#3 – Clean, sterilize treatment areas

Our very purpose for existing is to provide a health service. Clean and sterile are healthy.  Anything less is inexcusable. Your responsibility is to keep the entire treatment area spic and span.  Let’s look at your responsibility area by area. Every Monday and Thursday morning when you come in make up a new solution of Dentaphene.  Keep a spray bottle between operatories for easy use.

1. Operatories:  Since we are a busy practice, you may need to clean some of them while a dentist is working in other rooms. The doctor and his staff will work around you.  You have the priority.  At end of day when you do the final cleaning in a room, tell them which rooms are clean so they don’t use them and force you to reclean.

Each room should have its own bottle of dentaphene.  Glutaralehyde’s can’t be used for this.  The fumes are toxic and evaporate too fast.  Put the spray bottle nozzle near the surface with a paper towel behind the surface to catch extra spray, and wet the surface.  If you hold the nozzle away from the towel, the spray will escape and you will breathe the vapor that could be dangerous.  Wipe the surface thoroughly. Spray again and let air dry for 2-10 minutes (follow manufacturer’s recommendation).  If the surface is still wet when the client is to be seated, towel it dry.

The surface is adequately covered when it glistens.  Any more and it will run off.  Any less isn’t enough.   Each room should be thoroughly cleaned after each client plus four times extra per day of complete thorough cleaning.

Four best times:

  1. First thing in morning
  2. End of morning
  3. First thing after lunch
  4. End of day

Every 3 days a new solution of Iodophors (Dentaphene) ‑ is made up.  Keep a spray bottle in each operatory in the cabinets under the sinks. When using dentaphene remember to always “spray, wipe, spray, and air dry”.

Clean an operatory:

Put all used barriers and handpieces on the instrument tray.

Handpieces, air/water syringes, cavitrons:

1.  With a bur in the handpiece run the handpiece, syringe, or cavitron 20 seconds with water to flush the lines

2.  Remove the bur and wipe down the handpieces

High and low speed suctions.  Large aspirators are cleaned by running a brush through connector. Clean basket collector in small suction.  Run Evac through each of 3 suctions when done with that room at the end of the day.

Use Dentaphene(EPA registered disinfectant for both cleaning and disinfecting, use spray, wipe, spray)  on:

All uncovered surfaces – use gloves, eye protection, and mask

  1. Counter tops
  2. Chair ‑ switches, arms, headrest
  3. N2O inhaler
  4. Pens, pencils
  5. Amalgamator
  6. Pulp tester
  7. Sinks
  8. Doctor and assistant carts.

Be careful!  Overspraying can cause a mist in the operatory that can cause:

  1. Allergic reactions
  2. Breathing problems
  3. Eye irritation
  4. Hand/skin irritation
  5. Discoloration, breakdown of plastic or metal surfaces

After the operatory is clean, cover the surfaces that can’t be disinfected or you need to use immediately  with Reynold’s plastic wrap.

Light handles

Light shield ‑ dry paper towel (liquids can permanently cloud the lens), overhead light switch

Air/water syringe

X‑ray head

Replace the chair bag

X-ray controls

 

Put all instruments and disposables on blue tray and carry to sterilization area throw away all disposable items put instruments into holding solution if not ready to continue cleaning when ready ‑ place instruments in ultrasonic cleaner remove cover from tray and throw away. Spray tray and leave until dry then bag and store.

End of day:

1.  Clean light covers

2.  Flush Dentaphene through the large and small vacuum (suction) lines

 

Lab/ Sterilization area      

Counter tops

Lathe ‑ Change pumice weekly and autoclave rag wheels after each client

Microscope – keep cover on

Sinks ‑ end of day ‑ wipe with Dentaphene

Light curing equipment

Lead aprons, collars

Impression tray cleaner ‑ 2 scoops of orange powder to bucket of cold water ‑ clean all trays and return to tray holders daily

Keep plaster/stone containers filled

Other areas

1. X‑ray Room + x‑ray aprons daily

2. Preventive care area ‑ Clean mirrors, counter, sinks, and chairs with Dentaphene

3. Lead aprons ‑ remove all stains, etc.

4. Pulp tester ‑ clean case, probe

 

You will be assigned one or more rooms to deep clean. The list is kept: __________

Operatory

Responsible Person

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

This deep clean will include:

Operatory chairs and bases

All hoses

Cabinets

Counter tops

X‑rays

Carts

Lights above dental chairs

Sinks

Vacuum line traps

 

Lab Cross-Contamination

Disinfect all lab cases when sending out and receiving ‑ if not already disinfected.

Change burs, polishing items, rag wheels, etc., and disinfect or autoclave between patients.

Clean new lab cases with dentaphene.

Pressure pot ‑ change water and spray down between cases.  Use barrier in water, like a plastic bag.

Keep Dentophene and bur jar in lab.

Remember in the lab, infection can be transferred by surface contact, handpieces, burrs, pumice pans, dust/mist, unwashed hands, and aerosolization.

 

So how do I remove stains or other special problems?

Grease on wall paper ‑ cover with a paste of cornstarch and water let dry and scrape off

Vomit on carpet ‑ scoop up as much as possible, wash with soap and water, cover with a mixture of baking soda and water – vomit spill kits are kept in the storage closets

Scratches on wood ‑ cover with brown shoe polish and buff

Blood stains ‑ cover with cornstarch/water mixture, expose to bright light

Phone disinfection ‑ wipe off with alcohol or germicide

Ink ‑ wipe with a vinegar/milk mix

Carpet stains ‑ cover with wet cornstarch, wait 15 minutes, vacuum

Deep Clean Rooms

This should be done 1 time each month to the room(s) you are assigned.  Include these items:

  1. Floorboards
  2. Entire assistant cart
  3. Entire doctor cart
  4. Sinks
  5. TV & VCR’s
  6. X-ray machine
  7. Chair bottom/foot pedals, etc.

 

Vomit Spill Kit

Can be used on many types of spills:  blood, urine, vomit, oil, and most liquids.

Kits are located: __________

In these kits you will find:  gloves, trash bags, masks, dust pan with broom, and super-sorb.

How to use:

A.)   Use all universal precautions.

B.)    Shake can of super-sorb and sprinkle all over spill or vomit.

C.)    Wait 30-60 seconds.

D.)   Sweep up with a broom and dust pan and put into a trash bag.

E.)    Dispose of in an outside dumpster.

F.)    Thoroughly disinfect area.

G.)   Please make sure you restock the vomit kit with proper tools, disinfect anything that needs disinfected, and put back in it’s proper place.

Extra super-sorb is kept under the sink in the lab.  If you get the last one, please reorder.

 

Date review completed ____________________

Person reviewing  ___________________________