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Environmental infection prevention and surface safety: A balancing act

Sept. 4, 2019
Infection prevention protocols play an important role in the delivery of safe, high-quality dental care, especially in operatories, where surfaces are regularly contaminated during patient care.

Infection prevention protocols play an important role in the delivery of safe, high-quality dental care, especially in operatories, where surfaces are regularly contaminated during patient care. In each of these spaces, potentially harmful pathogens can survive on surfaces. Pathogens sometimes can survive for prolonged periods and contribute to infection transmission, making regular cleaning and disinfection a foundational component of effective infection prevention programs. However, it is also important to implement environment-focused infection prevention protocols that can be implemented without causing damage to the surfaces and equipment on which cleaning and disinfecting products are used.

The evolution of health-care surface disinfectants

Surface disinfectant manufacturers have worked through the years to create new products with fast contact times against key health-care pathogens. While fast contact times are important, some ingredients, such as alcohols, are added to enhance efficacy, but may not be compatible with key health-care surfaces. In dental settings, disinfectant wipes that commonly incorporate alcohol and quaternary ammonium compounds as active ingredients are commonly used to kill germs on environmental surfaces in the operatory. Recent technological advances in disinfection chemistry have resulted in quat-based disinfectants that can quickly kill pathogens on surfaces without the need for alcohol, which can damage surfaces after long-term use. 

Surface compatibility issues can be a barrier to compliant surface disinfection, but it’s easier to improve environmental hygiene and quality of care if the practice’s standard infection prevention protocol includes implementing products that offer broad compatibility and good aesthetics. By doing so, dental practices can lower their overall cleaning costs by eliminating the need for multiple products and mitigate the risk of damage to equipment. Alcohol-free quat-based disinfectants, such as Clorox Healthcare VersaSure Cleaner Disinfectant wipes, have proven to be compatible with the materials commonly found in dental settings, including plastics and stainless steel. 

Striking the balance

While all disinfectants can cause compatibility issues if used improperly, doing some extra research before selecting disinfectants can help prevent surface compatibility challenges down the road. Using broad-spectrum disinfectants with proven compatibility can help protect against infection-causing pathogens and damage to surfaces and equipment. When selecting and implementing disinfectants for your dental practice, consider these five steps to help strike the right balance between efficacy and compatibility.

• Start with efficacy. Patient safety comes first, so it is always important to select from US Environmental Protection Agency–registered health-care surface disinfectants. For dental practices, Clorox Healthcare recommends selecting health-care surface disinfectants with EPA-registered disinfecting claims against common pathogens found in health-care settings, such as MRSA, cold and flu viruses, and blood-borne pathogens. 

• Next, learn the surfaces in your facility. What surfaces do you disinfect? Are they polymers (such as laminate, acrylic, vinyl, or polyurethane), stainless steel, or another material such as Corian? Most dental facilities include a wide range of materials. Knowing the surfaces in your facility is the best way to ensure they are maintained appropriately. 

• Take the time to read the cleaning and care guides. These documents are the go-to sources for important manufacturer recommendations, warning statements, and warranty information, but they can be dense. Locate digital copies of cleaning and care guides and search the PDFs for key words (such as “clean” or “disinfect”), active ingredients, and product names to find what you need more quickly. Remember, surface disinfectants should only be used on noncritical patient care equipment. Many dental instruments require high-level disinfection or sterilization.

• Evaluate the compatibility of the selected disinfectant. Look for cleaner/disinfectants that are designed to be compatible with a wide range of hard, nonporous surfaces. Check the product labels for use sites. If you’re not sure about something, reach out to the disinfectant manufacturer. They should be able to provide additional information and technical resources on compatibility. Dental equipment manufacturers can also submit their equipment for testing with Clorox Healthcare products through the Clorox Healthcare Compatible Program to ensure their compatibility. This makes it easier for practices to know which products are safe to use on which surfaces. 

• Establish and reinforce standardized protocols. Once you have the right products in place, establishing proper protocols and training staff to follow them become the keys to ensuring compliance. Make sure your whole team knows how and where to use surface disinfectants and why it matters. Taking time to review this information after initial training and providing ongoing education can help promote compliance. Reference tools such as checklists are a good way to measure success and identify areas for further training.

Achieving balance between disinfectant efficacy and surface compatibility is possible, but it requires a holistic view of the surfaces and equipment in your practice and careful consideration of cleaning and disinfecting products, as well as the areas in which they are used. 

With prudent purchasing decisions and consistent, compliant use, dental facilities can better protect patients from dangerous pathogens and preserve the equipment and environmental surfaces that are vital to delivering quality dental care.

Sarah Bell-West, PhD, serves as a technical liaison for Clorox Healthcare, where she supports the development and implementation of surface disinfection solutions across the health-care continuum. Bell-West holds a doctorate degree in chemistry from the University of California, Berkeley, and is an active member of the Association for the Healthcare Environment and Association for Professionals in Infection Control and Epidemiology. She has authored articles in infection control periodicals as well as developed and presented educational sessions for environmental services technicians and infection preventionists on compliance in health-care settings.