by Mary Govoni, CDA, RDA, RDH, MBA
I frequently hear questions from dental team members about their confusion over barriers vs. disinfectants on dental equipment and surfaces. Many team members ask if OSHA requires barriers, and if surfaces need to be disinfected underneath the barriers. The answer to the first question is “no.” OSHA does not require the use of barriers.
In the Bloodborne Pathogens Standard, OSHA states that “all equipment and environmental and working surfaces shall be cleaned and decontaminated after contact with blood or other potentially infectious materials.”
OSHA further states that “Protective coverings, such as plastic wrap, aluminum foil, or imperviously backed absorbent paper used to cover equipment and environmental surfaces, shall be removed and replaced as soon as feasible when they become overtly contaminated …”
Roughly translated, this means that if a surface is contaminated, it must be disinfected. In addition, barriers must be replaced when they have become contaminated. This would be following each patient procedure.
The choice of disinfectant vs. barrier should be determined by the potential for damage to the equipment or surface by a disinfectant, and the ability to easily clean and disinfect the item or surface.
The use of disinfectants on some dental equipment and some surfaces in dental treatment rooms can damage the items. Many disinfectants contain some levels of alcohol, and they can be drying to surfaces, such as patient chairs.
If a practice chooses to use disinfectants on equipment, those that have low levels or no alcohol to prevent damage to equipment should be used.
ProSpray™ and ProSpray Wipes™ from Certol and SciCan OPTIM®33TB are surface disinfectants that do not contain alcohol.
Cavicide™ and CaviWipes™ from Total Care™, and Sani-Cloth® and Sanitex® wipes from Crosstex are examples of low-alcohol disinfectants. These types of products tend to be much less damaging to surfaces and equipment.
Barriers make sense for many smaller pieces of equipment, such as digital X-ray sensors, intraoral cameras, curing light wands, and toggle-style switches on older patient chairs. Barriers on headrests and other surfaces also save time in cleaning and disinfecting surfaces since the barriers can be removed and replaced.
Plastic barriers, such as the Pinnacle product line from Total Care™, are readily available in various sizes and shapes to fit most any type of equipment or surface. As long as the barrier is not torn or broken, the surface underneath does not need to be disinfected in between patients since the surface will not have been contaminated by the impervious barrier.
There is some concern about the amount of plastic waste that is being created by dental practices using these types of barriers. Although disposing of plastics that do not easily degrade is not the best environmental practice, substituting reusable cloth barriers may not be the best alternative.
Some cloth barriers, which are commonly used on patient chairs and headrests, are not impervious to liquid. This may cause the surfaces underneath to be contaminated and require decontamination with a surface disinfectant after use.
In addition, reusable barriers must be laundered. This also has some environmental impact.
Many dental practices use a combination of barrier protection and surface disinfectants to maintain operatory asepsis. Making well-informed choices for these products should result in an environment that is safe for both the patients and dental team.
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].
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