Breaking the Chain of Infection

The first link in the chain is the pathogenic agent that causes infection or disease. Infectious agents include viruses, bacteria, parasites, and fungi.

The next link is the reservoir, which is the place in the environment where pathogens live. A few examples of places where pathogens may be living in the dental office include people, dental units, and waterlines.

A portal of exit is the way in which the pathogen leaves the reservoir. Portals of exit in your operatory include—to name a few—aerosols, blood splatter, and saliva.

Mode of transmission is the way the pathogen is transferred to another person. Modes of transmission during hygiene procedures include unsafe sharps use, inhalation, and direct contact.

The portal of entry is the way the pathogen enters a new host. This portal of entry can be a person's respiratory tract, skin if it has cuts or abrasions, and the eyes.

The last link in the chain of events is a susceptible host. This is an immunocompromised person or someone without a strong immune system or antibodies against the pathogen.

On average, healthcare professionals do not clean their hands as thoroughly as they should or as often as they should. Manual handwashing with soap and water or the use of an alcohol-based rub is effective only if performed properly.

Consider adding an automatic hand washing machine that cleans both hands effectively. This creates more compliance because machines can take less than 10 seconds, leaving your hands not only clean but moisturized as well. They can be invaluable tools in the prevention of infection. There are many different models available.

Cross-contamination is real, so it is critical that all team members receive adequate training in infection prevention and safety measures. Training should be conducted at least annually and upon adding additional duties. Attending training together as a team is best, so that everyone is on the same page.

Technology has made it easier when getting together in person is not an option. You can sign up for a virtual live team training or choose an online course that you can take together. Or, as a last option, take classes individually.

Have solid standard operating procedures (SOPs) that all team members are trained in.

Creating SOPs does not have to be daunting. There are apps and templates available to help you write your custom SOPs.

Infectious patients should not be allowed to enter the front door unless your clinic specifically treats them.

Using a HIPAA-compliant patient messaging system will allow your scheduling coordinator to send out prewritten questions asking patients if they have any symptoms of an infectious disease. Always let your patients know that they must call you to reschedule if they develop any symptoms up to their appointment time.

If all else fails and you yourself develop symptoms, you should not enter the front door either.

Have a policy in place so that you know how to notify the practice that you will be keeping them safe by staying home.

Having a policy that includes the use of text messaging or other messaging apps will allow you to notify your co-workers promptly and allow you to rest. They will also be aware to look out for symptoms themselves.

The infection cycle is a chain of circumstances that must be present for an infection to spread. By adding technology and innovation, you can break the chain and prevent infectious diseases from reaching your operatory.

Cindy Rogers, RDH, is a healthcare compliance consultant and speaker who specializes in dental infection control and team culture. She joined the dental profession in 1998 and has been practicing dental hygiene for the past 10 years. Rogers is also the host of the Dental Alements Podcast. Visit her website for information about future courses: https://www.rootuon.com/about/.