Infection Control and Prevention

Designed to Make Cleaning Easier

In reality, safety begins long before the patient arrives for an appointment and is part of a comprehensive, well-thought-out infection prevention concept. Medical devices are designed to meet specific standards and norms. But manufacturers also develop their own design language to minimize the risks of contamination and to make infection prevention as easy as possible. For example, Dentsply Sirona products have very smooth surfaces and are free from flourishes or other stylistic elements that could make cleaning more difficult. Gaps and cracks are also avoided so that dirt and debris cannot get trapped in difficult to access areas. In addition to their smooth surfaces, treatment centers are designed and equipped with durable materials that are chosen to prevent moisture from penetrating into the chair to avoid hygiene problems down the road. Treatment centers even let the dentist or assistant know that the hoses should be flushed for at least 20 seconds after every patient’s appointment. Parts such as light handles and trays are removable so that they can be properly disinfected separately between uses.

How can the Practice’s Design Facilitate Infection Prevention?

While the interior design of a dental practice may correspond to an overarching trend or theme, there are some ways in which design can be used to promote good infection prevention practices. According to Stella Nehr-Werner, Global Clinical Affairs Manager, Dentsply Sirona, “It starts with the reception or registration desk. Ideally, I like to see short pathways throughout the dental office from point A to point B. It’s also a good idea to consider having the reprocessing room in a central position in relation to the treatment rooms.”

Steffen Bucher, architect and founder of 12:43 Architekten, an award-winning company specializing in the planning of dental practices, agrees: “We have always made sure that the sterilization room is located quite centrally, so that everyone in the team has short walkways, or that we avoid many crossroads between staff and patients, as well as long walkways in practices in general.” 

Within the treatment rooms, the location of equipment should also be carefully considered as well as tables and counter space needed for the types of treatments that will be performed. The needs of different workflows can differ significantly depending on personal preferences, the areas of dentistry offered and the size of the practice. It’s possible that not every treatment room needs to be fully equipped if space is limited. Tools and equipment should be easily reachable, particularly for things that are used often to minimize the number of items that need to be handled. Of course, the dental team knows their patients and the practice’s design has to take their needs into account. Children and elderly patients may have particular needs that also influence the layout and design of the practice.

Many practices have also tried to minimize the time that patients spend in waiting areas. In Shanghai, Dr. Eison of DENSDE Dental explained that patients undergo a pre-examination including a temperature check prior to entering practices. His practice strictly ensures enough time between each patient for the disinfection and cleaning work and patients can go directly to their treatment room to reduce crowding in the waiting area.

Disinfectant dispensers have also become a common sight in healthcare settings during the COVID-19 pandemic and these are unlikely to disappear from practices once the public health emergency has abated. Therefore, design professionals are now including these dispensers in their furniture planning, as Steffen Bucher notes, “So that there are no unsightly dispenser columns standing around that don't fit in with the overall concept of the practice.”

How has infection prevention changed during the pandemic?

Stella Nehr-Werner: The COVID-19 pandemic has really put infection control and prevention once again in focus. In addition to occupational health and safety for the employees of the practice, dentists are especially focused on what needs to be done in between patient visits. For example, did I disinfect all surfaces fully and correctly?

Even before the pandemic, dental offices did an excellent job with infection prevention. Dental professionals have always had to deal with aerosols and in preventing their patients from acquiring any microorganisms.

What is most important for infection prevention in the dental office?

From my point of view, the topic of aerosols is quite important. We want to reduce aerosols and avoid them if possible. Secondly, reprocessing of dental instruments, particularly transmission instruments – handpieces, turbines – anything that is rotating. Third, reprocessing of the room after each patient: preparing for the next patient by disinfecting surfaces, flushing and preparing water lines.

How will the pandemic affect future trends?

I believe that people will think carefully about the waiting rooms and the actual registration desk including all of the things on the desk like figurines or paper, or anything else that clutters the surfaces. People will ask: “Do I really need this?” “Can I actually disinfect all of this?” Plants are also another design element that probably needs rethinking. If you disinfect your plant after every patient, it will surely leave the room on its own in a matter of speaking. We also need to consider what we learned about equipment design from the pandemic. Can the materials resist the kinds of chemicals we needed to use for disinfection? Do the materials lose their color? Do they react with the strong disinfectants as more aggressive chemicals were used? As a manufacturer we need to do more testing of these disinfectants and should include additional advice for users.

Of course, dentists are rethinking their processes, and waiting room areas, but overall, all of the dentists I know have traditionally done a great job in infection prevention.