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"Infectious" infection control.

How the U.S. Air Force manages infection control in the dental clinic

Masks, gloves, scrubs, protective eyewear, and face shields? "Seems like a lot for just a dental appointment" a patient stated. Are all these precautions really necessary? Though many would like to believe that the dental clinic is just that place you go to when you need to get your teeth cleaned or filled occasionally, we all know that there are several different types of treatment. All these treatments have one thing in common: They each require dental treatment team members to don Personal Protective Equipment (PPE). PPE is the foundation of the Infection Control Program and without constant emphasis and compliance, infection control would be impossible. I would like to explain why we need a solid Infection Control Program and how we apply its policies throughout the Air Force Dental Clinics.

As with any career in the medical field, there are always going to be infection control risks, and dental is no exception. All dental appointments that require any instruments to be used inside the patient's mouth require the donning of PPE. The selection of appropriate PPE requires judgment based on the procedure being performed and the possibility of exposure. All body fluids are to be treated as infectious. Standard precautions require us to treat all patients the same.

Some of the most common ways that a dental treatment team member may be potentially infected is through exposure to bloodborne pathogens, aerosols and sharp instruments. Proper PPE while working in direct patient care includes: clinic approved scrubs; puncture proof, non-absorbent, solid clinic approved shoes; clear protective glasses; a mask; a treatment room jacket; and gloves. Wearing your PPE is just one of the many ways to prevent the spreading of infectious diseases. Without wearing the proper PPE, dental treatment team members are susceptible to potentially infectious diseases their patients may have. To some, it may seem a little "overdone," but rest assured, compliance is the only way to mitigate potential risks.

Let's take a brief look at the duties of the Air Force Dental Infection Control Monitor. Outside of direct patient care, the Infection Control Monitors often work behind the scenes in Air Force Dental Clinics. They are required to accomplish daily, weekly, quarterly and yearly inspections ensuring proper infection control policies are being enforced. These mandatory inspections ensure that each clinic is in compliance with the Infection and Prevention Control Program. Infection control is highly important and should never be taken lightly. When referring to infection control, the dental treatment room (DTR) does not stand alone; infection control measures extend well beyond the DTR. When members are leaving the DTR, it is required that they remove all of their PPE prior to walking out of the room. Doing so prevents the spread of potentially infections diseases.

Now let's look at the application of the infection control program within the confines of the Dental Instrument Processing Center (DIPC). Instrument processing requires multiple steps and is a complex process requiring specialized equipment, adequate space, qualified dental healthcare professionals who are provided with initial, ongoing training, and regular monitoring for quality assurance. Correct cleaning, packaging, sterilizer loading procedures, sterilization methods or high-level disinfection methods are essential to ensure that an instrument is adequately processed and safe for reuse on patients. DIPC contributes significantly to the prevention of potential contamination. DIPC is where all of the cleaning and sterilizing of dental instruments takes place. Though DIPC may vary from clinic to clinic, the end result is the same.

There are usually three sections in the DIPC: a dirty section, a clean section and a sterile section. Extreme precaution is taken when entering the DIPC. It is prohibited for anyone to enter this room without first donning PPE. Once the instruments are properly cleaned, the dental assistant moves them to the clean section of the DIPC. In the clean section, the instruments are ready to be prepared for sterilization. After instruments are properly wrapped and packaged with their required items, including a sterilization indicator strip that is placed inside each peel pack and kit, the assistant will sterilize the instruments. Once the instruments are sterile, dry and cooled down, the assistant will place all of the instruments in their proper locations, inside a cabinet that can be closed when not in use. After instruments have been properly put away, it is the responsibility of the Infection Control Monitor to go through every peel pack and instrument to ensure there are no ripped, poked or torn peel packs that would deem the instruments unsterile.

As you can see, the DIPC section plays a huge role in infection control, and this role is increasing both for the Infection Control Monitor and the DIPC dental assistants. Approximately 70 percent of Air Force dental facilities provide sterilization support for entire medical groups and Central Instrument Processing Centers (CIPC) skills of dental assistants have never been more essential. This has nearly eliminated the need for duplicate or even numerous sterilizing centers within a particular medical group. CIPC dental assistants are now responsible for a wide range of medical instruments and appropriate procedures particular to their specific use. As a dental assistant and infection control monitor I look forward to learning new processes and continuing to make an impact, not only within the dental community, but now possibly the entire medical group as well.


One may stand on the outside looking in and sag, "All this PPE and focus on infection control is a bit overdone." However, anything we can do to prevent cross contamination is well-worth the effort. Infection control is most certainly a group effort. If each person maintains responsibility and completes each of his or her own tasks, cross contamination can most certainly be avoided. On the flip side, if just one person fails in their duties to adhere to infection control procedures, the end result could be deadly. Wearing PPE and strict compliance with the infection control program is absolutely paramount for the safety of not only treatment team members and their patients, but everyone who walks into the dental clinic.

Senior Airman Kaitlyn D. Henjes

Dental Assistant & Infection Control Monitor

39th Medical Operations Squadron, 39th Dental Clinic, Incirlik Air Base, Turkey

Senior Airman Kaitlyn D. Henjes is a dental assistant and infection control monitor assigned to the 39th Medical Operations Squadron, 39th Dental Clinic at Incirlik Air Base, Turkey. She is from Peru, IL, and joined the Air Force in 2009. She is currently enrolled at the University of Maryland and pursuing her CCAF degree. Senior Airman Henjes works proudly in the Dental Instrument Processing Center. In her spare time, she enjoys various activities from scrapbooking to drawing and painting, as well as being a mother to her seven month old son.
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Title Annotation:U.S. Air Force
Author:Henjes, Kaitlyn D.
Publication:The Dental Assistant
Date:Nov 1, 2013
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Next Article:DARW 2013.

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