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hygiene tribune Dental Tribune Middle East & Africa Edition | July-August 20152B < Page 1B that can remain in the air for a long time and travel with air currents. Most dental aerosols are less than 5 µm in diam- eter; therefore, they are able to penetrate and stay within the lung, causing respiratory or other health problems. Among dental procedures that produce high aerosol concentration are ultrasonic scaling, tooth prepa- ration using high-speed hand- pieces, and dental extraction involving bone removal via a dental handpiece.[8] The World Health Organization (WHO) has reported a rise in airborne infections worldwide. Tuberculosis in particular has increased in the developing world.[12] It has been stipu- lated that the risk of exposure to tuberculosis in susceptible DHCP is greater than in healthy individuals. Bennett et al. con- cluded that dentists and their assistants, who are exposed for approximately 15 minutes during peak aerosol concentra- tion, have a slightly higher risk of exposure to Mycobacterium tuberculosis than the general public does.[9] During this pe- riod, the DHCP inhales about 0.014–0.12 µl of aerosolised sa- liva, which may contain viable pathogens that can have a det- rimental effect on the health of susceptible DHCP. With all of this in mind, it is the responsibility of DHCP to ad- here strictly to recommended infection control guidelines and policies. Several measures should be taken to reduce and control airborne contamina- tion in the dental clinic. For example, it has been demon- strated that the use of a mouth- rinse, high-volume evacua- tion or a combination of both methods significantly reduces the number of colony-forming units in aerosols emitted dur- ing ultrasonic scaling.[13] Rou- tine use of rubber dam isolation provides a clean and dry area for placement of dental resto- rations, prevents salivary and blood splatter, and protects the patient’s mouth and airway. Using personal protective equipment (PPE), such as sur- gical masks (with at least 95% efficiency against particles 3–5 µm in diameter; changed for every patient or every 20 min- utes in an aerosol environment or 60 minutes in a non-aerosol environment), safety glasses with lateral protection to pre- vent contact with eyes, as well as disposable gowns and gloves to reduce the penetration of or contact with bacterial aerosols and splatters, is vital. Regular maintenance of the air-conditioning system is rec- ommended too, as good ventila- tion has a diluting effect on the airborne microbial load, espe- cially at night when the clinic is closed.[14] Air samples taken at different times at a multi- chair dental clinic showed that bacterial aerosols are more concentrated during treatment and that there is higher con- centration of circulating bacte- rial aerosols at the beginning of the day, which may be related to reduced ventilation.[14] Re- sidual bacterial aerosols can be removed through air filters or ultraviolet light. As splatters can travel as far as the door or supply counter in the middle of a multi-chair den- tal clinic,[14] all clean, unused instruments and equipment should be kept in closed cabi- nets or drawers to prevent con- tamination. Other important measures that must be taken to prevent cross-infection include adequate sterilisation of dental instruments, disinfection of work surfaces before and after each dental procedure, disin- fection of all dental materials and work sent out to the labo- ratory, and regular mainte- nance of the dental water lines and equipment, which has the potential to harbour bacteria. All dental water lines should be purged at the beginning of each day for between 5 and 10 minutes and flushed thorough- ly with water, as residual wa- ter may become contaminated overnight and biofilm may de- velop along the inner side of the tube. Purging will result in a significant decrease in bacte- rial counts.[15, 16] The Canadian Dental Asso- ciation recommends running high-speed handpieces for 20–30 seconds after each treat- ment to purge all potentially contaminated air and water. This procedure has been prov- en to reduce the bacterial load in the water line significantly. [17] Blood cells, as well as bac- terial and viral particles, can survive inside handpieces even after disinfection. They must therefore be sterilised between patients.[17, 18] The clinic floor should be dis- infected and cleaned with an antimicrobial disinfectant so- lution at least twice per day to eradicate any bacterial residue from splatter or aerosols. It is a well-known fact that pri- vate dental clinics sometimes employ dental assistants who have not received certified training. Improperly trained personnel, however, may lead to poor infection control prac- tices. It is the responsibility of every dentist to educate and train his or her assistants in the standard procedures. Further- more, DHCP immunisation sta- tus should be up to date. Eliminating the risk of expo- sure to dental aerosols remains a difficult task. The best way to reduce the risks, however, is to employ routine cross-infection protocols recommended by the health authorities, such as the CDC, WHO and ministries of health. To date, various infec- tion control reports and pro- cedures have been published to inform and educate dental health care personnel (DHCP) about the importance of prac- tising adequate infection con- trol. Editorial note: A complete list of references is available from the publisher Dr. Safura Baharin is Head of Clinical Services at the Faculty of Dentistry of the National Uni- versity of Malaysia near Kuala Lumpur in Malaysia About the Author For more information about Philips Sonicare DiamondClean or the Philips Sonicare range, including copies of clinical stud- ies, visit www.mea.philips.com/e/ oralhealthcare/ar Contact Information Philips Sonicare DiamondClean; Product of the Year Winner in the Oral Care Category in the GCC Countries By Philips D UBAI, UAE - Philips is proud to present that its most sophisticated brush, Sonicare Diamond- Clean has been elected Product of the Year in the oral care cat- egory. The independent survey was conducted among 3,600 consumer in the GCC and it is among the most valued awards in consumer perception of products. Sonicare DiamondClean takes sonic tooth brushing to its most sophisticated level and which delivers Sonicare’s best clean yet removing up to 100% more plaque in hard to reach places than a manual toothbrush. Sonicare DiamondClean har- nesses Philips Sonicare’s pat- ented sonic technology to produce a powerful dynamic cleaning action for a difference users can see and feel. It is gen- tler on teeth and gums than a manual toothbrush, helping to keep teeth stronger and health- ier for longer. Philips Sonicare gently whips toothpaste into an oxygen-rich foamy liquid and directs it between and behind teeth and along the gumline- where plaque bacteria flourish. Sonicare DiamondClean is clinically proven to remove up to 100% of plaque from hard to reach places and to improve gum health in just two weeks. It is also clinically proven to whiten teeth in one week; and its gentle technology actually helps protect against gum irri- tation and recession to help re- duce sensitivity. Now is the per- fect time to give your teeth the celebrity treatment and switch to Sonicare to really experience the difference. The brush is able to deliver a unique whole mouth clean feeling thanks to its five brush modes that allow you to tailor your brushing according to your needs as well as your den- tal professional’s advice. The brush modes range from: • Clean – the standard mode for a whole mouth clean • White – removes surface stains to whiten teeth • Polish – brightens and pol- ishes teeth to bring out their natural brilliance • Gum Care – gently stimu- lates and massages gums • Sensitive – an extra-gentle mode for sensitive teeth Highly charged DiamondClean’s chrome base also features a unique charg- ing glass that can be used for mouth rinsing, but also incor- porates the latest in inductive charging technology to charge the toothbrush as it rests in the glass – making it stylish enough to display in the most fashion- forward bathroom. Not only is Sonicare Diamond- Clean Philips’ most advanced brush yet, it’s also our most easy to use and stylish. Dia- mondClean’s power handle has a ceramic finish and a chrome accent ring highlights the el- egant neck of the brush. The technology in the handle is hidden so that the sleek matte white finish of the brush is un- cluttered by electronic visual displays. Only when the on but- ton is pressed are the brushing modes illuminated to reveal the array of options. These are then simply selected by scroll- ing down using a one button action. When travelling or on the go, Sonicare DiamondClean is de- signed for convenience with users being able to keep their brush fully charged using a rev- olutionary USB travel case that can be plugged into almost any lap top computer and saves the hassle of having to pack plugs and adaptors. But only the most intrepid travellers need worry about this advanced feature as Sonicare DiamondClean holds an impressive three weeks charge. Brilliant cut Sonicare DiamondClean brush heads also sport a new diamond-cut tuft formation to provide you with an even more efficient brushing expe- rience. The uniquely designed diamond bristle heads have 44% more bristles than Philips Sonicare’s standard sized Pro- Results brush heads, providing you with both superior plaque removal and whiter teeth. The heads come in two sizes – Stan- dard and Compact – for focused cleaning in areas of special need, for orthodontic patients and those with smaller mouths. 2015