Safety in Dental Labs (University of Griffith/ Australia) Prof. Newell Johnson - Dean of Dentistry & Oral Health

1. Welcome to the World of
Dental Technology
Jane Evans: Program & Course
Convenor
Prof Newell Johnson: Dean of
Dentistry & Oral Health

3. individualindividual

4. Hand washing
Wash and dry
hands before and
after patient
contact &
between each
case.Diagram courtesy Ansell Medical

5. Personal protective barriers
Use personal
protective barriers
including gloves,
masks, protective
glasses, gowns
and plastic
aprons.Photo courtesy Ansell Medical

6. Safe handling and disposal of sharps
Strategies to
reduce the risk of
a sharps injury
must be practiced
by all staff
Photo courtesy Rexam Healthcare Packaging

7. Additional precautions
Applied in additionApplied in addition
to standardto standard
precautionsprecautions
Used for patients whoUsed for patients who
are known to haveare known to have
highly infectioushighly infectious
diseasesdiseases

8. Personal hygiene
A high standard of personal
hygiene protects you, other staff
and patients from infection

9. Personal hygiene includes
Fingernails kept short and clean
Hair short or tied away from face
Clean uniforms
Hand and wrist jewelry removed at start of
day
Hands washed before and after patient
contact
Hands washed before and after any activity
likely to cause contamination.

10. Hand washing
An important measure in preventing
the spread of infection

11. Hands are washed and dried…
Before starting work and after finishing
work
Before and after each patient/case
Before and after going to the toilet
Before working in a clean area
Before and after a meal break.

12. Hands are also washed and dried
After working in a ‘contaminated’ area
Following any incident where hands are
contaminated with blood or body fluids.

13. Hand wash at the start of the day
Remove all jewelry
Check hands for cuts, abrasions or
sores
Cover open cuts and abrasions with a
waterproof dressing
Clean fingernails with a plastic or wood
stick
Perform a routine hand wash.

14. A routine hand wash
Lather hands with liquid soap and water
for 10 to 15 seconds
Rinse with cool water
Dry hands with clean paper towels
Use paper towel to turn off hand
controlled taps.

15. Hand washing technique
1. Palm to palm
2. Palm over
dorsum of hand
Diagrams courtesy Ansell Medical

16. 3. Palm to palm
with fingers
interlaced
4. Back of fingers to
opposing palms
Diagrams courtesy Ansell Medical

17. 5. Rotate thumbs in
palm
6. Rotate fingers in
palm
Diagrams courtesy Ansell Medical

18. Hand care
The skin is a natural barrier to
invading microorganisms

19. May cause dry
cracked skin and
dermatitis
Frequent hand
washing and
wearing gloves

20. Dry cracked skinDry cracked skin
gives disease
causing
microorganisms the
opportunity to
cause infection

21. Preventing dermatitis
Remove all jewelry before washing
hands
Rinse hands thoroughly after washing
Avoid using hot water for hand washing
Dry hands completely after washing
Handle irritant chemicals only while
wearing gloves.

22. Personal protective barriers
Lab Coats, Adequate Footwear
Glasses, Gloves, &
Mask

23. Personal protective barriers
When worn properly
provide a physical
barrier between you
and a risk.
Protects feet from
injury
Protects feet from
contact with sharp
instruments that are
accidentally dropped

24. Lab Coats
Protect street clothes from aerosols and
splatter contamination
Are not worn outside the laboratory
area
Are changed/washed daily or more
frequently if visibly soiled.

25. Facemask
Provides a physical barrier by filtering
microorganisms from the air
Protects the wearers mouth from direct
splash or splatter from the patient’s
mouth.

26. Once a
mask
becomes
damp
Microorganisms are
able to pass through
and can then be
inhaled.

27. Guidelines for wearing a mask
Wear a mask to protect yourself from fumes
or dust
Wear a mask while assisting with all patient
procedures
Wear a new mask for each new patient
Put on the mask before pulling on gloves
While wearing a mask do not touch it with
your hand.

28. Removing a mask
Remove the mask after removing
gloves by touching only the strings or
loops
Discard the mask with the general
waste.

29. Protective glasses
Protect eyes from sharp flying debris
Protect eyes from blood and saliva
splatter
Protect patient’s eyes from accidentally
dropped instruments
Protect patient’s eyes from chemical
splashes.

30. Guidelines for wearing glasses
Wear protective glasses while cutting,
trimming or polishing
Wear protective glasses while assisting with
all patient procedures
Put on protective glasses and mask before
pulling on gloves
Wash glasses between patients with water
and detergent
Rinse glasses well after washing.

31. Gloves
Worn whenever there is a potential for
contacting blood and saliva
Cannot protect hands from a sharps
injury.

32. Non-sterile examination gloves
Used in all non-
surgical procedures
Fit both hands and
come in small,
medium and large
sizes
Gloves are single-
use and must never
be washed or
reused.Photo courtesy Ansell Medical

33. General purpose utility gloves
More resistant to
puncture
Worn when handling
contaminated
instruments
Worn during clean-up
Washed in detergent
and reused
Stored dry
Replaced when torn or
cracked.PhotoPhoto HuHu--FriedyFriedy DentalDental

34. Guidelines for using non-sterile
examination gloves
Remove rings and watches
Cover cuts and abrasions with waterproof
dressing
Wash, rinse and dry hands
Choose a glove size that fits well
Remove gloves that are torn, cut or
punctured
Discard gloves with general waste
Wash hands thoroughly after removing
gloves.

35. Aerosols A fine mist of tiny air-
borne particles that may
contain bacteria, viruses
and fungi
Splatter Larger particles of blood
and saliva contaminated
debris

36. Sharps injury
All dental practices should have a
written procedure for a sharps injury
that involves exposure to blood or
body fluids

37. Reducing the risk of sharps
injury
Strategies to reduce
the risk of a sharps
injury must be
practiced by all staff
An injury caused by
contaminated sharps
is potentially very
serious.

38. A sharps injury is most likely to
occur
DuringDuring
proceduresprocedures
using bursusing burs
During transferDuring transfer
and disposal ofand disposal of
sharpssharps
While workingWhile working
in confinedin confined
areasareas

39. Procedures using burs
The operator is responsible for
removing the bur from the handpiece
after use
Slow speed burs are discarded into the
sharps container
High speed burs are cleaned and
sterilized.

40. Managing a sharps injury
Immediately wash the injured area of
skin with soap and water
Cover the injury with waterproof tape
Report the sharps injury immediately to
the person in charge of the surgery
Complete an accident report form.

41. The accident report form records
The date of the injury
The time of the injury
How the injury occurred
The name of the person whose body
fluid was involved.

42. Dispose of
Dental Waste Safely

43. PackagedPackaged
According to
legislative
requirements
WasteWaste
must bemust be
LabeledLabeled
StoredStored
TransportedTransported

44. Waste generated from a dental
practice includes
Clinical
waste
Related
waste
General
waste

45. Clinical Waste
Waste that has the potential to
cause sharps injury, infection or
public offence

46. Clinical waste includes
Discarded sharps
Human tissues including materials or
solutions that contain free-flowing or
expressible blood
Laboratory and associated waste.

47. Discarded sharps
Wear personal protective equipment
Discard all sharps into a clearly labeled sharps
container
Keep the sharps container out of the reach of
children
Replace the container when three-quarters
full
The operator who generated the sharp is the
person responsible for their safe disposal.

48. Sharps include
Needles
Disposable syringes
Scalpel blades
Slow speed burs
Endodontic files

49. Sharps container
A clearly labeled yellow
rigid sharps container
Located close to where
waste is generated
Collected by a licensed
medical waste
contractor.
Photo courtesyPhoto courtesy RexamRexam MedicalMedical
PackagingPackaging

50. Human tissues
Pathological specimens
Biopsy specimens
Tissue taken during surgery
Free flowing or expressible blood
Other body fluids removed during surgery

51. Laboratory and associated waste
This category includes
All specimens used for laboratory testing
Cultures of microorganisms used in
biological indicators

52. Disposal of clinical waste
Yellow leak proof bag
marked with biological
hazard symbol
Located close to where
waste is generated
Collected by a licensed
medical waste contractor.

53. During waste disposal
PracticeUse
Personal
protective
equipment
+ Personal
hygiene

54. Related Waste
Wastes that are contaminated
with chemicals or pharmaceuticals

55. Related wastes include
Amalgam
waste
Radiographic
waste

56. Radiographic waste
Used fixer and developer solutions should be
stored in secure, plastic, leak proof containers
Containers must be labeled with the contents and
safety instructions
Processing chemicals are highly corrosive and
must not be tipped down the sink
Personal protective equipment must be worn
when handling chemicals
Processing chemicals should be collected by
an approved recycling company

57. Stored in a small box in
the developing area
LeadLead
foilfoil
Collected by a metal
recycling company
Or disposed of by a
licensed contractor
Cannot be disposed
of into the general
waste
OldOld
filmfilm

58. Disposal
Lead foil
Stored in a small box in the developing
area
Collected by a metal recycling company or
disposed of by a licensed contractor
Old films
Collected by an approved recycling
company or disposed of by a licensed
contractor.

59. Amalgam waste
Stored in a tightly closed container
under radiographic fixer solution
Storage of amalgam waste must protect
staff from mercury vapour
Container should be labeled with the
contents and safety instructions
Collected by a metal recycling company
or by a licensed contractor

60. General waste
Waste that is not classified as
being within any of the categories
of the clinical and related waste
streams

61. General waste
General waste bag is coloured black,
buff, green or white
Collected by the community waste
contractor
Includes gloves, mask, rubber dam,
single-use cups and protective
coverings
Handled using heavy duty gloves.

62. Instruments
that cannot be
cleaned and
sterilized after
use
must be
discarded

63. Disposables include
Anaesthetic cartridges and needles
Prophylaxis cups and brushes
Mouthwash cups
Saliva ejector tips
Patient bib
Gloves and mask.

64. Undertake necessary measures
to ensure prevention of
transmission of infection

65. ContaminatedContaminated
instruments andinstruments and
equipmentequipment
Should be confined to
a well designated
zone

66. Limiting contamination
Clearly defines the contaminated and
clean zone in the surgery
Means that surgery clean-up is easier
and faster
Reduces the chances of cross-
contamination.

67. Clean zone
Must never become contaminated with
items used during patient treatment
Stores sterile instruments, equipment,
materials and medicaments
Includes the interior of drawers and
cupboards which must never become
contaminated during patient treatment.

68. Retrieve instruments and
equipment if needed by one
of the following techniques
• Remove gloves
and wash hands
• Retrieve
instruments /
dispense materials
• Re-glove before
returning to assist
‘Overglove’ with
a food handlers
glove Use transfer
tweezers

69. Contaminated zone
Contains contaminated material from
the current patient
All surfaces in the contaminated zone
must be cleaned and dried between
patients
Single-use coverings are used to reduce
surface contamination.

70. Contaminated zone
•Receiving area for
contaminated items
•Sinks and instrument
washer
Clean zone
•Packaging area
•Items awaiting
sterilization
Sterile zone
•Cooling area for
sterilized items
•Storage area for sterile
packs

71. Blood and/or body fluid spills
Managing a spill is always easier
when the cleaning items needed to
remove the spill are readily available

72. Disposable spills kit
A large reusable plastic container, with
a fitted lid, containing the following
Leak proof bags for disposal of waste
material
A disposable scraper and pan for spills
Disposable rubber gloves for cleaning
Protective glasses and a plastic apron.

73. Removing a small spill
Wear heavy duty gloves, mask, protective
glasses and a plastic apron
Wipe up the spill immediately using paper
towel
Discard contaminated material in to a plastic
bag for disposal
Clean the area with warm water and
detergent solution
Remove gloves and mask and wash hands
Clean and dry protective glasses before re-
use.

74. After
removing
the spill
Ensure the
area is clean
and dry
Replace
disposable
items in the
spill kit

75. Summary - it is your responsibility to collate
and maintain evidence to demonstrate
Knowledge of how infection is spread
Knowledge of infection risks in a health
environment
Compliance with NHMRC infection
control guidelines
Compliance with Australian Standards.

76. Summary cont….
Safe waste handling and management
procedures
Knowledge of personal hygiene practices
Knowledge of personal protection
Selection and use of appropriate cleaning
agents
Selection of the correct sterilization method.

77. YOUR responsibilities
1. Comply with instructions given for
workplace health and safety.
2. Use personal protective equipment.
3. Do not wilfully misuse anything provided
for workplace health and safety.
4. Do not wilfully place at risk the health
and safety of others.
5. Do not wilfully injury yourself.

78. Hazard Identification & Risk Control
The hazards in the laboratory need to be identified and the risks
assessed and controlled, so the laboratory is as safe as
possible.
Types of Hazards:
Biological: Disease, micro-organisms
Chemical: Solvents, acid, dust, (silica) resins
Electrical: Leads, equipment
Ergonomic: Position while working
Physical: Noise, lighting, hot/cold, radiation
Stressors: Discrimination, harassment, production pressure

79. Risk Management Procedures:
It is essential to either eliminate the risk or
control the risk.
1. Identify the hazard
2. Minimise the risk by using the hierarchy
of hazard control:
• Design
• Substitute
• Redesign
• Separation
• Administration
• Personal Protective Equip.

80. Risk Management & You…
Hazard Risk Control
Hand contamination Gloves
Eye contamination Eye protection
Aerosols / Dust Mask, Dust extraction Eye protection,
Sharps injury Good technique, Safe disposal
Contaminated waste Safe disposal of waste

81. Handpiece…
Following Operating Instructions when
using equipment