Michelle Aubé (Simmonds), RDH

As a consumer standing in front of a well orchestrated display of oral care products, one word comes to mind; overwhelming! Added into the already overwhelming list of products is an entire line up of natural oral health care products. Marketing is aimed to have every product promise to deliver something wonderful. That may be the case, however, is that ‘something’ wonderful suited for your clients' needs? Is what your client is putting in their mouth good for them? Even if they are natural products?

Sterilization process challenging is not a new concept. It’s important for any industry that operates a sterilizer to develop a thorough quality assurance sterilization monitoring program. Notice how I called it a sterilization monitoring program. Sterilization testing is a disjointed task in many dental offices because it is not viewed as its own system within IPAC.

Before being an RDH, I was a CDA and then a CPDA for 4 years. I oversaw ordering burs, sterilizing burs, and storing them in bur blocks in an official bur drawer. These were the years where a loose unpackaged sterile burs in a bur block was acceptable in infection prevention and control.

Dental offices are no strangers to the potential of having an unannounced IPAC Public Health inspection. Now dental offices can add the possibility of the Ministry of Labour randomly arriving to the dental practice to inspect the offices pandemic plan and compliance. The difference between the two inspections is Public Health is mandated to protect the public and the Ministry of Labour for the employee/worker safety. Every workplace must be free of hazards to the employee, this includes infection control with the SARS-COV-2 being an infectious hazard. The missions of both authorities do overlap in the end with the result being overall human safety.

The question above in the title can be answered by a question… Who has first stated a DUWL system was needed and since when? The manufacturers of the DUWL’s have been the initiating source since the new design of equipment with a closed water system design. The water system is ‘closed’ to outside contamination...

Some provinces require an ACH test and some do not.

Some require adherence to a specific fallow time and some do not.

For the geographical areas that must adhere to a fallow time, the sequence of the operatory turnover and where and when the clinical notes are written is causing some confusion and must be addressed.

A common question is when does the fallow time begin?

The fallow time begins when the clinician and client leave the operatory.

It does NOT begin when the last AGP was performed.

Why?

The reasoning is while the client is still in the operatory conversing with no mask there could be a chance for airborne transmission.

Air quality has surfaced as a hot topic in the pandemic control measures for dental offices.

Air quality falls under Additional Precautions in a dental office's IPAC Program.

Pre-pandemic, offices were following Routine Practices covering hand hygiene, sharps safety, risk management, and personal protective equipment.

Additional precautions are just that, an addition to the routine practice.

Additional precautions are required during respiratory viral outbreaks such as SARS-COV-19.

Dental services are now categorized as either aerosol gas producing (AGP) or non-aerosol gas producing (NAGP) with each having its own lineup of PPE.

Aerosols have always been a known subject in dentistry.

A hand hygiene program is embedded within the contents of an office's IPAC Program and is often ill-defined. Dental offices may be performing hand hygiene tasks, have procured the necessary products and posted directions for proper hand hygiene, however, it goes much further than this.

In the last article, I discussed the need to reflect on DUWL as part of the pre-planning to eventually return to practice once the coronavirus pandemic emergency state is lifted. I received many inquiries on product selection ranging from a regular maintenance program to the ‘oh no my DUWL biofilm is out of control’ action program.

In the current situation of dental office closures due to the COVID-19 pandemic, there are varying degrees of concerns that dental professionals are facing. Myself, as an RDH working clinically and an IPAC educator, I have a constant barrage of "what’s and if’s" anxiously circling through my mind like a movie stuck on repeat.