Personal protective equipment (PPE) is there for a reason

Aims & Objectives

  • To teach readers about the importance of wearing Personal Protective Equipment (PPE)
  • To communicate how PPE protects the wearer from various hazards
  • To teach readers about what elements are included in standard PPE

Learning Outcomes

  • Readers will be aware of the importance of wearing Personal Protective Equipment (PPE)
  • Readers will understand how PPE protects the wearer from various hazards
  • Readers will learn about what elements are included in standard PPE, and the appropriate application and removal of these items

Minimising the risk of cross-infection is a important aim for every dental practice. Infection prevention and decontamination measures are not just designed to protect the health and well-being of patients, they are very much there to protect every member of the dental team.

Safeguarding both patients and staff is imperative for compliance. Every dental practice must have a robust infection control policy, with a nominated lead member of staff responsible for infection control and decontamination. All staff carrying out decontamination procedures should have the appropriate personal protective equipment (PPE) provided by their employer who must also ensure PPE items are CE marked as required, to guarantee they are fit for purpose. As stated in HTM 01-05 6.13: The local infection control policy should specify when PPE is to be worn and changed. PPE training should be incorporated into staff induction programmes.

What is PPE?

PPE is exactly what its name implies – it is designed to protect dental care professionals from the risk of exposure to occupationally-related infections and harmful pathogens in the working environment. PPE should be single-use wherever possible and should not be worn outside of the practice environment.

PPE is designed to interfere with each of the four main pathways through which disease can spread within a dental practice – direct contact, indirect contact, droplet infection and airborne infection via inhalation. Essential PPE for the dental care professional consists of disposable gloves and aprons, surgical masks, eye protection and appropriate footwear.

Hand protection

Surgical gloves provide a barrier to protect the wearer from contamination against blood and saliva and direct contact with microorganisms from the patient’s oral cavity. They should be worn for all routine dental treatment and changed/disposed of between each patient to prevent cross contamination between patients and contamination of hard surfaces in the surgery. Non-sterile gloves are suitable for routine procedures whilst sterile surgical gloves are used for more invasive oral surgery such as periodontal and dental implant surgery.

Hands must be washed thoroughly before donning and after removal of gloves. Disposable clinical gloves should never be used for cleaning instruments as they offer no protection from the risk of sharps’ injuries or puncture wounds. Instead, use heavy duty, reusable household gloves which are also suitable for routine environmental cleaning.

Gowns and aprons

PPE such as gowns and aprons are designed to cover skin, general clothing and uniforms to prevent contamination from emitted droplets, splashes and debris. Single-use aprons are worn over the top of dental uniforms to act as a barrier to fluids during treatment and should be discarded after each procedure and between patients. Splatter generated by the use of rotary equipment falls mainly on the operator’s face, chest, wrists and hands. It is essential to make sure disposable aprons are not worn too low or loose so that the chest area is adequately covered.

Eye protection

Protective eyewear is needed to protect both the eyes of the dental team as well as the patient against splatter, aerosols, projectiles and hazardous chemicals. Normal glasses do not provide sufficient eye protection unless specifically designed for the purpose. Goggles or visors give additional side protection and should be worn during treatment and when manually cleaning instruments. Patients should always be given eye protection prior to any examination or treatment.

Surgical facemasks

Conventional facemasks provide a barrier against the splatter of blood, saliva and other potentially infectious substances, as well as reducing the inhalation of aerosols generated during patient treatment. Masks should be single-use, disposable PPE that is be changed after every patient and, once in place on the face, not touched unless being removed. Always wash your hands after removing the mask to prevent any cross-contamination to the surgery environment.

Get in order

The order of putting on and removing PPE is vital in order to prevent the spread of infection. NHS England advise the following sequence:

Putting on PPE: Apron (or gown) > surgical mask (or respirator) > eye protection > gloves

Removing PPE: Gloves > apron (or gown) > surgical mask (or respirator) > eye protection

It is important to keep hands away from the face and limit surfaces touched in the patient environment. Gloves should be changed if they become torn or heavily contaminated and always between patients. Regularly perform hand hygiene and always clean hands after removing gloves, preferably using proven bactericidal hand cleansers rather than just soap and water, before and between every patient. All single-use PPE should be disposed of as hazardous clinical waste.

Prevention is the cure 

PPE is the final link in the chain of protection when used in conjunction with risk assessments and other infection control measures. Dental professionals can readily come into direct contact with pathogens, especially those found in blood and saliva, and any patient visiting a dental surgery could potentially be carrying an undiagnosed infection. Ensuring rigorous implementation of infection control protocol and the proper use of PPE drastically reduces the likelihood of contracting any infection in the dental surgery.