Mary Govoni, CDA, RDA, RDH, MBA
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The weather is turning cooler, and the holidays are closing in. That means flu season is not far behind. Because influenza, or the flu, affects both patients and members of the dental team, it is always a good idea to review prevention protocols.
The Centers for Disease Control and Prevention states that the single most important tool for preventing flu transmission is vaccination. Flu vaccines for the 2011-12 season have been available since September. This season’s vaccine includes two strains of seasonal influenza, as well as the H1N1 strain.
There are two forms of flu vaccine: the injectable, inactivated form and the live, attenuated (weakened) vaccine in the form of a nasal spray. The nasal spray is given to persons between the ages of 2 and 49 who are healthy and not pregnant. The injectable vaccine comes in three types: a regular flu shot for those 6 months and older, a high-dose shot for people 65 years and older, and an intradermal shot for people between the ages of 18 and 64.
Neither the nasal spray nor the injectable vaccine is capable of causing someone to get the flu. Dental team members often report that they became sick right after receiving a flu shot, or they received the flu shot and became sick anyway.
First, no vaccine is 100% guaranteed to prevent illness. An individual might be exposed to a strain of the flu that is not in the current seasonal vaccine. This means they do not have immunity. Second, if someone is exposed to the flu prior to being vaccinated, they may not be protected. It takes up to two weeks to develop antibody protection after vaccination. Third, it is important to note that influenza is a respiratory illness. Individuals who experience gastrointestinal symptoms, such as vomiting and diarrhea, most likely have been exposed to a different type of virus. Influenza vaccines are not meant to protect individuals from what is commonly called the “stomach flu.”
Aside from vaccinations, there are many other things that we can do to be protected from flu transmission. Hand washing is a critically important step in infection prevention. While the members of the dental team are well- versed in hand-washing protocols, patients may not be. It is a good idea to have hand sanitizer products available at patient check-in and check-out areas. I recommend using the same products that are used in clinical areas.
Some recommendations include Sterillium Comfort Gel from Hu-Friedy, and CloroxAnywhere Hand Sanitizer from Bosworth. These two products have 85% and 71% ethyl alcohol, respectively. This means these products exceed the FDA recommended minimum alcohol level of 60%. Both products also contain moisturizers to prevent drying of the skin.
During flu season, it is a good idea to clean and disinfect environmental surfaces in the patient reception area and the check-in/check-out areas. I would not recommend using the broad-spectrum disinfectant that is used in treatment rooms since there is not likely to be blood present on these surfaces.
There are many general-use disinfectant wipes that can be used on these surfaces. Bosworth provides a variety of products from Clorox, including Disinfecting Wipes and Clean-Up Wipes, that are effective against influenza viruses and are not harmful to most surfaces.
The next line of defense against influenza when treating patients is respiratory protection. Since a fair amount of aerosol is produced from a dental handpiece or an ultrasonic scaler, treating a patient who may be infectious poses some risk to the dental team. It is important to note the CDC states that the appropriate barrier mask for protection from influenza, including H1N1, is the N-95 particulate respirator/mask. These are not the typical masks worn by dental team members. This mask would be appropriate for respiratory protection when performing emergency treatment on a suspected tuberculosis patient, as well as one who is coughing, sneezing, and possibly infected with influenza.
The Isolator Plus N95 Particulate Respirator from Crosstex meets these criteria. It is also important to remember that face masks must be changed after each patient. But keep in mind that it is even more effective to reschedule patients who have respiratory symptoms. This is for their comfort and your safety.
Be responsible about preventing the flu. Get vaccinated, wash your hands, and recommend that your patients wash theirs, too. Follow CDC guidelines for covering your cough or sneeze, or cough/sneeze into your sleeve to prevent the spread of viruses. And stay home if you are sick!
Here’s to a healthy and uneventful flu season.
Mary Govoni, CDA, RDA, RDH, MBA, is the owner of Clinical Dynamics, a consulting company based in Michigan. She is a member of the Organization for Safety, Asepsis and Prevention. She can be contacted at [email protected].