DENTAL LABORATORY POLICY

Definition

Dental technician are required to follow standard precautions practices. Eye protection and mask are required only when performing hazard related tasks. Work surfaces should be wiped down daily. However lab personnel may be exposed via direct contact from impression of contaminated residual blood and saliva (trough cuts and abrasions), aerosols created during lab procedures. Inhaled or ingested. Patients can be at risk due to potential cross-contamination between dental prostheses/ appliances, potential for cross-contamination from dental office to lab and back to dental office. Because of that, each dental laboratory should have a SOP for infection control  

Procedure

Guidelines for developing a dental laboratory infection control protocol :

1.      Dress code should be maintained, cleaned and disinfected.

2.      Gloves must be worn at all times receiving the impression from dental surgery room.

3.      Make sure the impression is clean of blood and saliva. If it is still on there, impression must be clean and disinfected under cold running water followed by the application of diluted detergent and further rinsing must continue until all visible contaminations is removed.

4.      The gloves are then remove and hands are washed using an anti-bacterial soap.

5.      Put on the face mask, new gloves and prepare the material/stuff before beginning another procedure.

6.      Carefully remove all chemical waste from working area and do not use bare hand.

7.      Any combustion from metal (none), residual smoke burning from burning out wax obtaining sucked through the channel exhaust direct ventilation to the outdoors.

8.   Every work related residual dust from investment current deflasking or during polishing must be sucked up with vacuum cleaner.

Incoming cases :

All contaminated incoming items should be cleaned and disinfected before being handled by lab personnel, and before being returned to the patient.

Simple steps for dental impression:

1.      Rinse under tap water to remove as much debris as possible.

2.      Disinfect the impression using an intermediate level hospital grade disinfectant following the contact time that is recommended.

3.      Rinse under tap water to remove the residual chemicals.

4.      Shake in the sink to remove adherent water.

Outgoing cases :

1.      All item such as crown or bridges that are ready to insert into the patient should be clean from dust or polishing material result.

2.      Crown or bridges should be cleaned by ultrasonic cleaner and steamer.

3.      All materials transported to and from dental laboratories must first be cleaned and placed in a sealed bag or container.

Equipment Required

1.      Equipment for manufacturing casts and dies :

This includes equipment such as model trimmers, vibrators, plaster bins, dowel pins, saws and other equipment necessary to manufacture models and or dies.

2.      Burnout and casting area, with casting wells made of non-flammable material; from bego and using electric induction system to melting the metal. There have local direct exhaust over all burnout, casting and/or boil out areas, providing direct ventilation to the outdoors. This exhaust will remove high heat produced from this equipment and provides better air quality to employees by the removal of odors, smoke, etc. to  the outdoors. The local, direct exhaust should be located within 18’’ of the source equipment in order to effectively remove heat, smoke or odors. The installation of a chimney can help in directing the exhaust in many instances.

3.      Equipment for investing :

This includes instrument such as casting ring, silicone ring, vacuum mixer, bowl, spatula and other instrument.

4.      Finishing and polishing equipment

These include hand pieces and lathes equipped such as polishing machine, mandrill, diamond bur, separating disc, fisher and rubber polish with proper shielding and/or evacuation devices.

Must have suction devices to prevent the accumulation of dust in the workplace and in the worker’s breathing zone.

Hand instruments, surveyors and occludator ;

This includes instrument such as electric knife non flammable, spatulas, electric deep waxes, brushes, pliers and mallets which are necessary to perform the functions normally associated with the respective specialty area.

Equipment for processing crowns and bridges :

This includes all equipment necessary to perform the functions normally associated with the respective specialty area. For all ceramic crown/e-max product such as porcelain furnances programat EP3000, sandblaster, steamer, and ultrasonic cleaner.

Monitoring

Monitoring of dental laboratory infection will be monitored on a daily basis by the dental laboratory supervisor and braches of infection control is to be reported to the dental department manager.

Policy and procedure will be update accordingly.

References

-          ADA’s ( Australian Dental Association ), The Practical Guides in The Dental Laboratory November 2012

-          Certified dental laboratory 

-          Dental laboratory infection control procedure (Florida Department of Health) available at www.doh.state.fl.us/mqa/dentistry