Taking radiographs is one of the procedures in dental practice that is often overlooked. Oftentimes, film-holding devices are merely washed and disinfected. The x-ray tube head is a surface often contaminated while positioning it to take a radiograph. Transport of the film to the developing area is a potential source of contamination with blood or OPIM. Contamination of the developing solution should also be taken into consideration.

Digital radiography sensors and other high-technology instruments (eg, intra-oral camera, electronic periodontal probe, occlusal analyzers and lasers) come into contact with mucous membranes and are considered semi-critical devices. Use of a barrier does not always protect from contamination. One study determined that a brand of commercially available plastic barriers used to protect dental digital radiography sensors failed at a substantial rate. This rate dropped to 6% when latex finger cots were used in conjunction with the plastic barrier. To minimize the potential for device-associated infections, after removing the barrier, the device should be cleaned and disinfected with an EPA registered hospital disinfectant (intermediatelevel) after each patient. Manufacturers should be consulted regarding appropriate barrier and disinfection/sterilization procedures for digital radiography sensors, other high-technology intra-oral devices and computer components.

RECOMMENDATIONS:

Dental Radiology
1. Wear gloves when exposing radiographs and handling contaminated film packets. Use other PPE (eg, protective eyewear, mask and gown) as appropriate if spattering of blood or other body fluids is likely.
2. Use heat-tolerant or disposable intra-oral devices whenever possible (eg, film-holding and positioning devices). Clean and heat-sterilize heat-tolerant devices between patients. At a minimum, high-level disinfect semi-critical heat-sensitive devices, according to manufacturer’s instructions (IB) (243).
3. Transport and handle exposed radiographs in an aseptic manner to prevent contamination of developing equipment (II).
4. The following apply for digital radiography sensors:
a. Use FDA cleared barriers
b. Clean and heat-sterilize or high-level disinfect between patients. If the item cannot tolerate these procedures then at a minimum, protect with FDA approved barriers and clean and disinfect with an EPA registered hospital disinfectant with intermediate level activity between patients.
c. Consult with manufacturer for methods of disinfection and sterilization of digital radiology sensors and for protection of associated computer hardware.