Clinical Practice Guideline for an Infection Control/Exposure Control Program in the Oral Healthcare Setting
Environmental Infection Control

Background

Environmental surfaces such as walls, floors, and sinks do not appear to contribute to significant cross-contamination in the oral healthcare setting. Other surfaces that are frequently touched may serve as reservoirs for microbial contamination and are categorized as clinical contact surfaces (e.g., light handles, switches, radiographic equipment, dental chairside computers, reusable containers of dental materials, drawer handles, faucet handles, countertops, pens, telephones, and doorknobs) and housekeeping surfaces (e.g., walls, window drapes, other vertical surfaces, floors, sinks, carpeting, and cloth furnishing).

1. Clinical contact surfaces
   1. To prevent contamination, use materials impervious to moisture (e.g., plastic wrap, bags, sheets, tubing, and plastic-backed paper).
      1. Coverings are removed and discarded between patients.
         1. After removing the barrier, the surfaces are examined for visible soil.
         2. Surfaces with visible soil are cleaned and disinfected with an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim, e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors.
         3. After removing gloves and performing hand hygiene, clean barriers are placed before the next patient.
      2. If barriers are not used, wearing appropriate PPE, the surfaces are cleaned and disinfected between patients using an EPA-registered intermediate-level hospital disinfectant with tuberculocidal claim, e.g., products containing chlorine, quaternary ammonium compounds with alcohol, phenolics, or iodophors.
      3. At the end of each day, general cleaning and disinfection of clinical contact surfaces are performed regardless of barrier protection.
         1. To facilitate daily cleaning, treatment areas are kept free of unnecessary equipment and supplies.
2. Housekeeping surfaces
   1. Unless visibly contaminated, cleaning walls, window drapes, and other vertical surfaces is unnecessary.
      1. Floors and sinks are cleaned regularly with a detergent and water or an EPA-registered hospital disinfectant/detergent designed for general housekeeping purpose.
      2. Carpeting and cloth furnishing cannot be reliably disinfected and are avoided in patient care, laboratory, or instruments processing areas.
3. Cleaning and disinfection strategies for spills and spatter (blood or OPIM)
1. Wearing appropriate PPE, visible organic material is removed using disposable paper towels, which are then discarded in a leak-proof and appropriately labeled container.
2. The contaminated surface is cleaned with a detergent and water and disinfected with an EPA-registered intermediate-level hospital disinfectant with a tuberculocidal claim.