sort of looks like the bench grinder found in many American garages. This bench-mounted electrical device is used with abrasive and polishing attachments to fabricate and finish dental prostheses.
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It has been shown that organisms can remain viable for up to seven days on dental casts and prostheses.1,2 Because of the methods used with this device and the amount of cases that are processed, the chance of cross-contamination is high. The very action of the rotating wheels, rags, stones, burs, pumice, and bands generate a large amount of aerosols, spatter, and the possibility of flying debris. Using infection control measures can limit these possibilities.
Disinfect items before processing -- Before any item is processed on the lathe, the item should be disinfected properly (see "Dental Laboratories And Infection Control" (\at RDHmag.com or in the December 2012 issue). This will help keep the microorganism levels down.
Wear proper personal protective equipment -- Anytime you're working in the lab areas, you should wear gloves, gown, eye protection, and mask. It is vital to read the warnings that accompany products.3 Some products require specific personal protective equipment.
Sterilization or disposable -- All laboratory items such as burs, polishing points, brushes, rag wheels, stones, and laboratory knives used on contaminated or potentially contaminated materials should be cleaned and heat sterilized between each patient. The lathe itself should be cleaned and disinfected at the start and end of each day or when contaminated. Fresh pumice should be used on every case. If you are not able to clean and sterilize your equipment, use a disposable instead.
Shield and ventilation -- A shield surrounding the lathe should be in place and functional when using the machine. Specially designed shields are available that enclose the area but allow access to the machine, which limits spatter, aerosols, and the possibility of flying debris. The air-suction motor should be capable of producing an air velocity of at least 200 ft/min.
The little details in the dental setting have a great effect on positive infection control outcomes. Knowing simple measures that are necessary in using dental equipment can make all the difference.
Ask yourself these questions before using the lathe:
- Has the item that is being processed (such as a denture) been disinfected?
- Is the lathe properly mounted to the counter?
- Are products such as pumice and rouge being single-unit dosed?
- Is a fresh pan liner being used for each case?
- Has the on/off switch been located before operating the machine?
- Is the eyewash station functional and is staff trained in its use?
- Is the Plexiglas shield in good working order?
- Is the ventilation system turned on?
- Has all the interchangeable equipment (such as rag wheels and stones) been heat sterilized and packaged properly? If using disposables, have they been changed?
- Has the lathe been cleaned and disinfected at the start and end of the day, or when it becomes contaminated?
- Are the manufacturer's directions for use and care of the machine being followed?
1) Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 3rd ed. St Louis, Mo: Mosby Year-Book; 2004.
2) Verran J, Kossar S, McCord JF. Microbiological study of selected risk areas in dental technology laboratories. J Dent 1996 and 24:77–80.
3) http://www.cdc.gov/mmwr/pdf/rr/rr5217.pdf accessed August 2013.
NOEL BRANDON KELSCH, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists' Association.
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