Infection Control: How it works

Infection control is the title given to the practice of taking precautions to ensure that pathogens do not pass from one person to another. The basis of infection control is to operate as though everyone is potentially infectious and also equally susceptible to infection. In any environment, infection control relies on taking the proper steps and following protocol to keep everyone safe and healthy. Protocols will differ, depending on the type of germ or virus that is being avoided, and on the designated space that is being controlled. 

Right now, South Africa has been put in a national lockdown, specifically to flatten the curve of the spread of the coronavirus. The world had been brought to a standstill by COVID-19 and has adopted international infection control measures. These measures include social distancing, isolation and quarantine. 

The coronaviruses belong to a large family of viruses. These viruses are capable of causing illness in both animals and humans. The most recently discovered of them causes coronavirus disease or COVID-19.

In humans, several coronaviruses are known to cause respiratory infections. COVID-19 is one of them. The coronavirus family can cause anything from a common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). 

What exactly are pathogens?

Better Health explains: Infection is caused by pathogens. Pathogens are bugs such as bacteria, viruses, protozoa and fungi. When these get into or onto the body, they cause infection. It can take some time before the microbes multiply to such an extent that they trigger symptoms of illness, which means an infected person may unwittingly spread the disease during this incubation period. 

These bugs can be spread in various ways.

How are infections spread?

Infections are transmitted in various ways, which all depend on the type of pathogen. Infection can occur via airborne germs, which are expelled from the infected person’s body through coughing or sneezing.  When the pathogens are inhaled by other people, the infection is spread. 

Skin-to-skin contact also puts people at risk of picking up germs. 

When people pass objects to each other, they also run the risk of contamination, just like with skin-to-skin contact. This is why the proper use of gloves and sanitiser is so important during an outbreak.

According to the World Health Organization, the virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air, so they quickly fall on floors and surfaces. You can be infected by breathing in the virus if you are within one metre of a person who has COVID-19, or by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands.

Infection control in the workplace, home environment and in public spaces is very important, especially during a pandemic. 

Under regular circumstances, workplaces are all expected to have an appropriate first-aid kit, with at least one staff member trained in first aid. Equipment such as gloves, gowns, eye goggles and face shields or masks should be provided. This is in case of an emergency that leaves people susceptible to infection.

But, how is infection control employed specifically in dentistry? 

Dentists work inside the mouth. This is a part of the body that is one of the main channels for both contracting and spreading germs and disease. The saliva glands, and the respiratory system and nose, which expel mucous and bodily fluids, are in constant contact with the dentists’ gloves and instruments. 

If these instruments are not properly cleaned and sterilised, the dentist’s office has the potential of being a smorgasbord of bacteria. 

Infection-control protocols are very particular about sterilising all equipment in a special antibacterial solution. For other instruments such as, among others,  the tips of the vacuum pipes and cotton swabs, dentists will use fresh packs and dispose of the used ones after each appointment. 

The same goes for other disposables such as Band-Aids. 

Dentists and dental assistants are all expected to wear protective gear during procedures. This includes gloves and clean coats and aprons. 

What about in the COVID-19 outbreak? 

On March 16, 2020, the American Dental Association issued guidelines to dentists regarding the COVID-19 pandemic, stating:

“In order for dentistry to do its part to mitigate the spread of COVID-19, the ADA recommends dentists nationwide postpone elective procedures for the next three weeks. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.” 

In South Africa, the South African Dental Association (SADA) has sent out several guidelines regarding proper protocol and has also cancelled the annual SADA 2020 Congress.  Many dentists have opted to do teleconsultations. It is understood that only emergencies will be tended to at their surgeries office, although this may vary depending on each dentist.

SADA recommends that “the initial contact be telephonic or electronic to determine if the patient’s condition warrants emergency treatment, which entails either seeing and treating the patient or by referral to another service provider or a government-accredited healthcare facility.

SADA’s newsletter continues: “The HPCSA is permitting teleconsultations for emergencies during the lockdown period, restricted to established patients, not for new patients. It will make new guidelines available after the lockdown.”

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