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Breaking the Chains of Disease Transmission

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I recently ran into the wife of my former dentist. This got me reminiscing about Dr. Smith (name changed to protect!!). I was his patient from the mid-70's until 1982, when he sadly passed away much too young. Dr. Smith had a big personality, a booming voice, and a ready smile. My most notable memory was his disappearing regularly into a small enclosure between procedures?and even mid-procedure?to have a drag off his ubiquitous Marlboro cigarette. I am not kidding. Looking back, I'm amazed I saw nothing wrong with this. Or the fact that he didn't wear gloves. Or that I had no idea whether or not he sterilized his instruments.

I started to search online to find out when glove use by the dental team became widespread. I came across this video (which references AIDS and so it had to have been produced early- to mid-80s at the earliest), complete with cheery background music and a disclaimer that the content should be viewed for historical purposes only. The video's goal is to show the extent of saliva aerosol contamination during dental treatment. But note: NO ONE is gloved! Missing the forest for the trees?

bib clip germs

Fast forward to 2012. The latest culprit in the disease transmission chain (no pun intended) has been identified: reusable clip-on bib chains. The most recent study showing that these holders harbor harmful microorganisms was done by a Tufts University team, who found that, even after disinfection, up to 30% of the studied holders were still contaminated. A previous UNC study and other earlier studies had similar results.

So why is anyone still using these things? There are alternatives. The bibs are disposable, so why not the holders? DUX Dental offers 2 types: Bib-Eze and Snap-Its. These are great options if you follow the recommendations from infection control experts: "There are ways to avoid the risk of bib chain contamination. A dental office can effectively sterilize chains between patients or choose a disposable bib holder that is discarded with the bib. When choosing a solution, an office should consider which option reduces the risk the most and which option is easiest to implement."

Dental practice infection control protocol has definitely come a long way in 3+ decades. Sorry, Phillip Morris!

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