There is no doubt the COVID-19 virus has changed the world forever. It has transformed the way we work, shop, socialize, eat, and our health care. Dentistry is no exception.
Actually, viruses have always existed. Some causes minor symptoms, while others can be life-threatening. It is not often that a virus shows up and changes the way we think about personal hygiene, sterilization, and disinfecting.
While having a healthy immune system can be our superpower, it is important that we take additional measures to help protect ourselves and our patients from the virus. It is also important to know that just because we have a strong immune system does not mean that we are not vulnerable. Even if we carry a virus and experience a mild illness, someone who is at a high risk, such as those with immune disorders, heart or lungs problems, and diabetes can be exposed through you, and the resulting outcome could be devastating.
So, yes, just like how dentistry changed when HIV or AIDS became the virus to dread, COVID-19 is changing the industry once again due to its highly contagious nature. Pre-HIV dental providers did not even ear masks and gloves then, something unthinkable to most people today.
You might be surprised the next time you visit the dentist. The CDC and the American Dental Association have submitted several recommendations to ensure everyone’s health and safety.
You have probably been hearing a lot about PPE since the advent of the novel coronavirus that leads to the more serious COVID-19. One thing you might not know is that dentistry is probably the most vulnerable occupation for exposure risk to illness. Aerosol transmission is the most important concerns in dental offices.
The use of high-speed hand pieces produce a large amount of droplets mixed with the patient’s saliva and sometimes blood. It is nearly impossible to keep the virus confined to the oral cavity. This is why aside from sterilizing common dental instruments, disinfection of the dental chair is also very important. Aside from the dental chair surface, its air–water syringe is also commonly contaminated.
Most dental offices and practitioners are aware of the need for regular maintenance and disinfection of dental equipment and tools. However, the proper techniques on how to disinfect a dental chair is often overlooked, and yet it’s an important part of routine dental office disinfection protocols during this pandemic.
According to the guidelines for infection control in dental health care settings, the dentist and the patient are commonly exposed to microorganisms like cytomegalovirus, herpes simplex virus, HIV, Mycobacterium tuberculosis, Streptococci, Staphylococci, Hepatitis, and now, Coronavirus. Aside from transmission through direct contact with body fluids, inhalational contact is very common in dentistry as procedures involve an open mouth.
The dental chair is that one piece of equipment that all patients use. It’s a clinical contact surface. Its upholstery is exposed to the spatter of saliva and blood during routine dental procedures.
Dental chair maintenance starts with reading the instructions and cleaning procedures that come with the dental chair. They provide clear instructions as which cleansers are good to use, how frequent should the chair be cleaned, and other tips for disinfection.
The CDC and the manufactures of dental chairs advocate the use of impervious, disposable barriers on dental chair surfaces and should be changed between patients. Aside from being a precautionary measure against COVID-19, this will help maintain the appearance and finish of the equipment and ensure durability and maximum lifespan of its surfaces. If the barrier was compromised or contaminated, it must be replaced immediately. Cleaning and disinfection after every patient is also highly recommended. If you see visible contamination, a hospital grade disinfectant should be used.
The following have been found to be least harmful in dental equipment surfaces:
These chemicals can harm the surface finishes of a dental chair; hence not recommended. Take note of these when shopping for a disinfectant.
Once you have purchased the appropriate dental chair cleaning and maintenance materials and solutions, it is important to test it on a small part of the upholstery that is in a discrete place on the chair to make sure it will not damage the upholstery. Some brands only allow the use of disinfectants that come with their products. Always check the label.
Do not forget to use the appropriate personnel protective equipment such as gowns gloves, and masks when disinfecting dental chairs.
The longer a stain is allowed to set, the more difficult it will be to clean. Use any of the recommended disinfectants above for convenient everyday dental chair cleaning. Their formulation are gentle and safe for use on upholsteries.
Alternatively, you can prepare a solution of 10% household liquid non-ionic dish mixed with warm water. Apply it using a soft damp cloth to remove most soiling. Re-dampen the cloth until all remaining residues are completely removed. Wipe the surface with a clean water-dampened fabric.
For hard to remove stains, you may do the following techniques:
In addition, maintaining for the upholstery on the chair itself, it is important to care for and disinfect other attachments on the dental chair. Specific instructions on how to disinfect a dental chair suction system is also included in the manual.
Part of knowing how to disinfect a dental chair properly is the schedule. Below is a general guideline for most brands.
After Every Patient or Treatment
Rinse, clean, and disinfect the following after every patient or treatment:
Every morning before accepting patients, the following must be rinsed and cleaned:
At the end of each day, the following must be rinsed, cleaned, and disinfected:
Weekly or After A Long Downtime
Professionals who are looking for more ways on how to disinfect a dental chair are now considering the use of enhanced measures. One effective technique is the use of ultraviolet light (UV). This is widely used in large medical facilities and hospitals. Sanitizing with UV light is important in dental offices as they do procedures that can easily transmit the virus droplets in the air.
The UV spectrum can be subdivided into 3 bands. UVA may range from 315 to 400 nm. UVB and UVC re from 280 to 315 nm and 100 to 280 nm, respectively.
Among these 3, UVC is the best in a clinical setting. The high energy from UVC light is well absorbed in the cellular and nuclear levels, thus preventing microorganisms from replicating and infecting. This results in virus inactivation, such that they are no longer able to replicate. Unlike other techniques, UVC does not produce harmful by-products. It has also been found to be very effective against Coronavirus family. It is very easy and convenient to use and no chemicals are needed.
Aside from understanding how UV light works, professionals should also know about the different techniques on how to disinfect a dental chair safely using UVC.
Portable units are placed right on top of the dental chair or equipment to sterilize. Disinfecting towers, which are portable columns that beam UV light into a room for decontamination, are popular in larger medical facilities. These products are often on the wheels, which can be easily moved closer to the chair to give a maximum dose of UVC radiation. It can also transported from one location to another; hence useful in passages, reception area, and more.
However, staff members need to take special precautions in order to use this equipment properly, including not being in the room when it is in operation.
To avoid any possible irradiation with UVC, most products have a delayed timer. It can be set from 10 seconds to a minute. The operator can switch on the UV light and comfortably move out of the premises.
While most fungi may take several minutes to get inactivated, coronaviruses only takes about 2 to 3 minutes! This is a huge advantage over other techniques, especially when disinfecting between patients. This will save more time!
The amount of inactivation is directly proportional to the UVC dose, which is received, and this, in turn, is the result of its intensity and duration of exposure.
The key point is that distance matters! For best results, put the light in close proximity to your target object. As the distance between the light and the equipment doubles, radiation weakens to only ¼ of its original energy.
Can You Keep It On For A Longer Period of Time?
Always follow the recommended time and duration of treatment. Long hours of exposure even to mild UVC can reduce the life of plastics, mica, and several other materials. Dark colored items may fade their color and whiter things become yellowish.
There are several brands of UV lights to choose from! They come in different sizes and prices. Check which one will work best on your precious dental chair and other equipment.
In the past, it has been a struggle to get people to invest on UV technology, but all that changed with the pandemic. Knowing what the world is having to put up with, it just brought UV and other disinfecting solutions to the top!
Dental chair disinfection is a crucial part of the routine maintenance needed in every office. Now that you have learned how to disinfect a dental chair properly and safely using the best solutions and UV light, you can now re-open your clinic with less stress.