Why it matters
Dental health care personnel (DHCP) are routinely exposed to blood, saliva, and other potentially infectious materials. Certain dental instruments, such as handpieces and ultrasonic scalers, produce a visible spray that contains droplets, spatter, and aerosols. Appropriate use of personal protective equipment (PPE) is an important strategy to protect DHCP from exposure to blood and other potentially infectious materials.
Background
Personal protective equipment includes special coverings designed to protect the skin and the mucous membranes of the eyes, nose, and mouth from exposure to disease-causing organisms. This includes gloves, surgical masks, protective eyewear, face shields, and protective clothing (e.g., reusable or disposable gown, jacket, lab coat). PPE can also prevent microorganisms from spreading from DHCP to patients.
PPE is a major component of Standard Precautions for DHCP. PPE should be worn whenever there is potential for contact with spray or spatter of blood or other body fluids, especially to mucous membranes of the face.
PPE should, at a minimum, be changed between each patient. Some PPE may require changing during patient care if the item no longer provides protection.
To prevent cross-contamination, PPE (including protective clothing) should be removed before leaving the work area, such as dental patient care, instrument processing, or laboratory areas.
Recommendations
Full recommendations for PPE can be found on pages 16–19 of CDC's Guidelines for Infection Control in Dental Health-Care Settings—2003 and in the Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.
DHCP should wear long-sleeved disposable or reusable gowns or lab coats that cover skin and personal clothing likely to become soiled with blood, saliva, or infectious material—for example, when spatter and spray of blood, saliva, or other potentially infectious material to the forearms might occur.
DHCP should change protective clothing when it becomes visibly soiled or as soon as feasible if penetrated by blood or other potentially infectious fluids.
DHCP should wear a surgical mask that covers both the nose and mouth, and protective eyewear with solid side shields or a face shield during procedures or patient care activities likely to generate splashes or sprays of blood or body fluids.
The mask’s outer surface can become contaminated with infectious droplets from spray of oral fluids or from touching the mask with contaminated fingers. Because of this, the mask should be changed between patients or if it becomes wet during patient treatment.
Gloves should always be worn when contact with blood, saliva, or mucous membranes is possible.
A new pair of gloves should be used for each patient. If the integrity of a glove is compromised by tears, cuts, or punctures, it should be changed as soon as possible. Gloves should be removed after patient care and hands should be immediately washed.
Patient examination or surgical gloves should not be washed before use. Disposable gloves should not be reused.
Safe work practices
In addition to wearing PPE, you should also use safe work practices.
- All protective clothing should be removed before leaving the work area—such as patient care, instrument processing, and dental laboratory areas.
- Avoid contaminating yourself by keeping your hands away from your face and not touching or adjusting PPE.
- Avoid spreading contamination by limiting surfaces and items touched with contaminated gloves.
Education and training
These videos, from CDC's Foundations: Building the Safest Dental Visit training, show one suggested sequence for donning, or putting on, and doffing, or taking off, PPE. Keep in mind that the combination of PPE used—and therefore the sequence for putting it on—will be determined by the level of precautions required.
Low Resolution Video
Low Resolution Video
Frequently asked questions
No. Gloves may have small defects that are hard to see or may be torn during use, and hands can become contaminated during removal of gloves. In addition, bacteria can multiply rapidly in moist environments underneath gloves; thus, dental health care personnel should make sure hands are dry before putting on gloves. Hand hygiene should be performed immediately before putting on and after removing gloves.
The type of glove used should be based on the type of procedure to be performed (e.g., surgical vs. nonsurgical, housekeeping procedures). Medical-grade nonsterile examination gloves and sterile surgical gloves are regulated by the Food and Drug Administration (FDA) as medical devices. Sterile surgical gloves must meet FDA standards for sterility assurance and are less likely than nonsterile examination gloves to harbor pathogens that may contaminate an operative wound. General purpose utility gloves are not regulated by FDA because they are not promoted for medical use.
Glove Type
Indications
Patient examination gloves
Patient care, examinations, and other nonsurgical procedures involving contact with mucous membranes; laboratory procedures
Surgeon’s gloves
Surgical procedures
Nonmedical gloves
- Housekeeping procedures (e.g., cleaning, disinfection)
- Handling contaminated sharps or chemicals
- Not for use during patient care
Modified from Miller CH and Palenik CJ (2010).
FDA notes that "[d]isposable PPE is designed to be used only one time and by one person; it cannot be washed. Washing PPE changes its protective or barrier capabilities, and it may no longer be effective."
No. General work clothes (e.g., uniforms, scrubs, pants, and shirts) are neither intended to protect against a hazard nor are they considered PPE.
