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Occupational risks for dental care providers and exposure risks for patients have declined significantly in recent decades, in large part thanks to proactive efforts. Yet, despite the numerous infection-control measures routinely employed in the overwhelming majority of dental settings, you may still occasionally ask, “Why are some of my patients so anxious about the infection-control practices and products we use, especially after all the work we have put into this area?”
Those of you who have been in practice for more than 20 years may remember when a similar situation arose in the 1980s when public fears about infection with hepatitis B virus (HBV), human immunodeficiency virus (HIV), and later hepatitis C virus (HCV) were circulated by media.
On the surface, current patient concerns about health and safety may appear to be an indication of a situation in which public trust in infection control practiced by health professionals is becoming strained. I do not believe this is the case. Instead, I think we are seeing a public response to the emergence, re-emergence, and documentation of a number of infectious diseases that present major challenges to the health professions and general population. Two recent examples that come to mind are methicillin-resistant Staphylococcus aureus (MRSA) and the A/H1N1 (swine flu) pandemic.
Many in the population are more conscious of routine prevention practices, such as frequent hand washing or use of waterless hand sanitizers, covering coughs, and checking on a mild skin lesion that does not seem to be healing properly. Because many infection-control practices are readily visible to patients, it is logical for them to ask questions about the infections they read and hear so much about. As health professionals, this provides an opportunity to affect the attitudes and perceptions of an increasingly inquisitive public.
How can you communicate and reinforce appropriate infection-control practices? Two approaches employed simultaneously can be effective — education and communication. The first requires that you and other practice personnel keep current with information pertaining to occupational infection risks and emerging prevention strategies.
By continuing to be updated in areas such as new developments in vaccines and vaccination recommendations, and improved equipment and product technologies, you may be able to use this information to reinforce and fine tune your professional infection-control program. Many opportunities are available to acquire information for this purpose. The key is discerning what material is based on scientific- and/or clinical-based evidence, or at the very least, appropriate inferential knowledge based on documented evidence.
As important as continuing education is in remaining current in this area, communication of pertinent infection-control information to patients is also of major importance. Talk with patients about your asepsis program. They see the obvious precautions you use, such as washing your hands frequently and/or using hand rub antiseptics, wearing gloves, masks, eyewear, and long-sleeve clinic jackets and coats.
But they probably know little about the “behind-the-scenes” activities. One example is instrument reprocessing. How aware are they that you efficiently clean contaminated instruments in an ultrasonic unit or instrument washer before you wrap them for heat sterilization? Do they know that you routinely check the efficiency of the heat sterilizer with chemical indicators located on and in pouches that indicate whether or not you have achieved sterilization conditions over a prescribed interval?
Similarly, when they ask about how you know items are “sterile,” take the opportunity to briefly explain how you routinely biologically monitor the sterilizer and keep records. When they ask about a separate water bottle attached to the dental unit, what better time to briefly discuss your efforts to provide them with water quality that meets or exceeds public health standards.
Another way to communicate this information is to develop a not-too-technical letter/pamphlet about the practice’s infection-control procedures to give to patients. By briefly outlining the procedures and protocols that have been incorporated into the practice routine, you send a positive message to them and the community. Many versions of these pamphlets and posters describing basic infection-control precautions are available if you do not want to develop your own.
The public is often bombarded with reports regarding emerging infections and disease control. Unfortunately, coverage can include exaggerations and misperceptions. You have an opportunity to be a positive influence by conveying what you routinely do to protect your patients and the dental care team.
Dr. John A. Molinari is director of infection control for THE DENTAL ADVISOR. Previously, he was professor and chairman of the Department of Biomedical Sciences at the University of Detroit Mercy School of Dentistry. Contact him at [email protected].
