Oral surgical procedures provide an opportunity for microorganisms to invade the vascular system through the surgical wound that will be created. Blood from the surgical site may also carry with it infective elements that may be transferred to the DHCP through open wounds, accidental cuts during surgery, needle prick or even splatter. Aside from blood, tissue obtained from biopsy, extracted teeth and other potentially infectious material may also be a source of increased concern during surgery. Transmission of infection may proceed from DHCP to patient and from patient to DHCP. From there, the infection may further be transmitted to other parties not directly connected to the surgery.
RECOMMENDATIONS:
Oral Surgical Procedures
1. The following apply when performing oral surgical procedures:
a. Perform surgical hand antisepsis by using an antimicrobial product (eg, antimicrobial soap and water, or soap and water followed by alcohol-based hand scrub with persistent activity) before donning sterile surgeon’s gloves.
b. Use sterile surgeon’s gloves.
c. Use sterile saline or sterile water as a coolant/irrigatant when performing oral surgical procedures. Use devices specifically designed for delivering sterile irrigating fluids (eg, bulb syringe, single-use disposable products and sterilizable tubing).
Handling of Biopsy Specimens
Biopsy specimens may carry infectious material. Care must be taken in handling and transporting these specimens. The specimen may contaminate the outside portions of the container in which the specimen will be placed. Inappropriate containers may allow leakage of infected material.
RECOMMENDATIONS:
Handling of Biopsy Specimens
1. Use wide-mouthed containers to minimize the occurrence of contamination of the outside portion of the container during specimen collection.
2. Avoid handling the biopsy specimen directly using your hands.
3. During transport, place biopsy specimens in a sturdy, leak-proof container labeled with the biohazard symbol.
4. If a biopsy specimen container is visibly contaminated, clean and disinfect the outside of a container or place it in an impervious bag labeled with the biohazard symbol.
Handling of Extracted Teeth
Disposal
Handling of extracted teeth is often overlooked in the dental clinic. The Occupational Safety and Health Administration (OSHA) considers them to be potentially infectious material. Extracted teeth are sometimes sent to dental laboratories for shade and anatomical comparisons. Occasionally patients request that their extracted teeth be returned to them. In many instances extracted teeth will include amalgam restorations.
Measures should be taken so that these teeth do not become a source of infection for other people who might come in contact with them. Also, possible pollutants should be taken into consideration.
Educational Settings
Students from dental school occasionally collect extracted teeth for use in their pre-clinical training. It should be kept in mind that these teeth are considered potentially infectious. Persons involved in handling and transport of these materials should be protected from possible infection.
RECOMMENDATIONS:
Handling of Extracted Teeth
Disposal
1. Dispose of extracted teeth as regulated medical waste unless returned to the patient.
2. Do not dispose of extracted teeth containing amalgam in regulated medical waste intended for incineration.
3. Clean and place extracted teeth in a leak-proof container labeled with a biohazard symbol and maintain hydration for transport to educational institutions or a dental laboratory.
4. Heat-sterilize teeth that do not contain amalgam before they are used for educational purposes.
5. Extracted teeth that contain amalgam may be immersed in 10% formalin for 2 weeks.
6. Although extracted teeth can be effectively sterilized, students must still follow standard precautions in handling these materials.