Personal Protective Equipment

The purpose of personal protective equipment (PPE) is to protect the skin and the mucous membranes of the eyes, nose, and mouth from exposure to blood or other potentially infectious material. Image 1

PPE is designed to protect the skin and the mucous membranes of the eyes, nose, and mouth of dental health-care personnel from exposure to blood or other potentially infectious material. A visible spray is created during the use of rotary dental and surgical instruments (e.g., handpieces, ultrasonic scalers) and air-water syringes. This spray primarily consists of a large-particle spatter of water, saliva, blood, microorganisms, and other debris. Spatter travels only a short distance and settles out quickly, landing either on the floor, nearby equipment and operatory surfaces, dental health-care personnel, or the patient. The spray may also contain some aerosol (i.e., particles of respirable size: 10 microns). Aerosols take considerable energy to generate and are not typically visible to the naked eye. Aerosols can remain airborne for extended periods and can be inhaled. However, they should not be confused with the large-particle spatter that makes up the bulk of the spray from handpieces and ultrasonic scalers. Appropriate work practices such as the use of dental dams and high-velocity air evacuation should minimize droplets, spatter, and aerosols. OSHA mandates that dental health care workers wear gloves, surgical masks, protective eyewear, and protective clothing in specified circumstances to reduce the risk of exposures to blood borne pathogens.

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During procedures and patient-care activities that are likely to generate splashes or sprays of blood or body fluids.

Dental health-care personnel should wear a surgical mask that covers both their nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood or body fluids. A surgical mask protects the patient against microorganisms generated by the wearer and also protects dental health care personnel from large-particle droplet spatter that may contain bloodborne pathogens or other infectious microorganisms. When a surgical mask is used, it should be changed between patients or during patient treatment if it becomes wet.

When should protective eyewear be worn?

Protective Eyewear should be worn during procedures and patient-care activities likely to generate splashes or sprays of blood or body fluid. Image 3

Dental health care personnel should wear protective eyewear with solid side shields or a face shield during procedures and patient-care activities likely to generate splashes or sprays of blood or body fluids. Protective eyewear protects the mucous membranes of the eyes from contact with microorganisms. Protective eyewear for patients also can protect their eyes from spatter or debris generated during dental procedures. Reusable protective eyewear should be cleaned with soap and water, and when visibly soiled, disinfected between patients.

When should protective clothing be worn?

When spatter and spray of blood, saliva, or other potentially infectious material is anticipated

Various types of protective clothing (e.g., gowns, jackets) are worn to prevent contamination of street clothing and to protect the skin of personnel from exposure to blood and body fluids. When the gown is worn as personal protective equipment (i.e., when spatter and spray of blood, saliva, or other potentially infectious material is anticipated), the sleeves should be long enough to protect the forearms. Protective clothing should be changed daily or sooner if visibly soiled. Personnel should remove protective clothing before leaving the work area.

Should wearing gloves replace the need for handwashing?

Dental health care personnel wear gloves to prevent contamination of their hands when touching mucous membranes, blood, saliva, or other potentially infectious materials and to reduce the likelihood that microorganisms on their hands will be transmitted to patients during dental patient-care procedures.

Wearing gloves does not replace the need for handwashing. Personnel should wash their hands immediately before donning gloves. Gloves may have small, unapparent defects or may be torn during use, and hands can become contaminated during removal of gloves. In addition, bacteria can multiply rapidly in moist environments underneath gloves; thus, personnel should dry their hands thoroughly before donning gloves and wash immediately after removing the gloves. If the integrity of a glove is compromised (e.g., if the glove is punctured), the glove should be changed as soon as possible.

Do Gloves replace the need for handwashing?

Gloves protect you against contact with infectious materials. However, once contaminated, gloves can become a means for spreading infectious materials to yourself, other patients or environmental surfaces. Therefore, the way YOU use gloves can influence the risk of disease transmission in your healthcare setting. These are the most important do’s and don’ts of glove use. Work from clean to dirty. This is a basic principle of infection control. In this instance it refers to touching clean body sites or surfaces before you touch dirty or heavily contaminated areas. Limit opportunities for “touch contamination” – protect yourself, others and environmental surfaces. How many times have you seen someone adjust their glasses, rub their nose or touch their face with gloves that have been in contact with a patient? This is one example of “touch contamination” that can potentially expose oneself to infectious agents. Think about environmental surfaces too and avoid unnecessarily touching them with contaminated gloves. Surfaces such as light switches, door and cabinet knobs can become contaminated if touched by soiled gloves.

NEVER WASH GLOVES: Washing of latex gloves with plain soap, chlorhexidine, or alcohol can cause micropunctures. This condition, known as “wicking,” may allow liquids to penetrate through undetected holes in the gloves. For that reason, washing of gloves is not recommended.

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