The invisible risk

02 October 2014
Volume 30 · Issue 1

Bob Newsome explains why the New Year is a good time to review hand hygiene.

Winter is always a time when we see an increased prevalence of viruses throughout the general population and, like all other healthcare environments, dental practices need to be vigilant about limiting the potential for staff and patients to contract any of the common infections that are rife at this time of year.

A growing number of studies show that, thanks to the greasy touch screens of smartphones and dirty computer keyboards, modern technology is fast becoming a new source of potentially dangerous germs and viruses. It has been found that the average smartphone has on it around 25,000 bacteria per square inch, more than is commonly found on toilet seats, soles of shoes or pet food dishes, and the warmth generated by phone batteries makes a perfect breeding ground for pathogens. In addition, many people, especially children, cannot go anywhere without their phones, and this includes going to the toilet, where the potential for dangerous contamination becomes even higher. This unfortunate habit increases the opportunity for spreading disease via hand to hand and hand to surface contact. Combine this with the fact that cold and flu viruses carried on a person’s hands can be easily transferred to phones, tablets and keyboards and the potential for the spread of disease is multiplied exponentially. In the case of phones, the matter is made worse as they are held close to the face, especially the ears, nose and mouth, meaning it is just a short journey to infecting the body.

In the modern day practice, computer keyboards located both at the front desk and in the surgery should also come in for close scrutiny. A 2004 study by the University of Arizona found that a computer keyboard can harbour up to 3,295 microbes per square inch and a computer mouse 1,676. This equipment often suffers from high levels of contamination due to people eating food at their desks, poor levels of personal hygiene and an almost non-existent computer cleaning regime. Whilst none of these in theory should be high-risk factors in a dental surgery, any practice not following strict decontamination protocols can easily find itself unwarily subject to the spread of contagious viruses. Salmonella, listeria and flu viruses are just some of the pathogens that can live for hours on hard surfaces and one such example that spreads easily is the Norovirus, more commonly known as the winter vomiting virus. This virus survives on surfaces and can be spread around a relatively confined space such as a patient waiting room in a relatively short period of time. It is therefore essential that staff and patients are encouraged to maintain good hand hygiene at all times and those responsible should ensure that surgery surfaces are decontaminated between patients and the reception area is kept clean and disinfected according to the practice’s infection control policy. Considering the need to clean and disinfect routinely between patients, many practices find that a one-stage, alcohol-free approach to cleaning and disinfection helps them reduce surgery downtime, whilst enabling them to remain confident that their decontamination procedures are helping to minimise the spread of infectious viruses.

In the same way, practices must go back to basics where hand hygiene is concerned and ensure that not only staff, but also patients have access to good quality, handwash, hand cream and post-wash hand santiser or disinfectant. Provision of these materials in the toilet and where appropriate in the reception area, will help reduce the spread of viruses amongst and between patients and staff. So although some practices prefer the aroma (and image) of having Molten Brown handwash and skin care treatments available for patients’ use, choosing specifically designed products will actually provide much better protection for those who come into contact with door handles, surfaces, dental chairs and the inumerable other objects that people touch in your practice, without even thinking about it.

As employers, it is vital that principal dentists take sufficient care in safeguarding the health of their staff and as healthcare professionals the same is true for patients. So maintaining clean and disinfected surfaces must be much more than just a quick once-over with a wipe or spray. Clean surfaces are the cornerstone of good infection control procedures and at this time of year more attention than ever should be given to this important aspect of decontamination.

References available on request.