The Ickiest Things You Can Do at the Dentist

Putting Your Finger Inside Your Mouth

It always hits me with surprise how clueless people are about transmission of infections. In the middle of the treatment they might show with their finger which tooth feels sensitive. That’s when I say Eew in my mind. Why would you put your finger inside your mouth? And it’s always the index finger which we use to operate our smart (and dirty) phones and push the elevator button (I don’t actually, I use the proximal interphalangeal joint (PIP) of index finger because of my fear of bacteria – read more about it here) that gazillion people have pushed before you with their dirty index finger. Some even do grosser things with their index finger.

So please, do not put your finger inside your mouth. Your tongue is able to do the job instead.

Carrying Your Toothbrush Without Cover

Some people are obsessed about brushing their teeth prior the dental visit. They might do it at the practice’s toilet just before they come in to the surgery. No problem with that, but when you walk in to the surgery with the toothbrush, your car keys and wallet in your hands and place them on our office desk, that’s when we go Eew again. Especially if the toothbrush doesn’t have any travel case. We don’t wipe all the practice’s surfaces after each patient, so there will be germs on the table surface where you leave your stuff. And where are you going to put it when you get back to your car?

Equally gross thing is to put your toothbrush inside your handbag without travel case. But at least then we are not able to see it.

“Sucking the Sucker”

By far the ickiest thing to my mind are the patients who close their lips around the saliva ejector or the high volume suction. I was horrified for the first time it happened with my patient. To be fair, it’s not their fault. They do this probably because some of the dental professional advise patients to do so. Honestly, fellow dental professionals, do your research and stop advising to close the mouth when the suction is inside the mouth.

Why?

It’s because of the backflow of bacteria and viruses. When patients close their mouth and form a seal around the tip of the saliva ejector, a partial vacuum occurs. That’s when the nasty stuff in the tube of the suction start travelling backwards – blood, viruses, saliva, bacteria, debris. They might travel as far as into the patient’s mouth. If you don’t believe me, read this.

If you are a patient and your dentist or hygienist advises you to close your lips around the suction, don’t do it. You don’t need to. This might of course mean that you need to swallow tiny amount of water, but the water is cleaner (or is it?) than the stuff that comes out from to suction with the backflow.

It is also absolutely your right to ask if they take care of the suction tube cleaning. They should answer you that

Yes, we flush the lines after each patient with clean water (this will take the nasty staff further away) and at the end of the day we flush the tubes with disinfectant. Also once or twice a week we use special cleaner for the suction lines.

Ok, there it was. Three of the ickiest things patients can do at the dentist. Do you know even grosser thing? Feel free to share it on the comment box below. Let’s see if it gets an Eew -reaction.


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Fox6Now.com: Tomah VA dentist accused of using improperly cleaned tools resigns

I shouldn’t read news as I always have something to say about them. This news above reminded me about working in the UK and how the instruments were cleaned there.

This Thomas VA dentist is not the only dentist that is underperforming in the instrument cleaning. There are dentists who have read this news and have wiped sweat from their foreheads and thanked their lucky stars it wasn’t their name on the headlines. Honestly!

Let me tell you how things were done in six of the practices I used to work in the UK. I will first go through the correct way of cleaning the instruments.

This I How It Should Be Done

1. Disinfect the contaminated instruments preferably in a washer disinfector like Miele Dental Disinfector

With this washer disinfector the cleaning job is half done. You just put used instruments within 4 hours of using them to the washing cycle and you get disinfected instruments in less than an hour (no need to soak them in anything prior the cycle).

No scrubbing is needed which will minimise the accidents of nurses cutting themselves.

2. Dry the instruments thoroughly. Use pressurised air on all the hard-to-reach areas like matrix retainers, sonic scaler tips, forceps.

3. Place the instruments that  don’t need to be sterile on the metallic tray to be autoclaved. Put the instruments that need to be sterile in pouches and close the pouches.

4. Put all the instruments in an up-to-date vacuum autoclave and run the cycle. Once they are cooked, put them in cupboards or drawers to be picked to the surgeries.

Simple and pathogen-free tools.

This Is How It Should Not Be Done

None of the surgeries I worked at in the UK had washer disinfector. Instead there was a dish brush and Hibiscrub. Yes, you read it correctly. Hibiscrub was used like washing up liquid on dish brush and the instruments were washed over a sink in the surgery. But this was done only up until health and safety regulations stated that using dish brush was a health hazard – there was too big risk of an injury from sharp instruments.

Once the instruments were brushed with Hibiscrub and rinsed with water, the instruments were placed on metallic trays (no drying) and put in the Instaclave, the simplest of the simplest model (non-vacuum). If there were surgical instruments, they were either put on the pouches and put on trays without closing the pouch. The pouch was closed after the cycle in the Instaclave. Sometimes the surgical instruments were put on the trays without pouches and once they had gone through the cycle, the nurse put them in the pouches that were taken straight from the package. This of course meant that the pouch was non-sterile as it had not gone through the cycle in the autoclave. Non-sterile pouch equals non-sterile instrument – no matter if the instrument has gone through the cycle.

So needless to say that many things went wrong. And let me clarify that all the above was done in the surgery. Every surgery had their own autoclave – just about five feet away from the patient.

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This was the typical setup in the dental surgery in the UK for cleaning tools used on patient

The Question: Did I Do It Too?

Well, as much as I think that you live by the rules of the country you are in, I did not follow this questionable way of cleaning instruments. I did inventory on surgery’s storage room and found a container with a lid. I asked the practice manager to order me instrument disinfection liquid. I had to do some convincing before the liquid was ordered – understandably of course as no-one else was using one. So why should I?

So all my instruments were brushed with dish brush under running water and then placed into this container which had disinfection liquid in it. The instruments were kept in there for the recommended time, rinsed with water, dried and then put in the Instaclave.

Not perfect, but enough for me to have a clean conscience.


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