your opinions welcome--dental hygiene

[isthistaken]

Not what you're thinking--the hygiene of the dental office. This was in the news recently, and has become a bit of a personal interest now. What would you consider unacceptable as far as the condition and practices of a dental office? For instance, would you consider badly damaged and stained carpet where the dental hygienist performs her duties okay? What about the dentist examining you with specks of blood from another patient spattered on his surgical mask?

[isthistaken]

Okay, I found this:

Q Should face masks be changed between each patient whether there is visible contamination or not?

A Yes, face masks should not only be changed between patients but they should also be changed anytime they become wet.

The Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings states the following:

A surgical mask protects against microorganisms generated by the wearer, with >95% bacterial filtration efficiency, and also protects DHCP from large-particle droplet spatter that might contain bloodborne pathogens or other infectious microorganisms. The mask's outer surface can become contaminated with infectious droplets from spray of oral fluids or from touching the mask with contaminated fingers. Also, when a mask becomes wet from exhaled moist air, the resistance to airflow through the mask increases, causing more airflow to pass around edges of the mask. If the mask becomes wet, it should be changed between patients or even during patient treatment, when possible. (1)

1. Wear a surgical mask and eye protection with solid side shields or a face shield to protect
mucous membranes of the eyes, nose, and mouth during procedures likely to generate
splashing or spattering of blood or other body fluids (IB, IC). (1)
2. Change masks between patients or during patient treatment if the mask becomes wet (IB). (1)

In addition, the authors of Infection Control & Management of Hazardous Materials for the Dental Team state that the mask should be changed with every patient because its outer surface becomes contaminated with droplets from sprays of oral fluids from the previous patient or from touching the mask with saliva coated fingers. Also, when a mask becomes wet from moist exhaled air, the resistance to airflow through the mask increases, causing more unfiltered air to pass by the edges of the mask. Thus one should replace wet masks to maintain high filterability. (2)

Resources:

1) Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm

2) Infection Control & Management of Hazardous Materials for the Dental Team. Third Edition.
By Miller and Palenik. Elsevier/Mosby Publishers. Copyright 2005

[isthistaken]

I guess this is a no-brainer, but I've switched dentists rather often recently. Has anyone switched general dentists during your ortho treatment? I am fine with my ortho. His office is pristine and well-run. But although I thought this dentist was well-respected, I have never seen such a cluttered, run-down, crowded office. And now he is examining me with a surgical mask that is obviously covered with someone else's body fluids. I should have gone with my first instincts and kept looking but I wanted to get ortho started ASAP so I guess I purposely overlooked some problems.

[anedia]

Yeah I wouldn't be comfortable in that dentist office. Luckily my dentist and ortho office are spotless. I don't think I would continue to use them if it wasn't clean and I felt uncomfortable.

[Ciara]

Yuck! Absolutely no way would I go to a dentist that did not change masks between patients. I expect excellent hygiene practices by all staff members: masks, gloves, all equipment have to be clean and changed between patients. The floor should have a surface that is easily cleaned (I think carpet would be a bad idea in the treatment area). Of course I expect everything that is reused to be sterilized between patients.
I also expect the reception, waiting area etc to be spotless, with up-to-date magazines. I've walked out of dental clinics that did not meet my expectations.

[isthistaken]

Thank you so much for your replies. I'm still traumatized by it.

[anedia]

Keep us updated to what you decide to do, I'm definitely interested

[isthistaken]

They try to do too much volume and multitasking. They wedge what they call "hygiene checks" in between drilling on various people.

[Matilda]

This was in the news recently

The Oklahoma dentist?

[Ciara]

They try to do too much volume and multitasking. They wedge what they call "hygiene checks" in between drilling on various people.

I'd be rather traumatized too if I were in your situation. I wouldn't be happy with this dentist and I'm sorry you have experienced this.
I expect my dentist to give me her undivided attention while I am her patient. I wouldn't be very happy if she were running back and forth between me and another patient, specially if she didn't change masks and gloves in between. If this were a one off situation (an emergency patient for example) and as long as she changed gloves and masks, it would be ok. But it sounds like this is a regular occurrence and hygiene is lacking so I would be rather unhappy and worried about bacterial or viral transfer from patient to patient.
I really am sorry you have to worry about this. I don't think it is the patient's responsibility to have to check or worry about the hygiene standards of a dental clinic. Dentists and their staff should maintain the highest level of hygiene at all times.

[isthistaken]

This was in the news recently

The Oklahoma dentist?

Yes, that is what I was thinking about. In that case, the patients reported that the office appeared "upscale" so I assume that means clean since no one seems to have suspected how bad it really was. You can't tell a book by its cover, but some things are definitely a red flag and shouldn't be overlooked.

[BraceFaceCH]

I think they should present themselves in the most professional and cleanly manner possible, especially since they are advocates of good hygiene! PPE should definitely be changed in between patients, soiled or not, it's just good practice.