Disinfecting Dental Impression Materials-Meeting the Challenges in Two Tertiary Hospitals in Lagos Nigeria
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 2
Abstract
Objective: The purpose of this study was to investigate the knowledge and practices of disinfection of dental impression in Lagos State University Teaching Hospital and Lagos University Teaching Hospital, Lagos Nigeria and also to find out if the practices of these two tertiary hospitals were up to acceptable standards. Material and Methods: This is a cross-sectional descriptive study of dental health givers in the two hospitals and it was carried out using self-administered questionnaires to investigate the knowledge and practices of dental impression disinfection. Data was collated and analyzed with SPSS version 20. Results: The questionnaires distributed were 270 and we had a response rate of 83.3 % (225 questionnaires were returned completed). Respondents with Bachelor of Dental Surgery degree were 118(52.4%) while 107 (47.6%) were final year dental students. Hand washing before wearing gloves was done by 208(92.4%); hand washing after making impression was practiced by 222(98.7%). Water and antimicrobial soap for hand washing was practiced by 109(48.6%); while 3(1.3%) made use of water without soap. Respondents who used 1% Sodium hypochlorite as choice disinfectant were 181(80.4%). Discussion: This study revealed a sufficient level of awareness and practices of disinfection of dental impression in the two institutions. The reason for this could be the importance attached to infection control during the training of dental students. Continuous training and updating of knowledge on new dental impression disinfection techniques is stressed. Conclusion: We can conclude at the end of this study that there is a good knowledge of dental impression disinfection among health givers in the two institutions studied and this is demonstrated by their regular practice. The oral cavity with the masticatory apparatus is a highly conducive environment for the growth and proliferation of bacterial [1]. Dentists and other dental care givers are at risk from cross-contamination from the mouth of patients and other infected working environment in the dental office [2,3]. According to the guidelines published by the British Dental Association, “the only safe approach to routine treatment is to assume that every patient may be a carrier of an infectious disease” [4]. In view of the above statement, standard precautions require that all dental health care workers should assume that the blood and body substances of all patients are potential sources of infection, regardless of the diagnosis, or suspected infection [5]. Dental workplaces are potential sites for the spread of various communicable and incurable diseases to, from and among patients and the dental staffs hence, cleaning and disinfection of dental impressions should be carried out before sending to the dental laboratory since a contaminated dental impression can spread infection in the dental laboratory [6]. Studies have shown that 67% of dental impressions sent to dental laboratories are contaminated by a host of different microorganisms [7] and some of these microorganism are known to have a survival rate of up to 5 hours on dental impression materials [7,8]. These microorganisms includes but are not limited to Streptococcus Species, Staphylococus Species, Escherichia Coli Species, Actinomyces Species, Anitratus Species, Pseudomonas Species, Enterobacter Species, Klebsiella Pneumonia and Candida Species [9]. The Federation Dentaire Internationale (FDI) requires as a standard precaution that all patients’ impressions should be rinsed under running water to remove saliva and visible blood. Then, they should be placed and sealed in a proper container and labeled as disinfected or not disinfected before being sent to the dental laboratory [10]. Also, the American Dental Association (ADA), the Centre for Disease Control (CDC) and Prevention with the Australian Dental Association, have all listed a similar standard procedure for the disinfection of dental impressions [11-13]. Nevertheless, care should be taken that the disinfection procedure does not have adverse effect on the dimensional stability or surface details of the dental impression. This is important because the various types of impression materials available have features such as: accuracy, elastic recovery, dimensional stability, flexibility, a long shelf-life, tolerable taste to patients and relatively affordable [14]. Thus, the choice of disinfectant depends on the type of impression material chosen since the composition, concentration of the disinfectant and the exposure time would greatly affect the compatibility of these disinfectants with the specific impression materials [15-18]. The ADA and CDC recommends the following disinfectants: 0.5% Chlorhexidine, 1% Sodium hypochlorite, 2% Glutaraldehyde and Iodine agents [11-13]. 1%Sodium hypochlorite has been generally accepted as the disinfecting agent of choice for alginate [19] and it is recommended by the Environmental Protection Agency (EPA) as a good surface disinfectant, with a non-irritating effect and efficacy against a wide variety of microorganisms; however, its unpleasant odor coupled with its considerable chemical instability is a major drawback [20]. Dental impressions should be decontaminated by immediate rinsing under running water and then completely immersed in a suitable disinfectant which exposes all the surfaces of the impression equally to the disinfectant or sprayed with the disinfectant which reduces the likelihood of distortion than immersion, before sending to the dental laboratory [21-23]. Tap water, used as pre-wash has been reported to reduce 40% to 90% of microorganism [22] and it also reduces the bacterial load, food debris, blood and saliva [11,13].
Authors and Affiliations
IKIMI Nathan Ukuoghene, Awotile Adenike Ololade, Ashiwaju Modupe O lufunmilayo, Enone Lilian Lami, Benjamin Oluwakemi
Keywords
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- EP ID EP567567
- DOI 10.26717/BJSTR.2017.01.000211
- Views 175
- Downloads 0
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