Dentisan Brochure August 2020 by HenryScheinUK

Practice Infection Control Catalogue

Taking care of everything dental

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As UK dental practices return to practice, concerns for the wellbeing of staff and patients will be a high priority. In addition to the regular infection control measures, there are obviously heightened concerns about public health threats in reception and waiting areas. The measures required by HTM 01-05 should be carefully followed, together with any Covid-19 specific instructions issued by the UK Government.

MAINS WATER SUPPLY

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Flush all mains water supplies to remove stagnant water that has been static during closure. This is

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Equipment used for water purification should also be cleaned and flushed in accordance with the

particularly important where there are storage tanks. manufacturer’s instructions before use.

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DENTAL UNIT WATERLINES (DUWL)

Recommissioning of DUWLs Your treatment centre is the most important equipment in the surgery and Dental Unit Water Lines should have been cleaned before closure by using a biofilm remover and the same process should be applied prior to use. Following guidance in HTM01-05 section 19.12, a suitable biocide that removes biofilm is particularly useful when chairs have been inactive for a period. This will help provide water of a quality that remains within guidelines (less than 200 cfu/ml). Testing of input and output water from DUWLs should be completed using dip slides and recorded prior to seeing patients. Bioclear should be left in DUWLs for 12 hours and ideally overnight, before flushing out with RO or distilled water. HTM 01-05 guidelines on recommissioning DUWLs need to be carried out before units are re-used:

19.12 In the absence of manufacturers’ guidance, flush the DUWL for at least three minutes, disinfect the DUWL with a suitable disinfectant (as recommended by the manufacturer for routine disinfection of the DUWL), then flush for a further three minutes.

19.13 Where in-line filters are used, these will require treatment using a cleansing solution that has been recommended by the manufacturer. This step should be performed after first flushing the DUWL. Note: Care should be taken to minimise the occurrence of splashing and aerosol formation. 19.14 If DUWLs have disposable filters, they should be replaced.

19.15 Self-contained water bottles (bottled water systems) should be flushed with distilled or RO water. Where

visual contamination is present, flushing with a suitable disinfectant followed by thorough washing is necessary.

The manufacturer’s instructions will specify which disinfectant to use. In instances where visual contamination is routinely detected, it will be necessary to decrease the interval between flushing operations. If good practice is followed, practices should not routinely detect evidence of visual contamination.

Note: The self-contained water supplies used for dental care systems should be distilled or RO water (see Chapter 17).

19.16 As part of the recommissioning, dental equipment requiring protection against backflow should have the anti-

retraction valves (incorporated on handpieces or waterlines) checked by the responsible person. They should ensure they are suitably decontaminated, refitted correctly and are operating in the correct manner. Examples of dental equipment requiring backflow protection are: •

dental spittoons;

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ultrasonic scalers;

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three-in-one syringes;

Recommended products • Bioclear box of 12 bottles • Bioclear Daily

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wet-line suction apparatus; and

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self-filling automatic radiographic processors (where still used).

• Dip Slides pack 10

• While virus contamination of waterlines is not expected, bacterial biofilms can develop very quickly. It is recommended that HTM 01-05 process is followed, using Bioclear to disinfect the DUWL before use.

• DUWLs should be maintained in accordance with HTM 01-05 using Bioclear Daily to maintain water quality and Bioclear as a periodic purge cleaner and disinfectant to deal with any biofilm build-up in the system.

Bioclear®

•• Weekly biofilm remover for dental unit waterlines.

•• Attacks constituent bacteria of biofilm, inhibiting regrowth and ensuring water quality is within guidelines. •• Ready-to-use, pH neutral.

1116307 Kit: Bioclear 200ml x 12 and Rinse Test Strips x 50 1189080

Bioclear Daily 1L

Accessories

1116308

Biological Dip Slides x 10

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Medical device surface cleaning & disinfection and the Coronavirus By Laura Yates BSc CChem MRSC, Technical Manager at dentisan.

Whilst the world is focussed on hand hygiene, let’s not forget the importance of surface cleaning and disinfection as part of the fight against COVID-19 in the dental surgery. What started as reports of a previously unknown virus causing serious illness in the Chinese province of Hubei has now become headline news around the world, as the battle continues to stop the global spread of COVID-19. COVID-19 is a respiratory disease caused by a new strain of coronavirus. Coronaviruses are enveloped viruses known to infect both humans and animals. In humans these pathogens cause respiratory illnesses ranging from the common cold to far more serious infections including severe pneumonia and bronchitis. With regards to surfaces within a practice, both cleaning and disinfection are required processes, but importantly cleaning must take place before disinfection to ensure that bacteria, proteins and other contaminants are removed from surfaces before disinfection takes place. This is why a single stage process which combines cleaning and disinfection is often the preferred choice for dental nurses. It is known that coronavirus can remain active on surfaces for up to 10 days, therefore surface cleaning and disinfection are of upmost importance in tackling the transmission of the virus. Biocleanse Ultra has proven efficacy against enveloped viruses such as Vaccinia virus, HIV, HBV and HCV H1N1 and H5N1. It is therefore expected that Biocleanse Ultra will have efficacy against coronavirus (also an enveloped virus). As this is a novel virus, specific testing on the COVID-19 strain is not yet available. The suitability of alcohol for disinfection of hard surfaces remains questionable. Despite being an effective disinfectant in clean conditions, alcohol is not effective as a cleaner, especially with proteinaceous soils. It evaporates very rapidly in use, limiting the effective contact time. In addition to its volatility, alcohol is highly flammable, and is incompatible with common surgery surfaces such as PMMA and upholstery. More worrying is that alcohol acts to fix proteins to surfaces, a problem highlighted in HTM 01-05. Section 6.57 that states, “…the presence of protein will compromise the efficacy of alcohol-based wipes. Note: Alcohol has been shown to bind blood and protein to stainless steel. The use of alcohol with dental instruments should therefore be avoided.” Biocleanse Ultra Wipes are a single-stage cleaner and disinfectant. They can be used for both cleaning (where a detergent wipe may be called for) and disinfecting, or both where appropriate. The wipes are wetted with a non-alcohol formulation so there is no concern of fixing protein to a surface, which is a significant issue with traditional alcohol wipes. The COVID-19 outbreak, along with a significant rise in cases of other viral illnesses, including mumps and measles, puts a spotlight on how easily infections can spread, and ultimately how they can be prevented using stringent infection control procedures. For the dental team and patients alike, such measures drastically reduce the likelihood of contracting any infection in the dental surgery. By complying with government guidelines on hand hygiene, surface cleaning/ disinfection and safe practices, as well as understanding how to break the chain of infection and how pathogens are transmitted, makes it far easier to take the correct preventive and control measures.

Laura Yates BSc CChem MRSC Technical Manager

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SURFACES AND EQUIPMENT

Coronavirus is an enveloped virus and is likely to remain active on hard surfaces for days or weeks. Biocleanse Ultra has proven efficacy against enveloped viruses such as Vaccinia virus, HIV and HCV. After being closed for a prolonged period every surface in the practice will need to be cleaned and disinfected and both of these are required processes. Importantly, cleaning must take place before disinfection to ensure that bacteria, proteins and other contaminants are removed from surfaces before disinfection takes place. An alcohol-free, all-in-one formulation with efficacy against bacteria, fungi and enveloped viruses will provide a fast and effective solution. Biocleanse Ultra has proven efficacy against bacteria, fungi and enveloped viruses, and cleans and disinfects in one solution and is compatible against all common surgery surfaces. Save time on cleaning floor surfaces by using a single stage cleaner and disinfectant. It is advisable to use colourcode mops and cloths according to the zone in which they will be used (kitchens/washrooms/offices/clinical and decontamination areas). This will reduce the risk of transmitting pathogens between areas. Dentifloor has proven efficacy against bacteria, fungi and enveloped viruses. Simply dilute with clean water to make a 20ml per litre solution. •

Biocleanse Ultra can be used to clean and disinfect medical device surfaces on a regular basis, in accordance

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Cleaning and disinfection of reception, office and waiting areas should also be undertaken.

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with HTM 01-05.

Frequently touched surfaces should be frequently decontaminated.

Biocleanse Ultra is a single-stage cleaner and disinfectant.

Wipes are wetted with a non-alcohol formulation so there is no concern of fixing protein to a surface, which is a significant issue with traditional alcohol wipes.

Section 6.57 of HTM01-05 states “…the presence of protein will compromise the efficacy of alcohol-based wipes.

Note: Alcohol has been shown to bind blood and protein to stainless steel. The use of alcohol with dental instruments should therefore be avoided.”