Compliance and Safety Combined: Efficient Infection Control - Richard Musgrave

While most winters bring with them a host of cold and flu-causing viruses, it is safe to say that this has been a pretty bad one. In the last few months we have seen outbreaks of several different infections and viruses beyond the usual colds and flues in the UK, including those of Measles, Whopping Cough, the Norovirus and even the Sars-like Coronavirus.

While the exact sources of such infections and illnesses are often difficult to identify, they can be spread very easily throughout our homes, workplaces and even healthcare environments. Regardless of whether the pathogens causing the infections are transmitted through either direct physical contact or droplet contact, they can be quickly passed from one place to another, contaminating an entire location in days.

In the dentistry we are no strangers to infection control and prevention, and we follow strict protocols to ensure our practices are as free of contamination as possible, keeping our fellow professionals and patients safe. Particular focus is placed on surface decontamination, with a potential for numerous different pathogens to enter the dental environment via any one of the staff or patients on the premises.

The Dental Unit Water Lines (DUWLs) are of course another high-risk area for contamination, providing ideal conditions for a wealth of bacteria, viruses and fungi to thrive in. The relatively large internal surface area of the water lines offers plenty of space for pathogens to adhere to, and the constant and low-pressure water-flow delivers all the nutrients bacteria need to survive. With the central heating on to combat the cold temperatures this winter has presented, our dental practices even provide a warm environment for existing bacteria, encouraging growth at an exceedingly accelerated pace.

Once the bacteria have formed a protective biofilm within the DUWL system, they become incredibly stubborn and can be remarkably more difficult to remove. The danger comes when planktonic or ‘swarmer’ cells are released from the biofilm and are subsequently aerosolised into the open when the dental unit instruments are in use, putting both patients and staff at risk of infection. While the majority of microbes found in this biofilm are often benign, opportunistic and respiratory pathogens such as Legionella spp (causative agent of the pneumonia, legionnaires’ disease), Mycobacteria spp and Pseudomonads, all present a very real and dangerous threat, especially for the elderly, the very young and the immunocompromised.[i]

As our understanding of how infections spread has developed and our technologies have advanced, our frontline of defence for such an assault remains as chemical intervention, and specifically designed products have become a major aspect of infection control in dentistry. In order to fully utilise their benefits however, it is crucial that the quality of the water within the practice is monitored closely. Monitoring all output water accurately is not only a mandatory aspect of compliance, but figures also indicate the frequency and concentration of chemicals needed for successful decontamination.

HTM 01-05 guidelines dictate a bacterial level of below 200 colony-forming units / millilitre (cfu/ml) in all dental output water in the UK. The EU Directive is even stricter, recommending lower bacterial levels than 100 cfu/ml, which is the same as the requirement for drinking water. You must be able to demonstrate that you are adhering to these regulations; hence why actively measuring, managing and stringently recording the microbial count in DUWL output is so crucial.

Internationally recognised for high quality and effective infection control products, schülke has worked hard to promote the importance of efficient decontamination for over a century. The schülke DUWL system provides a solution for the complete removal of biofilm, and it can then be used at low concentrations to maintain the DUWLs and prevent biofilm from reforming. schülke also offer free dip slides to test the microbial level of your DUWL to ensure your practice remains compliant with regulations, protecting both your colleagues and patients as much as possible.

As infection control is the domain of all members of your team, leading providers such as schülke also offer specialized training to make sure everyone has the knowledge and skills to reduce the risk of cross-contamination. As well as maintaining the DUWLs, it is the responsibility of your whole team to clean and disinfect all areas of the practice, including instruments, equipment and workbench surfaces. Training from the experts offers both insight and a better understanding of what you can do to further reduce the risk of infection in the practice, providing an even better service to your patients.

Without complete dedication to infection control, contagion is guaranteed. There are hundreds if not thousands of microbes infiltrating our dental practices every single day, and it is part of your job to eradiate the risks wherever humanly possible.

For more information, please call 0114 254 3500. Or visit www.schulke.co.uk

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