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FAQ - Training & Personnel - 2014
 FAQ - Training & Personnel -  2014

 

 

What is a good policy for a dental office to have regarding nail polish, acrylic nails and decorative hair pieces. Thanks

This is actually a two part question. First, regarding nail polish and acrylic nails:

Ask OSAP is not aware of any specific standard that prohibits dental healthcare workers from wearing fingernail polish. 

However, it should be noted that some facilities may prohibit artificial nails, nail extenders, and fingernail polish through policies and procedures that have been developed by the facility (e.g. dental assisting programs, dental hygiene programs, etc.).

Additionally, the 2003 CDC guidelines for infection control in dentistry states as follows:

Although the relationship between fingernail length and wound infection is unknown, keeping nails short is considered key because the majority of flora on the hands are found under and around the fingernails. Fingernails should be short enough to allow DHCP to thoroughly clean underneath them and prevent glove tears. Sharp nail edges or broken nails are also likely to increase glove failure. Long artificial or natural nails can make donning gloves more difficult and can cause gloves to tear more readily. Hand carriage of gram-negative organisms has been determined to be greater among wearers of artificial nails than among non-wearers, both before and after handwashing. In addition, artificial fingernails or extenders have been epidemiologically implicated in multiple outbreaks involving fungal and bacterial infections in hospital intensive-care units and operating rooms. Freshly applied nail polish on natural nails does not increase the microbial load from periungual skin if fingernails are short; however, chipped nail polish can harbor added bacteria. 1

The following Google search may contain some information of interest:

Fingernails and dental infection control

https://www.google.com/?gws_rd=ssl#q=fingernails+and+dental+infection+control  2

Second, regarding hairpieces, Ask OSAP is not aware of any specific standards that prohibit hairpieces.

OSHA's Bloodborne Pathogens Standard does not address the issue of personal grooming, such as hair length and control and hair pieces in the dental office. OSHA also does not have regulatory authority regarding patient safety issues. Your concerns are infection control issues rather than regulatory issues. There is little in the scientific literature regarding hair and infectious contamination risks.  Common sense and simple logic may be used to deduce the answer to your question. 

Anything that is in the direct path of spatter generation or that is directly touched by contaminated gloved hands is at risk of contamination. Hair of clinical health-care personnel can both become contaminated from spatter generated during dental procedures and from touching with contaminated gloved hands. This risk is increased when the hair is not controlled/contained. Longer loose hair that is not pulled back or up from the face is more likely to be in the direct path of spatter and is more likely to be touched with contaminated gloved hands in a attempt to control the hair during clinical procedures. Below are some examples of ways to reduce the risks and degree of contamination to hair.

Once gloves are donned, one must avoid touching the hair, face, skin, etc. with the gloved hands. Therefore, it would be difficult to reposition the hair unless the gloves are removed and hands washed first.

The majority of dental hygiene and assisting programs require students and faculty to wear their hair pulled back away from the face, up, and off the collar during laboratory/clinical sessions.  These infection control policies are in writing and given to the students in the form of clinical protocol/procedures manuals; infection control protocol manuals; and/or program student handbooks, etc. Students are educated as to the importance of such policies and understand that the primary concern is for the health and safety of patients, students, and faculty.

Ask OSAP is not in the position to offer legal advice. Therefore, you should consult with your practice's attorney for legal guidance on establishing, implementing, and enforcing written infection control policies/protocols. 

It is important that you involve the staff in the process and provide infection control education that will help them better understand the importance of implementing infection control policies that address issues such as hair control during patient treatment procedures.

The following Google search may contain some information of interest:

Hairpieces and dental infection control

https://www.google.com/?gws_rd=ssl#q=hairpieces+and+dental+infection+control  3

Resources

1)   Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM, Centers for Disease
      Control and Prevention (CDC). Guidelines for infection control in dental health-care settings—2003. MMWR           Recomm Rep 2003;52(RR-17):1-61. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm  Accessed on       November 10, 2014.

2)   Google.com. Google search using the terms “Fingernails and dental infection control".                                             https://www.google.com/?gws_rd=ssl#q=fingernails+and+dental+infection+control  Accessed on                           November 11,    2014.

3)    Google.com. Google search using the terms “Hairpieces and dental infection         
      control”. https://www.google.com/?gws_rd=ssl#q=hairpieces+and+dental+infection+control  Accessed on               November 11, 2014. 

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