Routine cleaning and disinfection of surfaces plays a key role in the infection control of any dental practice. Dental surfaces should be cleaned and disinfected between treating patients and at the beginning and end of each day. This is done to help prevent bacteria and viruses being transferred to patients and staff.

 

How important is surface disinfection?

During treatment, all surfaces in a dental setting are at risk of becoming contaminated with bacterial and viral pathogens. This includes bacteria (such as TB), fungi, yeast and enveloped viruses such as Coronaviruses, HIV, HBV, HCV H1N1 and H5N1.

Transmission of these pathogens to patients or members of the dental team can happen either directly or indirectly (cross contamination). Studies have shown that the area potentially becoming contaminated during treatment practically encompasses the whole room.

And with many items temporarily or semi-permanently stored on work surfaces, the importance of maintaining these areas is vital. To combat this, disinfection should be made as easy as possible and ideally extend to all work surfaces.

 

What’s the best way to disinfectant dental surfaces?

Removing harmful viruses and bacteria from dental surfaces requires cleaning and disinfection. This can be done in either two stages or simultaneously. In a two-stage process, surfaces are first cleaned using a detergent. This is to remove soil (protein-based material like pus and blood) from a surface. This is followed by disinfection of the surface to kill or inactivate microorganisms using a wipe or spray.

In a one-stage process, simultaneous cleaning and disinfection is done with the use of multipurpose pre-saturated wipes that clean and disinfect in one go. All in one wipes, such as Biocleanse from Dentisan, are preferable for treating surfaces between patients because they are time saving and easily disposable.

Properties to look for in a disinfectant wipe

The two most important characteristics of an effective disinfectant wipe are spectrum of activity and efficacy. Spectrum of activity relates to how many different viruses and bacteria the wipe can kill or inactivate. Efficacy relates to how efficiently the wipe kills and inactivates. The best disinfectants will be clinically proven against a broad range of microorganisms, such as bacteria, non-enveloped viruses, fungi and yeast. The wipes should also be compatible with a wide range of surface materials.

Other important considerations include:

• Contact time - The amount of time the disinfectant needs to remain in contact with the surface to kill or inactivate microorganisms
• Safety – is the wipe/spray safe for frequent use, and can it be disposed of without harming the environment?
  
  

 

Alcohol or non-alcohol wipes?

Disinfectant wipes are available with or without alcohol. Both can be used for cleaning multiple surfaces in the dental practice and have a broad spectrum of virucidal, bactericidal and fungicidal activity. Alcohol wipes come with different alcohol percentages. Some contain as much as 70% isopropyl alcohol (Azo Wipes), while others contain as little as 17% (CaviWipes). Non-alcohol wipes are free from isopropyl and all other types of alcohol. Most of these products are types of quaternary ammonium compounds (quats).

While both alcohol-based wipes and quats kill a wide range of bacteria and viruses, alcohol wipes tend to kill more microorganisms. Both alcohol-free and alcohol wipes provide rapid speed of action, requiring less than a one-minute contact time in most cases. Alcohol-free wipes are often preferred for wiping certain surfaces in the practice, such as chair covers and glass, as alcohol wipes can discolour or harm these materials over time.

 

How to properly use disinfectant wipes

Manufacturer instructions on contact time, dilution concentrations and technique should be followed always. Even in a one-stage process, it is recommended that surfaces first be wiped clean to remove any visible material before being wiped again to kill pathogens. Wipes should not be used across surfaces to avoid cross contamination.

 

What are the relevant surface disinfection guidelines?

When disinfecting dental surfaces it is important to be conscious of the following HTM 01-05 recommendations:

• All work surfaces where clinical care or decontamination is carried out should be impervious and easily cleanable.
• The dental practice should have a local protocol clearly outlining surface- and room-cleaning schedules.
• The use of disinfectant or detergent will reduce contamination on surfaces.
• The patient treatment area should be cleaned after every session using disposable cloths or clean microfibre materials – even if the area appears uncontaminated.

European EN standards tests related to spectrum of activity are also important to observe. These include:

• EN1276 and EN13727 - Pseudomonas aeruginosa, Staphylococcus aureus, MRSA, VRE, E.coli
• EN14476 - Norovirus, HIV, Hepatitis C, MERS Coronavirus, Influenza A H1N1
• EN1650/EN13624 - Candida albicans
• EN 14348 – mycobactericidal, tuberculocidal
  
  

 

Beware cheap disinfectants

Since the onset of the Coronavirus pandemic, lots of cheaper surface disinfectants began appearing on the market, especially via the internet. Many such products are unproven and can only claim limited efficacy against bacteria or simple viruses, rather than providing the broad spectrum microbicidal action required by dental practices. These products can also contain chemicals that can potentially damage surfaces and equipment, leading to unnecessary downtime and expense.