Eastern Shore Mission of Mercy 2013
Infection Control and Sterilization Plan
Mission of Mercy adheres to the Centers for Disease Control and Prevention’s (CDC) Guidelines
for Infection Control. This document is based on information from OSAP’s Guiding Principles of
Infection Control for Dental Settings Using Mobile Vans or Portable Dental Equipment.
Hepatitis Vaccine for Volunteers
All volunteers who work in patient care, instrument sterilization and waste management must
be vaccinated for Hepatitis B.
Hand hygiene is the single most important way to reduce the risk of disease transmission.
Alcohol based hand sanitizer will be available at every station.
WASH HANDS with antimicrobial soap and water if hands are visibly dirty or
contaminated. Sinks are located in the sterilization area.
Use hand sanitizer or wash hands
o Before donning gloves and after removing gloves
o Before leaving the treatment or sterilization area
o After handling objects that may be contaminated
o Before eating and after using the restroom
Personal Protective Equipment (PPE)
Personal protective equipment is provided for all clinical volunteers except for eyewear.
PPE includes exam gloves, heavy duty utility gloves, masks and disposable gown.
Volunteers must bring their own protective eyewear and loupes.
Wear fresh gloves with each new patient and sooner if gloves become compromised.
Disinfect eyewear and utility gloves when visibly contaminated.
Disposable gowns should be discarded when visibly soiled and before leaving the
Environmental Surfaces: Clinical Contact Surfaces
Clinical contact surfaces are touched by contaminated instruments, devices, hands or gloves.
This includes light handles, chair, headrest, instrument tray, curing light and other surfaces
touched during treatment.
Tables will be covered with plastic. Limit the number of items set on table.
Disinfect all clinical contact surfaces after treating patient and at the end of the day.
Tuberculocidal disinfectant will be located next to all stations and in the sterilization
Follow manufacturer’s directions for cleaning and contact kill time.
All waste will be designated as Bio hazardous in the clinical area.
Red bag containers for waste will be located near the clinical treatment tables, in the
sterilization area and at the exit doors of the clinic floor.
Designated individuals will empty these containers twice daily or as needed.
Safe Handling of Sharp instruments and devices
Handle sharps with care. Treat every patient as though they are infectious.
Use the one handed “scoop” technique to remove the needle or a recapping device.
All sharps must be disengaged at the chair and placed into the sharps container before
transporting dirty instruments to the sterilization area or transport cart.
A transport cart for dirty instruments will be located at the end of each treatment area.
Sharps containers will be between every 4 chairs and in the sterilization area.
Sharps include suture needles, unusable burs, syringe needles, scalpel blades and
extracted teeth. (unless they contain amalgam-see Amalgam Recycling)
Pass instruments with care and announce instrument passes so the person knows a
sharp instrument is coming into his/her work space.
Use instruments instead of fingers to retract tissues during suturing and anesthetic
Designated volunteers will remove sharps container when ¾ full for disposal.
Return all instrument set ups to their cassettes and close cassette securely.
Place loose single instruments in plastic biohazard box and close lid securely.
Transport dirty instruments to the sterilization area or transport cart wearing gloves.
If volunteer returns sharps to sterilization area, please advise NOT to do so in the future.
Plastic biohazard boxes will be disinfected and returned to clean supply area.
Bins for clean storage of sterile instruments will be cleaned and disinfected prior to use.
No hand scrubbing is recommended. If necessary, use a long handled brush.
Sterilization techs will wear heavy duty utility gloves for processing instruments.
Fill ultrasonic unit with water to fill line adding enzymatic cleaner according to
Operate the unit for 15 minutes with the lid on.
Lift basket out of ultrasonic and rinse instruments in sink.
Dump rinsed instruments from ultrasonic basket onto clean absorbent toweling.
Do not reach into basket with hands. Use forceps if needed to retrieve instruments.
Remove excess moisture with several thicknesses of towels.
NOTE: Sterilization techs must wear utility gloves to reduce risk of injury.
Bag instruments/cassettes for sterilization. Use sharper marker to label pouches with
autoclave identification used in case tracking of instruments is necessary.
Dentists may bring their own instruments, but must supply labeled pouches.
Do not place Cavitron tips or hand pieces into the ultrasonic cleaner. Wipe with
disinfectant to remove debris.
Do not place instruments into the ultrasonic cleaner without a basket as this can cause
damage to the transducer of the unit.
Contaminated reusable burs are placed in mesh bur holder for ultrasonic cleaning.
Rinse, package and heat sterilize.
Check burs and when in doubt of further use, dispose of burs in sharps container.
Flush high speed hand piece chair side.
Remove the bur chair side.
Wipe hand piece with disinfectant to remove debris.
Disconnect hand piece and transport to sterilization area or transport cart.
Sterilization techs will attach hand piece cleaner/lubricant spray and flush debris from
the hand piece, then use Midwest Air-station to remove excess cleaner/lubricant.
All autoclaves will be spore tested to ensure the sterilization process and documented
on ESMOM Autoclave Log.
Spore test ampules will be run through a sterilization cycle in each autoclave and
incubated with a control in a block incubator to assure sterilization.
Use distilled water only in the autoclaves. Check /refill periodically.
Processing of instruments will proceed from decontamination to sterilization to clean
area keeping dirty separated from clean at all times.
Place absorbent pads under autoclaves and on tables where needed.
Load trays in single layers. Mark each pouch with identifier for autoclave.
Run any load containing hand pieces on the “hand piece” cycle.
After cycle is complete and air drying, wear clean gloves to remove instruments to
“clean area” covered with absorbent pads.
Cool and dispense instruments to sterile instrument supply area.
DO NOT ALLOW patient to close and form a tight seal around the saliva ejector or HVAC
tip to prevent backflow.
After each patient, flush the lines with a 1% peroxide solution. Obtain a Dixie cup with 3
oz. of solution from a 5 gallon cooler located adjacent to each treatment area. The
solution is made by adding 8 oz. of 3% peroxide to a 5 gallon bucket of tap water.
Self- contained 20 gal water tanks will supply tap water to the event.
Surgical extraction sites will be irrigated with syringe of sterile or saline water.
Management and Follow Up of Occupation Exposures
In the event of an exposure to blood or other potentially infectious material, this is a
Cleanse wound or affected area with soap and water immediately.
Flush mucous membranes with water for 15 minutes.
Report the event immediately to your area lead and the Medical Lead.
Volunteer will complete a confidential Exposure Report/Questionaire and incident
The Medical Lead or qualified healthcare professional will evaluate the exposure and
advise the volunteer of any options for medical management.
Volunteer will report to the Emergency Room at Peninsula Regional Medical Center
located at 266 Tilghman Rd, Salisbury where some medications may be provided to
reduce the risk of disease transmission if necessary.
These drugs, if needed, must be given within 1-2 hours after exposure to be most
MSDS sheets for all chemicals used during the event will be available in the sterilization
area in the event of a chemical splash or exposure to skin or mucous membranes.
Spills of Blood and Body Substances
Wear PPE and isolate the area
Notify your area lead.
Obtain a spill kit from the sterilization area
Collect waste and dispose in bio hazardous waste.
An amalgam filter on vacuum pump will collect amalgam waste and be sent to Solmetex
for proper disposal at the end of the event by ADCF.
Scrap/contact amalgam, amalgam capsules and extracted teeth containing amalgam will
be placed in labeled containers on tables adjacent to restorative and oral surgery chairs.
Amalgam in containers will be recycled at the end of the event by DRNA.
Barriers will be used on sensors for infection control.
X-ray equipment will be disinfected between patients.
Shielding will be used on all patients.