Dental Tribune United Kingdom Edition

21Infection Control Tribune To request your FREE sample, view the Biocleanse Ultra video at www.dentisan.co.uk Use biocides safely. Always read the label and product information before use. CO M PLIANT C O M P L I A NT HTM 01-05 To place an order call Henry Schein Minerva on 08700 102043 or Claudius Ash on 0500 500 322 ONE wipe does it all! Biocleanse Ultra is an alcohol-free wide spectrum microbiocide that cuts through contaminants, lifting them from surfaces and leaving a physically clean and disinfected surface in a single operation. Like us on Dentisan Ltd @DentisanLtdFollow us on • Cleans & disinfects in a single wipe • Alcohol free • pH neutral • Ultra-low residue • Broad surface compatibility • Proven efficacy • HTM 01-05 compliant HTM 01-05: 6.57 “Care should be taken in the use of alcohol wipes, which – though effective against viruses on clean surfaces – may fix protein and biofilm.” A s the dental profession is only too well aware, cleaning and disinfec- tion processes within the dental practice are of paramount con- cern, not only in relation to CQC and HTM01-05 compliance, but also with regard to staff and patient well-being – which the compliance guidelines are there to ensure and protect. Protein contamination in the dental surgery is an obvious area for serious concern, since residual soiling on surfaces can harbour pathogens. Blood has the potential to carry and transmit viruses such as HIV, HBV and HCV. The risk of trans- mission of communicable blood- bornevirusesmightbeconsidered to come only from high risk areas such as accidental sharps injuries, but greater research and advanc- es in the sphere of microbiology now provides evidence that many micro-organisms can survive on a variety of surfaces, making the danger of disease transmis- sion from contaminated surgery surfaces or equipment a genuine threat to patients and staff. In addi- tion, an increasingly mobile popu- lation including greatly increased economic migration has resulted in a resurgence of diseases such as TB, which are associated with overcrowding and poor standards of general health. In order to overcome the po- tential issue of surface decon- tamination and the prevention of transmission of pathogens, den- tal practices must have rigorous infection control policies which establish clear protocols for clean- ing and disinfection and docu- ment the practice’s adherence to the procedures laid down. Decontamination is defined as a reduction in the risk of contami- nation to a level that is acceptable, ie controlling the number of mi- crobes in an environment. Within a dental surgery, both cleaning and disinfection are required but although the terms are often confused they are not the same thing. Cleaning involves physical removal of soiling matter from surfaces while disinfection is in- activation of pathogens. Cleaning must take place before disinfec- tion to ensure that bacteria, pro- teins and other contaminants are removed from surfaces before disinfection takes place, unless a suitable single stage process is in use. Decontamination of a specific area is aided by the use of com- mercially available products and many of these agents are based on alcohol. In dentistry, alcohol has been widely adopted as a dis- infectant for many years and its efficacy in this role is well docu- mented. The widespread use of alco- hol as a disinfectant in dentistry has been largely driven by its low cost and quick drying properties, where its rapid drying is per- ceived as beneficial in achieving a short turn-round time between patients. However, rapid evapo- ration of alcohol based products also means that by the time the treatment of a surface has been completed, most of the alcohol has evaporated from the wipe or surface, so the areas wiped at the end of the process will be neither cleaned nor effectively disinfect- ed. A fact frequently overlooked, but one that is highlighted by the HTM 01-05 guidelines, is that al- cohol is not effective as a cleaner, particularly where protein based soils are present as is likely to be the case in medical and dental en- vironments. Section 6.57 of HTM01-05 states: Evidence suggests that the use of commercial bactericidal cleaning agents and wipes is help- ful in maintaining cleanliness and may also reduce viral contamina- tion of surfaces. Care should be taken in the use of alcohol wipes, which – though effective against viruses on clean surfaces – may fix protein and biofilm. However, the careful use of water with suitable detergents, including those CE- marked for clinical use, is satisfac- tory provided the surface is dried after such cleaning. NOTE: Alcohol has been shown to bind blood and protein to stain- less steel. The use of alcohol with dental instruments should there- fore be avoided. Some of the limitations of alco- hol are as follows: • Protein fixation • Materials incompatibility (par- ticularly PMMA) • Rapid evaporation • Flammability If we consider the ideal prop- erties of a combined disinfectant and cleaning agent, most “ex- perts” would agree that the fol- lowing would be a reasonable, though not exhaustive list: • Excellent cleaning action • Broad spectrum microbiocidal action – some microbes present bigger challenges than others, for example TB • Non-toxic – or at least selectively toxic • Short contact time – driven by time pressure and the need for short turnaround between pa- tients • Stability – some agents have a very short shelf life • Ease of use – no complicated making-up requirements • Competitively priced As stated in HTM 01-05, al- cohol does not clean effectively but will disinfect clean surfaces, therefore, a two-stage process is required when using an alcohol based disinfectant. 1. Clean to remove physical soil- ing 2. Disinfect with alcohol to inacti- vate pathogens This process however is less than desirable from an opera- tional point of view due to the ad- ditional time required to carry out two procedures between each pa- tient as well as the additional cost of buying two products and the additional inventory required. Therefore we have seen in recent years a growing demand for water based combined clean- ers and disinfectants. The ideal solution is a carefully formulated water based product that can both remove soiling and disinfect in a single process, greatly reducing the time taken and providing an effective solution. The properties required in such a combined cleaner and dis- infectant would be: • Broad spectrum efficacy • Wide surface compatibility • Effective cleaning • CE marked Class 2a (required if a product is to be used to disinfect medical devices) • pH neutral • Two-year shelf life • Low residue • Supplied in all formats (ready to use, concentrate and wipes) The ability to deliver all the required features and their asso- ciated benefits in a single product will answer the demands of the market and provide a means of ensuring complete compliance with current guidelines. DT Protein contamination in the dental surgery Peter Bacon discusses surface cleaning and disinfection Peter Bacon is Techni- cal Director at Dentisan. www.dentisan.co.uk About the author