For dentists, successful decontamination is a multi-layered process, where vigilance is key. The microorganisms found in dental settings are often on surfaces and hidden in self-contained water supply systems. Moreover, many pathogens are growing ever more resilient to disinfectants and drugs so preventive methods are even more crucial. Also, our increasingly ageing population have weaker immune systems and greater susceptibility to water and blood-borne illnesses.
The quality of water supplying dental unit water systems (DUWS) e.g. autoclaves, washer disinfectors and Reverse Osmosis filters, has to be of optimum purity. The complex network of connecting plastic tubes integral to DUWS, have consistently proven to be prone to microbial biofilm cultivation. Whilst the majority of opportunistic pathogens are eliminated by chlorine added to our water supplies, the composite nature of some bacteria renders them either completely resistant to, or more robust in their defence against disinfectants.
One example is Cryptosporidium – a parasite causing the diarrheal disease, cryptosporidiosis, acquired through drinking contaminated water. It is resistant to most forms of disinfection and therefore constitutes something of a headache to the water industry and health officials. Reverse Osmosis water filters that have been correctly maintained, have shown to effectively eradicate this insidious pathogen.
Other gram-negative (multi-drug resistant) microorganisms found in DUWS output water include:
Reverse Osmosis water filters dilute water from a more concentrated state by passing it through a semi-permeable membrane. They are highly effective in removing protozoa (single celled microscopic organisms) such as Cryptosporidium and viruses such as Hepatitis A and Norovirus[iii].
CleanCert is one of the UK’s foremost suppliers of infection control solutions. For example, its range of exemplary Reverse Osmosis filters are demonstrably effective at reducing the risk of waterborne infections. The team is also dedicated to providing you with more cost-effective ways of maintaining compliance, by developing simple to use ‘annual maintenance kits’ and water analysis ‘dipslide apps’, to ensure you can manage and maintain your own decontamination protocols effectively, quickly and inexpensively.
Protect yourself, your staff and your patients, call CleanCert today.
[i] Daily Mirror - Five Former Patients of HIV-Scare Dentist D’Mello Test Positive For Hepatitis C. http://www.mirror.co.uk/news/uk-news/five-former-patients-hiv-scare-dentist-5353918 (Accessed 7/10/2015)
[iii] CDC Centers For Disease Control And Prevention – A Guide To Drinking Water Treatment Technologies For Household Usem 2008, http://www.cdc.gov/healthywater/drinking/travel/household_water_treatment.html (Accessed 7/10/2015)
Like any conscientious practitioner, I take these responsibilities very seriously and, ultimately, I think the changes that have been made have been positive.
But all I want is a little consistency. I’m sure we can all remember when we were required to keep our sterilised equipment in bags, to be re-sterilised after 30 days of non-use. That quickly changed to 60 days and now it’s gone up to one year. Why?
The science that dictates these guidelines is not made widely available to professionals – we are simply required to dogmatically follow them. What’s more worrying, however, is the fact that private practitioners are not consistently informed of these regularly changing guidelines. NHS practices and hospitals receive regular updates from the Department of Health – but we are too often left in the dark. Gone are the days when the BNF was sent to all practices: we now have to purchase it or subscribe online.
In fact, and I say this with a certain amount of trepidation, I regularly find out about new guidelines by reading through some of the GDC fitness to practise hearings. I often see cases where practitioners are being penalised for something of which I’m not even aware. In this, I think, there has been a fundamental failing in the profession – which is having serious ramifications for practitioners right across the country.
I also couldn’t help tallying up just how much compliance could end up costing. With all the changes, with all the considerations, I was left wondering what strategies I would have to employ to make it feasible – and it all came back down to the question of consistency again. Should practices spend significant sums of money to replace their old sinks with ones that are compliant this year but potentially not the next? Should they have to budget for the government’s indecisiveness?
It’s a difficult situation and, ultimately, the patient will suffer. If practitioners are always having to buy new equipment, new cabinetry or new PPE the cost of treatment will inevitably go up to accommodate the additional costs. It’s not a case of ignoring these topics – the protection of our patients is, and always will be, our foremost consideration – but in order to best do that, we need a consistent direction and a better system for sharing the knowledge we need.
For further information please call EndoCare on 020 7224 0999
Or visit www.endocare.co.uk
Dr Michael Sultan BDS MSc DFO FICD is a Specialist in Endodontics and the Clinical Director of EndoCare. Michael qualified at Bristol University in 1986. He worked as a general dental practitioner for 5 years before commencing specialist studies at Guy’s hospital, London. He completed his MSc in Endodontics in 1993 and worked as an in-house Endodontist in various practices before setting up in Harley St, London in 2000. He was admitted onto the specialist register in Endodontics in 1999 and has lectured extensively to postgraduate dental groups as well as lecturing on Endodontic courses at Eastman CPD, University of London. He has been involved with numerous dental groups and has been chairman of the Alpha Omega dental fraternity. In 2008 he became clinical director of EndoCare, a group of specialist practices.
The increase has been driven largely by Quadralene’s expansion in healthcare markets and their products are now sold in 41 countries worldwide. In 2012, overseas sales increased by 70% and are forecast to rise by a further 50% this year.
Managing Director of Dentisan, Andy Corley, said, “I am thrilled to receive this award on behalf of a terrific team that works hard each day to build our growing reputation as a leader in the field of infection control. Their tireless effort on behalf of our international clients is what makes the difference. This award is proof that their work is recognised not only in the UK market but also on a global stage.”
Medilink is an organisation that celebrates the latest technologies, outstanding business achievement and international success across the UK Life Sciences sector and this is not the first Medilink award-win for the company. Two years ago, Dentisan received an “Outstanding Achievement” award for their collaborative work with University of Nottingham School of Biosciences in developing Bioclear, a biofilm remover for Dental Unit Water Lines. The company now goes forward to Medilink’s National Finals, held at the end of the year.
For more details of Dentisan’s full range of infection control products visit www.dentisan.co.uk
As a dental professional, you will be more aware than most that bacteria, viruses and fungi are everywhere – in the air, on surfaces and in our food. They are an unavoidable part of life, and while most, thankfully, are harmless, some have the potential to be extremely dangerous.
Every winter the news seems to be full of recent outbreaks of diseases caused by these organisms, such as MRSA often associated with the healthcare industry. Indeed, in January this year, a huge spike in illnesses caused by the Norovirus was reported in the UK. However, the number of reported cases of both MRSA and E-coli do still seem to be falling, with figures showing significant reductions in recent years.
While most people overcome simple infections without too much of a problem, those with a compromised immune system, caused by either chronic illness or certain medications, young children and the elderly are all at a much greater risk. A more serious infection in a vulnerable person could become fatal.
This is of course, a high priority within the dental profession, with infection control and prevention procedures required as a mandatory element for all practices. Any surface, instrument or device that comes into direct contact with an infected patient or practitioner has the potential to harbour pathogens and help spread them around the practice. While the greatest risk of contamination is associated with the use of improperly sterilized instruments and equipment, other areas present a very real threat.
From the reception area to the surgery rooms, dozens of people will circulate around the average practice every day, introducing a variety of different bacteria each time, which can infect everything from chairs, to light switches, door handles and children’s toys. As a result, your practice team must put emphasis on ensuring these infections are destroyed effectively, and measures are put in place to prevent the future colonisation of such pathogens.
Not only do these protocols keep visiting patients and your staff safe from infection, they are also necessary to ensure dental practices meet the governing regulations. As you know, HTM 01-05 and CQC outline the minimum standards every healthcare provider in the UK must meet in order to maintain registration and continuing offering services to the public. These regulations must be interpreted and applied to dentistry, and you must be able to demonstrate your practice’s compliance through detailed written records.
Such protocols of course include procedures followed at the beginning and end of every day, as well as between patients, in an attempt to remove pathogens from the environment and reduce the risk of transmitting infections between patients and from patient to professional and vice versa. Instruments must be sterilised effectively by suitable methods, hands should be disinfected and the surfaces of all equipment should be decontaminated regularly and efficiently. It is important to remind your entire dental team that this is not an area that allows for complacency.
In order to clean and disinfect everything from worktops to the dental chair to the reception desk, it is essential that your team have the appropriate tools. The best infection control products now available are highly effective against many of the known viral and bacterial infections, when used as instructed. They can protect patients and staff alike from a wide range of infections and illnesses including MRSA, TB, enveloped viruses such as HIV and Hepatitis B, rotaviruses, and papovaviruses.
These products are effective in low concentrations and are available in liquids or wipes to decontaminate surfaces, and depending on the alcohol content, can be used on a variety of materials such as ceramic, glass, acrylic and laminates.
One provider of such infection control products is schülke, an internationally renowned company with over 120 years of hygiene experience. The extensive product range is compliant with HTM 01-05 regulations and chlorhexidine-free, and includes both alcohol-based and alcohol-free products to suit all surface materials. Products are manufactured with advanced, safe and environmentally friendly production processes.
In addition, schülke also provides specialist training in infection prevention, to ensure every member of your practice team has the knowledge and skills to contribute towards the on-going decontamination process. You can even make savings through repeat purchases with schülke’s Plus Rewards Scheme, which also enables you to utilise the help of a local consultant who can provide tailored advice and guidance on the local regulations for infection control.
Microorganisms are a natural part of our environment and we cannot escape them. It is, therefore, essential that your dental practice ensures that pathogens are limited and controlled to ensure both patients and staff are safeguarded. By employing the help of clinically proven products, you and your team can make a huge difference to your patients’ health.
For more information, please call 0114 254 3500 or visit www.schulke.co.uk.
 Macnair, T. (2010) ‘Infections’, BBC Health, available at: http://www.bbc.co.uk/health/physical_health/conditions/infections1.shtml
 Satran, J. (2013) ‘Norovirus Infections Spike In UK, Canada This Winter’ The Huffington Post, 7 January, available at:
 ‘Health Protection Report’, Health Protection Agency, 19 October 2012: available at http://www.hpa.org.uk/hpr/infections/hcai.htm