Family Dental Care is committed to the management of infection control in accordance with the NSW Department of Health & Regulations and Australian & NZ standards.
Our policy for infection control has been formulated to address the issues of infectious disease and its control. In formulating this policy the following documents have been referred to:
- Anti-discrimination Act (1983)
- NSW Department of Health Infection Control Policy circular 2002/45
- NSW Department of Health Infection Control Guidelines for Oral Health Care Settings circular 2002/80
- O H & S Act 1983 (Amended 1987)
- United Dental Hospital of Sydney infection control policy 1997 (Reviewed 00)
- NSW Department of Health Infection Control Guidelines circular 2002/80
- Australian and New Zealand Standards 4815:2006
- NSW Environment Protection Agency Guidelines
- ADA Infection Control - Systematic Operating Procedures
- DAA Infection Control Manual 2003
Our aims and objectives are to:
- Contribute to high quality patient care by ensuring adherence to Standard and Additional infection control precautions
- To ensure the utilisation of optimum sterilisation and disinfection measures to minimise staff exposure to potentially infected material
- To ensure that this policy is at all times consistent with the NSW Health Department of health and its regulations in infection control
STANDARD & ADDITIONAL (TRANSMISSION BASED) PRECAUTIONS
Standard precautions refer to a method of infection control in which all human secretions are assumed to be potentially infectious. Standard precautions are designed to reduce the risk of micro organisms from both recognised and unrecognised sources of infection. They include use of protective clothing such as gowns, gloves, masks and eye protection and regular hand washing. Standard precautions apply to blood, all body substances, secretions and excretions (except sweat) regardless of whether or not they contain visible blood, non-intact skin and mucous membranes. This also applies to dry blood.
Additional (transmission based) precautions are designed for patients known or suspected to be infected with pathogens that Standard precautions are known to be insufficient to stop the transfer of pathogens from one person to another person. The types of transmission based precautions are airborne precautions, droplet precautions and contact precautions. Transmission based precautions may include Standard precautions, masks with extra filtration for diseases such as TB, gowns, minimisation of aerosols and isolation for very infectious cases. Additional precautions are usually reserved for hospitals.
Airborne precautions apply to patient’s known or suspected to be infected with pathogens that can be transmitted by the airborne route. They are designed to reduce the risk of airborne droplets, which may remain suspended in the air for long periods of time or dust particles containing infectious agents. Examples are Mycobacterium Tuberculosis, measles and chickenpox.
Droplet precautions apply to any patient known to be or suspected of being infected with pathogens that can be transmitted by droplet. It is designed to reduce the risk of droplet transmission of pathogens. Droplet transmission involves contact of the conjunctiva or the mucous membrane of the nose or mouth of a susceptible person with large particle droplets. These droplets do not remain suspended in the air. These droplets are the result of coughing, sneezing or the fine spray caused by the spinning of a high-speed handpiece, an ultrasonic scaler or a triplex syringe. They cause such diseases as mumps, influenza and rubella.
Contact precautions are designed to reduce the risk of contact transmission of pathogens by direct or indirect contact. Contact transmission involves the transfer of organisms that are able to live outside the body to areas that could cause infection or poisoning. Contaminated food or drink, un-sterile instruments and needles can all result in infections. Hepatitis, food poisoning and wound infections are examples. Direct or indirect contact can cause infection from diseases such as MRSA (Multi-drug Resistant Staphylococcus Aureus) and herpes.
This surgery enforces the combination of both Standard precautions and Additional (transmission) precaution with each and every patient.
EQUIPMENT
Mocom Millennium B+: The Mocom Millennium B+ is an autoclave.
An autoclave will completely destroy micro organisms - including spores, thereby sterilising items placed within it.
Some items need to be kept sterile while they are waiting to be used. To do this, we place the items in a sealed pouch and then process them in the autoclave. The pouch will remain sterile until it is opened. We track and record all tests and their results including the printouts of each processed load so any possible failure in the sterilisation process can be detected immediately.
We do a physical check of the autoclave at the start of the sterilisation process. Each load that goes through the autoclave has a chemical indicator placed into a pouch. This will indicate to us that the temperature inside the autoclave has reached the required temperature for sterilisation to occur.
We do a biological test (to ensure that spores are being destroyed effectively), a vacuum test (to ensure the air entering the autoclave is being effectively filtered) and a Helix/BD test (to ensure the complete penetration of the steam and heat is effective) on the autoclave to ensure the autoclave is performing optimally.
The autoclave is calibrated according to Standards and the validation is performed on the autoclave after. The validation involves processing 3 x heavy loads with a biological indicator in each load in the autoclave. The results of the tests must show the autoclave is sterilising effectively before it continues to be used.
Additionally, the external surface of the autoclave is disinfected daily, each month the pressure valves and filters are checked and the internal surface of the unit is cleaned.
Assistina:
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An Assistina is an automatic internal cleaner and lubricator of handpieces (drills).  Cross section of a handpiece |
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We disinfect the handpieces after each use, process them in the Assistina, drain them, place them in a pouch and process them in the autoclave. They remain sterile until they are to be used.
The internal and external surfaces of the Assistina are disinfected and a functional test is performed daily. Each month the oil and cleaning fluid level is checked and the filter is changed when appropriate. Also the O rings are tested and changed every 8 weeks.
Soniclean:The Soniclean is an ultrasonic cleaner.
It is a tub of water and solution that we place our used instruments into.
It works by subjecting the items placed in the solution to high-frequency, high-energy sound waves. These create tiny bubbles which, when they come into contact with a surface, implode. This causes the debris on the items to dislodge and fall to the bottom of the tank. The items are then removed, rinsed, dried and inspected before being placed into sealed pouches and autoclaved.
The ultrasonic cleaner is emptied, disinfected and fresh solution replenished each day, prior to use. A functional test is also performed daily.
Dental Chairs/Units: The dental chair is where patients sit to have treatment. The unit includes the overhead light, the bracket table that holds the treatment tray and handpieces, the suctions and the spittoon. The areas that are touched by the dentist and assistant are bagged to allow for greater infection control. The bagged areas include the headrest, the overhead light, the bracket table handle, the suctions and the handpieces. At the end of treatment all bags, used instruments and handpieces are removed and the entire chair and any area touched by the dentist, assistant or patient is disinfected.
Relative Analgesia (R. A.) Equipment:
The R. A. unit is a mobile nitrous oxide/oxygen (“Happy Gas”) unit.
The gas can be helpful to some people. It can help you to relax during treatment.
It is disinfected after each use, barrier wraps are placed over two areas and the nose piece is sterilised. To ensure the R. A. unit is performing optimally, each month we perform a failsafe test, non-rebreathing valve test, the air inlet valve test, the oxygen flush test, the 100% oxygen test and the total flow test.
All test results, tracking of sterile items and maintenance of equipment are documented and archived.
Lab Work: Lab work is considered anything we have to send to the dental laboratory including impressions, dentures or crown or bridge work that is under construction as well as denture repairs.
All lab work is disinfected before leaving our surgery and after the lab has returned it to us.
X-rays: We use a digital imaging system. All of our intra-oral radiographs (x-rays) have barrier wraps on them. After the x-rays have been taken, the barrier wrap is torn open and the clean film inside is removed and can be developed.
Reception: The receptionist adheres to our infection control protocol. This includes washing the children's toys regularly, disinfecting the play station, the bench top and the office equipment as well as damp dusting daily.
Cleaner: Our cleaner adheres to our infection control protocol when he cleans our surgery. Most people forget that the cleaner can be a major contributor to cross contamination if not educated and trained correctly.
All of our staff have been trained in infection control policy and protocol, strictly adhering to the Australian and New Zealand Standards 4815:2006 and the NSW Health Department of health and its regulations in infection control.