Picture a generic dental surgery in your mind. Close your eyes, just for a second, if it’ll help.
What do you see? Alongside a treatment centre, a wide array of cabinets, and perhaps an extraoral radiograph system, there are subtle details your mind will have already filled in. The room will no doubt be bright, but one odd element that you may have thought about without realising is that the flooring will likely be a vinyl covering, or something similar.
It seems like a strangely specific aspect, but if it was true for you, it’s important to think why – and what it says about the importance of surface contamination control.
Managing amalgam spills
Using vinyl flooring in a dental practice over a material that may bring more comfort underfoot – such as carpet – is one of function over form. It all links back to the materials used in dental care and the potential knock-on effects of accidental spills and exposures. Carpet, in particular, is not recommended where amalgam (and its mercury contents) can accidentally spill.[1] And since the placement and removal of amalgam fillings is still a mainstay in modern dentistry, it is sensible to avoid this flooring choice in clinical areas.
The recommendation is primarily made because chemical decontamination of carpets may not be effective, with mercury droplets able to seep through the material and avoid a decontaminant kit.1 Spillages could therefore create the risk of long-term mercury inhalation, especially if the material is consistently spilt over time, and cannot be properly removed. The inhalation of elemental mercury can cause nausea, vomiting and flu-like symptoms, as well as coughing, breathlessness and chest pain.[2] Professionals working in dental practices are recognised to be at an occupational exposure risk.2
The admission of carpets from dental surgeries is not only to avoid contact with amalgam products but also exposure to other bacterially contaminated products that may not be easily removable. This includes biological fluids, blood, and potentially even water from a damaged dental unit water line.
By taking this one example of the considerations regarding contamination and infection risks in dental practice, we can look wider at the actions needed to protect clinicians and patients. Amongst these surface cleaning is essential for ensuring a safe and efficient practice.
Lying in wait
It is well known that bacteria can survive on surfaces for an extended period, depending on the type of infectious agent and the surface material itself.[3] Dentists will be familiar with the ability of bacteria to adhere to biotic surfaces, such as teeth, in an environment where they can thrive, multiply, and cause direct harm to the oral cavity. On abiotic surfaces like the dental chair and surgery countertops, for example, microorganisms may be able to retain infectivity for hours, days and weeks at a time. Severe acute respiratory syndrome (SARS) Coronavirus (CoV) (which caused an outbreak first recognised in 2003[4]) remains effective for up to nine days on an abiotic surface, which pales in comparison to the influenza virus, which can present a risk for up to four weeks.3 Whilst they are both airborne viruses which can also be transmitted through hand-surface contact, their structures and features make them survive differently on inanimate surfaces.
The extensive periods in which microorganisms can survive in the dental practice must be combated by implementing effective hand and surface hygiene measures that minimise the spread of infection. Similarly to the preference of carpets over vinyl flooring, conscious steps must be taken immediately to protect patients and practitioners alike.
Pathogen control, decontamination and cleaning, and hand hygiene should all be key aspects of staff induction programmes, and each aspect should have its own practice policy according to Health Technical Memorandum 05-01.[5]
Actions should be taken to directly remove the source of infection when it contaminates a surface. This might involve the use of a surface cleaner or, in the case of exposure to products such as amalgam and blood, a dedicated spillage and decontamination kit.
Initial Medical can help clinicians reduce the incidence of cross contamination in everyday practice by providing a range of solutions that aid surface infection control. Alongside a Mercury Spill Kit, which contains all of the necessary solutions to remove mercury beads and contain recovered material safely, clinicians can also access high-quality handwashing products for gold standard infection control. This includes the alcohol-free UltraProtect™ Hand Sanitiser, which kills 99.9% of germs and provides up to eight hours of hand surface protection.
Understanding the risks posed by bacteria lying dormant on the surfaces in the dental practice is essential. By enacting effective protocols, including hand hygiene and spillage control workflows, simple changes can be made to optimise safety – without ripping up the floorboards first.
To find out more, get in touch at 0808 304 7411 or visit the website today www.initial.co.uk/medical
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] Rathore, M., Singh, A., & Pant, V. A. (2012). The dental amalgam toxicity fear: a myth or actuality. Toxicology international, 19(2), 81.
[2] UK Health Security Agency, (2022). Mercury: general information. GOV.UK. (Online) Available at: https://www.gov.uk/government/publications/mercury-properties-incident-management-and-toxicology/mercury-general-information [Accessed December 2024]
[3] Kramer, A., & Assadian, O. (2014). Survival of microorganisms on inanimate surfaces. Use of biocidal surfaces for reduction of healthcare acquired infections, 7-26.
[4] World Health Orgnaisation, (N.D.). Severe Acute Respiratory Syndrome (SARS). (Online) Available at: https://www.who.int/health-topics/severe-acute-respiratory-syndrome#tab=tab_1 [Accessed December 2024]
[5] Department of Health, (2013). Decontamination, 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 2024]
