Are you making these top 5 infection control mistakes?

When I think back to hygiene school, I remember how long it took to turn over an operatory. I slowly and methodically wiped and disinfected each surface and carefully cleaned and inspected my instruments before wrapping them. Then, I reset the operatory for the next patient. It might have taken 30 minutes or more to get that all done. Now it happens in less than 10 minutes. While some of that efficiency stems from familiarity with the tasks, let’s be real: we probably aren’t as thorough as we once were.

Time is the enemy of the dental hygienist. It seems that with every CE course we learn something else, and we should be cramming it into our patient visits. Yet. appointment times aren’t getting any longer. So, Room turnover happens in a flash out of necessity. But what mistakes might we be making in our rush to get the next patient in the chair?

1. Overuse of items 

Everything we use has a lifespan. Some products are intended to be sterilized only a certain number of times. If that’s the case, how are you tracking that? Many of our items are plastic or resin-based and, over time, they develop cracks or divots. Are those microscopic crevices able to be sterilized or are they harboring microbes? Having a robust sterilization log can help you track how often items are reprocessed. Be sure to inspect items for integrity before you use them.

A product that has a number two with a slash through can be used only for one patient and then discarded. Many of you are reading this and rolling your eyes. Of course, I know that. I would never reuse a product! Well, let me tell you what I see, read, and hear about one-time-use-only products. No matter how sturdy it looks, if it doesn’t have reprocessing instructions, you can’t use it more than once.

2. Not separating loads

It’s crucial to read the instructions for use (IFU) for all items you use. Many have specific temperatures for sterilization, much like when doing laundry, with hot, cold, and delicate settings. You might need to separate your items. Exposing everything to the highest temperature could shorten an item's lifespan or, worse, destroy it.

Having a bin system in central sterile with temperature labels can help you sort your devices after packaging. Many of the newer sterilizers have preset time/temperature loads (like your washing machine) to set you up for success. 

3. Placing wet packaging in sterilizer

In that busy turnover process, instrument drying often gets skipped. But this is a crucial step to maintaining sterility.¹ If instruments are placed in the sterilizer wet, they come out wet. Wet packs can wick in microbes. When the packaging is wet, the microscopic fibers are open, allowing steam to penetrate. Think of it like a facial. When all your pores are wide open, allowing the toxins to escape, you would never slap on makeup. You’d end up with blackheads. Your pores need to close, just like the fibers on the package. 

Ensure instruments are dry prior to packaging, and don’t pop the door open before the drying cycle is complete. If you find yourself playing hot potato at the autoclave because you need something fast, perhaps it’s time to invest in a few more. (I’m looking at you, hygiene handpieces … yes, you have to heat sterilize those between EVERY patient.¹)

4. Sterilizing noncompatible products

Much of the new technology coming into our operatories is heat-sensitive and cannot be sterilized. All heat-sensitive semicritical devices (meaning they touch but do not penetrate mucous membranes) must be covered with an FDA-approved barrier and disinfected after the barrier is removed.¹

But have you checked which class of disinfectants the product recommends? The same is true for items that go in the instrument ultrasonic, and even your chair and vacuum pump. The IFUs might have recommendations for compatible products. Using the right cleaning product not only helps with cleaning and disinfection but also prolongs the device/equipment's lifespan.

5. Not cleaning waterlines correctly or often enough

I couldn’t write an infection control article without mentioning dental unit waterlines. As the self-proclaimed Waterline Warrior, I receive many questions on this topic. Your office should have a system to shock, treat, and most importantly, test water. No matter how the water gets to your chair, what kind and frequency of shock and treatment product you use, you have to test. Testing your waterlines is the only way to know (and prove) if the water you’re using is under the EPA’s recommendation of <500 CFU/mL.¹

The Association for Dental Safety (ADS) recommends testing monthly until you achieve two consecutive passes, then move to quarterly testing.² I recommend using a mail-in lab at least once a year and monitor with chairside tests for the other testing intervals. While chairside tests are convenient and cost-effective, mail-in tests are the most accurate measure of what’s happening in your waterlines. Think of it like a self-breast exam and a mammogram. 

Bonus: Do you write it down?

As we know in patient care, if you didn’t write it down, it didn’t happen. This is true for infection control as well. Your office needs written Standard Operating Procedures (SOPs)³ for all the processes listed here and many more. Having a written plan for room turnover, instrument reprocessing, and waterline maintenance (and testing logs) is crucial for team success. It’s all proof of compliance if you are ever audited.

If you find yourself scratching your head about IFUs and SOPs, ADS recently launched a chatbot called Ask ADS.4 While other AI search engines will give answers, they aren’t always correct. Ask ADS has only been fed information that is current and accurate. It will even suggest resources and help you write those pesky SOPs. If you find yourself struggling to figure out what is accurate in a world of misinformation, check it out.

In this busy dental life we lead, it’s easy to lose track of infection prevention. According to a new survey by the Dental Assisting National Board,⁵ only one in four patients said their dental office discusses infection control with them, while 98% of them think infection control is important. With all this work you’re putting into infection control, you can brag about all you’re doing to keep your patients safe.

Editor's note: This article appeared in the January/February 2026 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.

References

1.  Guidelines for infection control in dental health-care settings—2003. Morbid Mortal
   Wkly Rep. 2003;52(RR-17):1-61. https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf
2. Dental unit water quality: Organization for Safety, Asepsis and Prevention white paper and recommendations. Association for Dental Safety. 2018. https://www.myads.org/assets/docs/resources/toolkits-topics/dental-unit-water-quality-organization-for-safety-asepsis-and-prevention-white-paper-and-recommendations-2018.pdf

3.  29 C.F.R. § 1910.1030(c)(1): Exposure control plan. US Department of Labor, Occupational Safety and Health Administration. 2012. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
4. Quackenbush A. Ask ads AI assistant: Association for Dental Safety. Organization for Safety, Asepsis, and Prevention. https://www.myads.org/ask-ads-quicklink
5. Aronovich H. Survey confirms patients trust dental safety, but communication can improve. Dental Assisting National Board. August 25, 2025. https://www.danb.org/news-blog/detail/news/patients-value-dental-infection-control