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Practice Safety/Patient Safety Archived Through 2012
 FAQ - Practice Safety/Patient Safety - Archived Through 2012



I am looking for some photos and articles on artificial nails, nail polish and infection control.

OSAP does not maintain photos or images, however, we can provide you with information concerning artificial nails and nail polish and links to additional information.

OSAP would like to refer you to the Centers for Disease Control and Prevention's Guidelines for Dental Healthcare Settings and the CDC's Hand Hygiene Guidelines for Healthcare Settings. Both of these guidelines should provide you with helpful information. The Hand Hygiene Guidelines also provide powerpoint slides.

The CDC Guidelines for Dental Healthcare Settings state:

Fingernails and Artificial Nails

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 nonwearers, 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)

Detailed hand hygiene information including bacteria and artificial nails may be viewed in the CDC's hand hygiene guidelines. A Powerpoint slide presentation is also provide. This information may be viewed at:

CDC hand hygiene guidelines state:

Healthcare workers who wear artificial nails are more likely to harbor gram-negative pathogens on their fingertips than those who have natural nails, both before and after handwashing. Personnel wearing artificial nails also have been epidemiologically implicated in several other outbreaks of infection. While these studies provide evidence that wearing artificial nails poses an infection hazard, additional studies are warranted. (2)


1) CDC Infection Control Guidelines for Dental Healthcare Settings:

2) CDC Hand Hygiene Guidelines:

Additional resources include:

1) CDC's Materials to promote hand hygiene:

2) CDC provides a link to the hand hygiene center. The link is:

3) CDC photos of fingernail infections:

4) Article in Medscape:

5) Abstract From Infection Control and Hospital Epidemiology:

6) Google search provides links to numerous articles:





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