In early December, Professor Meghana Pandit, the NHS national medical director, said that the severe impact of flu cases had led to the “worst-case scenario for this time of year” in hospitals across the country.[i] Seasonal viruses are, to an extent, predictable; we expect the winter months to bring an increased risk of infection, and understand that this will put a strain on services. Quite how volatile a seasonal strain will be is another question altogether.
In the dental practice, it’s paramount to protect patients and staff from seasonal viruses. Since the COVID-19 pandemic, the general public have a heightened understanding of good infection prevention measures, but this has always been vital for dental professionals.
It’s important to regularly revisit the steps you have in place in your practice to prevent the spread of viruses on site.
Severe impacts
Seasonal influenza viruses are not confined to the winter season, but are typically more prevalent during the colder months as people spend more time indoors. Each year, between 5-15% of the world’s population is affected.[ii] As these viruses rapidly evolve, they surpass the immunity built up by prior infections, meaning patients can become ill year after year, with mitigation available in the form of regularly updated flu vaccines.ii
Patients may be advised not to present to the practice if they have cold or flu symptoms, but individuals with minor issues may still be allowed to visit if they are struggling with oral pain. If a patient does have seasonal flu and requires emergency care, it’s recommended that their appointment is scheduled late in the day to minimise contact with other patients, and aerosol-generating procedures should be minimised.[iii]
Members of the dental team who succumb to the flu or any other seasonal illness will need to spend time away from the practice to protect against onward spread to their colleagues or patients.
Risk in the air
Mitigating risks of airborne transmission year-round is vital.Influenza is typically spread through opportunistic airborne transmission, where contact and droplet transmission are the primary methods of spreading infection, but inhalation of aerosol particles is also a prominent risk.[iv]
Aerosols and droplets may be produced when an individual coughs or sneezes, but clinicians may also create these when performing procedures in the oral cavity, through the use of high-speed instruments and scalers. This creates both near-invisible particles, in the form of aerosols, and larger droplets, in the form of splatter.
The literature has recommended that practice teams and patients take steps like using preprocedural mouth rinses, high volume evacuation (HVE) systems, air purification systems and personal protective equipment (PPE).[v] Each is found to be effective, with suction devices playing a notable role in reducing the dispersion of aerosols into the treatment environmentv – studies show that suction devices used with low-volume saliva ejectors reduce contamination by almost 62%.[vi]
However, due to opportunistic airborne transmission, it is not simply enough to control aerosol projection; seasonal influenza germs can survive on hands and surfaces for up to 48 hours.[vii] Controlling the risk of physical contamination is therefore just as important.
A hands-on approach
Alongside the thorough decontamination of dental instruments, surface cleanliness and hand hygiene are paramount to avoiding the spread of infection, especially during peak winter illness seasons.
Training on infection risk reduction should be part of staff induction programmes, as per Health Technical Memorandum 01-05.[1] As part of this, hand hygiene is crucial for preventing the spread of infection and requires clinicians to perform the routine at the following key stages:
- Before and after each treatment session
- Before and after the removal of PPE
- Following the washing of dental instruments
- Before contact with steam-sterilised instruments
- After cleaning or maintaining decontamination devices
- At the completion of decontamination workviii
Practices should locate an effective soap at cleaning stations, and position hand sanitisers at frequent touchpoints, as well as in patient areas for visitors to use. These should come from a trusted provider such as Initial Medical, a leading UK-based hygiene and medical waste service provider. The UltraProtect™ Hand Sanitiser from Initial Medical is an alcohol-free solution that is equally powerful, gentle and long-lasting. It kills up to 99.99% of germs, including Norovirus, Swine Flu and MRSA, and provides 8-hour hand surface protection.
Protecting patients and practitioners against seasonal infections helps to ensure the practice can consistently provide high-quality care and maximise the health of your community.
To find out more, get in touch at 0808 304 7411 or visit the website today www.initial.co.uk/medical
Author: Rebecca Waters – Rentokil Initial
About Initial Medical
Initial Medical set the standard in healthcare and infectious waste management in the UK, providing a reliable, effective and fully compliant service built around customer needs and delivered by our highly trained local teams. We are ISO 9001:2015 accredited, with technology fully integrated into our operations, providing full traceability of service delivery, electronic waste documentation and the best customer experience possible. We also offer innovative healthcare waste management services and infection control products to help break the chain of transmission and prevent cross contamination.
Initial Medical are a company with a ‘World Class’ Health and Safety record, and ISO 45001:2018 accreditation. We are also accredited to ISO 14001:2015 environmental standards and pride ourselves on our sustainable approach with a focus on delivering eco-friendly products and operational solutions.
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[1] Department of Health, (2013). Health Technical Memorandum 01-05: Decontamination in primary care dental practices. (Online) Available at: https://www.england.nhs.uk/wp-content/uploads/2021/05/HTM_01-05_2013.pdf [Accessed December 2025]
[i] Thomas, T., (2025). NHS ‘facing worst case scenario as hospital flu cases jump 55% in a week. The Guardian, (Online) Available at: https://www.theguardian.com/society/2025/dec/11/nhs-worst-case-scenario-hospital-flu-cases-jump-week [Accessed December 2025]
[ii] Petrova, V. N., & Russell, C. A. (2018). The evolution of seasonal influenza viruses. Nature Reviews Microbiology, 16(1), 47-60.
[iii] Bromberg, N., & Brizuela, M. (2023). Preventing cross infection in the Dental Office. In StatPearls [Internet]. StatPearls Publishing. (Online) Available at: https://www.ncbi.nlm.nih.gov/sites/books/NBK589669/ [Accessed December 2025]
[iv] Ratnakaran, K. A., & Sahoo, H. S. (2020). Risk of airborne infection and transmission-based precautions in dental setting. Journal of Operative Dentistry & Endodontics, 5(1), 18-24.
[v] Saini, R. S., Binduhayyim, R. I. H., Mosaddad, S. A., & Heboyan, A. (2025). Strategies for preventing aerosol-generated microbial contamination in dental procedures: A systematic review and meta-analysis. American journal of infection control.
[vi] Noordien, N., Mulder-van Staden, S., & Mulder, R. (2021). In vivo study of aerosol, droplets and splatter reduction in dentistry. Viruses, 13(10), 1928.
[vii] Norfolk and Norwich University Hospitals, (2023). Information about Seasonal Influenza (‘Flu) for Patients, Relatives and Carers. (Online) Available at: https://www.nnuh.nhs.uk/publication/information-about-seasonal-influenza-flu-for-patients-relatives-and-carers-2/ [Accessed December 2025]
