The objective of the study was to determine the level of knowledge, practice, and attitude of dental professionals in the UK orthodontic departments regarding cross infection control in dentistry. Dental professionals are at a high risk of cross-infection during dental treatments. The occurrence of certain infectious diseases such as herpes simplex, hepatitis B, and tuberculosis has been significantly high amongst dental professionals since much dental staff fails to implement effective procedures and precautions regarding infection control. A review of the literature was completed to inform that a questionnaire was designed to collect information about procedures and policies used for the prevention of cross-infection in orthodontic departments. It determines the awareness and attitude of orthodontics to their procedures in 2008. The five main areas that were focused on include education and personal protection, training, the clinical environment, decontamination of instruments, disposal of waste, and decontamination of appliances and impressions. Most of the orthodontics complied with the use of barrier techniques such as gloves and mouth mask during patient care, training in cross infection control, policy to check staff immunization status and decontaminate impressions/appliances at the chairside. Overall, cross-infection plays a significant role in the dental field regarding patient/staff safety and ensure to keep a high standard of cross infection control.
Keywords: Safety, cross infection, UK orthodontic, infection control, prevention, dental environment.
The Importance of Cross-Infection Control in Dentistry
The objective of this study is to evaluate the level of consciousness and regulate the practice of cross infection control between dental professionals. Cross infection control is the prevention of transfer of harmful microorganisms, such as viruses and bacteria. The spread of infections can occur within the body, between people, or pieces of equipment. It plays a significant role for all healthcare professionals and it can lead to client’s safety if the gap is not addressed. Shah (2009) attempted to research the UK orthodontic departments on how they had executed rules and procedures which would guarantee a high standard of cross infection control (Shah, Collins, Hodge, ; Laing 2009). The five keys areas that could be experimented on, including training, education and personal protection, the clinical environment, decontamination of instruments, decontamination of appliance and impressions, and disposal of waste to ensure a high standard. According to these experimental results, the development method of study is going to perceive which is most effective through targeted participants, outcome measures, and sample sizes to keep the high standard of cross infection control.
Review of Literature
Dental healthcare professionals are at risk of infection control during pre and post dental treatment worldwide and possibly can lead to clients as well. Regardless of being mostly avoidable, these infection controls are a significant contributor to client death and illness and are pricey to the health care world. The instructions became essential for standard infection control because it was proof that dental professionals contaminated themselves and patients to the danger zone for serious infectious diseases, such as HIV, tuberculosis, and hep B and C. Meanwhile, much dental staff fail to execute effective protections and techniques concerning infection control. In the UK orthodontics blind observational study, one of the results shows eight percent, which is five of the offices answered “no” to disinfect the dental waterlines and suction tubing (Shah, Collins, Hodge, ; Laing, 2009). Somewhat it was a rule to just disinfect the suctions rather than the waterlines (Shah et al, 2009). The dental unit waterlines play an important role in the dental field as it is used daily by dental professionals. For it not to be clean thoroughly, bacteria such as biofilm can form in the tube of the waterline. It can deliver water to the dental handpiece used in client care and ultimately causes infection/disease to the client.
In the UK orthodontics studies, everyone was invited to participate included all the orthodontic departments and hospitals. The studies consist of blind observational and questionnaires, which focus on the clinical environment, decontamination of instruments, disposal of waste, training, and decontamination of appliances and impressions (Shah et al, 2009). These researches help to establish the compliance of the team with their current cross infection control tactics and techniques. A second study is a cross-section study, which was conducted in Ernakulam city, India with some of the private offices and some respondents from the public. The questionnaire study was developed, it had two languages for better understanding: a self-administered in English and the other one is the same but in local language Malayalam. It divided into two parts: the demographic information and the second consisted of questions on the knowledge and practice of infection control measures (Taha, Joseph, Janakiram, ; Puttaiah, 2015). The third study is the questionnaire for dental assistants from private and public offices. This survey is to evaluate dental assistants’ skill concerning infection control accountability, disposal of clinical waste, aseptic method, and application of OSHA.
The three studies for infection control mentioned above is from different countries of the world. One similarity between the three studies is the questionnaire method, which is to seek the knowledge of dental professionals and understand the weakness. Another method that was being used in the UK orthodontic was a blind observational, which focus on the five key areas mentioned above to receive results from different participants and follow up on offices need to do a better training for their staff. The study in India used data collection as their method to retain all the information from the participants. Every single clinic in this study was personally visited by the investigator and the questionnaire was provided to the clinician present in the clinic (Taha et al, 2015). The investigator was only present to help the dentist in understanding the questionnaire, but the not interfere with the response or completion of the instrument by the respondents (Taha et al, 2015). The determination was to see what the area was missing and need more training to guarantee a high standard of infection control purposes. Lastly, the dental assistants’ study used to survey for their experiment to acquire the skill level of dental assistants consider infection control procedures and obtain information about the weakness areas for dental assistants.
The results in the three studies were like each other, as in most of the dental professionals does follow all the methods and procedures to make sure a high standard of cross infection control was delivered to clients. For example, the autoclave was the most common technique for the sterilization of instruments in all three studies. An outcome from the UK orthodontics showed 98% of participant followed all the infection control processes in different areas of the offices to prevent cross-contamination and client’s health (Shah et al, 2009). The result of a study in India showed that many of the dentists obeyed with the practice of barrier protection procedures, such as gloves and masks. In between the studies from India, a few offices were still not quite meeting the standard care of clients due to lack of training staff the proper way or financial issue. For instance, the outcome showed half of the dentists that participated didn’t know nor had their assistants’ staff immunized against hepatitis B and delivered unsuccessful technique of sterilization. Vaccination performs a huge part in the dental field, as it prevents the spread of diseases toward patients and staff. The third results for dental assistants’ study showed participants that have more experience developed more knowledge compare to the fresh ones in the field. Most of them, 92%, stated that infection control responsibility is the responsibility of all dental staff (Mustafa, Humam, ; Al-Mosuli, 2015). Overall, there was a small gap for results in between these three studies for infection control.
These studies combined altogether showed the significance of infection control and the gap for clients at risk can become larger if issues weren’t addressed, especially in the poor areas of the world. The main point out of these researches was dentists needed to keep themselves up to date about protocols and be able to carry out these guidelines successfully to their auxiliaries to secure a high standard of clients’ care. There were differences in dental professionals’ knowledge, skill, and commitment to infection control techniques both within established and establishing countries of the world. The setting is divergent in different countries, and some evaluate will involve money restrictions, but dental professionals’ knowledge should be the same and the small gap needs to be addressed. Results of these researches exposed that the level of infection control executed by the private dental offices in the city was insufficient in a few zones. It was found necessary to educate, raise awareness, and promote continuing dental education aimed at improving dental safety (Taha et al, 2015).
Methods and Procedures
Infection control plays an important part in the dental field and should serve as the basis for a safe, high-quality, and healthy treatment environment for clients. Client’s safety is a significant medical discipline which intentions is at improving the quality of client care, minimizing treatment errors and improving safety. Infectious diseases signify an important public health issue facing health care systems in many countries around the world.
Resource Search and Selection
A review of the important literature associated with the infection control in healthcare providers. The search was reduced to the cross-infection control in dentistry limiting the search to 31,810 results. Review most of the articles were completed and 4 articles were selected for being the closest finding that related to the topic of this literature review.
Library/search engines and databases used: One data were used to search for the literature review, which was ProQuest. It eliminates the search more narrowed to 23,374 results.
Search terms: There were several search keywords were used to classify sources for this literature review. The search keywords comprised infection control, prevention of infection control, and infection control in dentistry. The search resulted in 655,471 results. It was narrowed down by including peer-reviewed, the age of the sources, and scholarly journals in the filters.
Boolean strings: None was used
Age of the Sources: The sources that were being used in the literature review was under ten years.
The findings suggest that these infection control studies need to be done more frequently to prevent the growth of bacteria, the spread of disease, and protect patient’s health. It also educates and raises awareness among the dentistry by all methods possible to improve safety in the dental practice. The common method that was being used out of all the studies were barrier techniques, which was the use of gloves and mouth mask during patient care. Barrier techniques such as gloves should be a one time use for every patient to avoid cross-contamination. The only problem with this method in one of the studies was that the staff tend to use the same barrier items throughout two to three patients care to save the cost of inventory. This usually occurs in the economically disadvantaged part of the world, where money limitations are involved.
Some of the recommended areas for improvement in infection control are medical history should be checked and regularly updated, staff immunization status, and mandatory training upon beginning employment with regular updates. There are many offices that only check their patient’s medical history every six months to a one-year period and this is not because the staffs are lazy, but the patient care level just wasn’t to standard. It could change constantly due to their health issues and not updating regularly could increase the risk of a patient’s life. In other countries, a few practices didn’t care too much about staff immunization status due to financial complications, but if they know what their responsibilities and duties are then it should be fine. The main idea was to keep the staff up to date about procedures and be able to carry out these guidelines effectively to secure a high standard of client’s care.
Cross infection control forms are a significant part of the practice for all healthcare professionals and remain one of the most cost-effective medical interventions accessible. Most stages in infection control are routine and directed at the prevention of contact with an infectious agent. Personal protection barriers play an important role in this process. Various methods like disinfection, decontamination and sterilization are essential. The use of disposable items may be expensive, but is an effective and simple means of infection control. Infection control routine can be employed in daily practice with the resources available and consistent checking and evaluating of infection control every day is required for best effectiveness. Lastly, it discovered that the level of infection control practices implemented by the private dental clinics in the city was insufficient in a few areas of the world.
In retrospect, infection control plays an important role in the dental field regarding patient and staff health. The method of study is the most effective through targeted participants, outcome measures, and sample sizes to ensure a high standard of cross infection control. Use of disposable items may be expensive, but is an effective and simple means of infection control. The contestants had a decent knowledge, skills, and attitudes towards infection control in dentistry. However, dentists need to update themselves about these procedures to be able to distribute these guidelines successfully, and evaluation of infection control routines is required for best effectiveness.