Design of dental surgeries in relation to instrument decontamination.

Recent guidelines advise that the decontamination of dental instruments should be undertaken outwith the treatment area. The aim of this study was to determine the physical area of rooms in dental surgeries that decontaminate instruments within and outwith the treatment area respectively, and other factors relating to practice layout and ventilation. Data were collected by interview and observation of dental healthcare workers in dental practice in Scotland, UK. Room layouts were recorded and measured at floor, benchtop and above benchtop heights. Thirteen surgeries with instrument decontamination processes occurring in the treatment area and seven surgeries with instrument decontamination outwith the treatment area were selected at random for detailed analysis of room dimensions. Of the 179 dental surgeries surveyed, 55% were located in converted residential premises and most practitioners (91%) did not share premises with other healthcare providers. The median number of rooms in the practices was 8 (range: 2-21) and the median number of surgeries present was 3 (range: 1-6). Regardless of whether instrument decontamination facilities were housed within the treatment area or not, the average treatment area room size for both was 15.8m(2) (range: 7.3-23.9) (P=0.862), with 20% of the room area available as work surfaces. The median size of the seven instrument decontamination rooms (local decontamination units) was 7.6m(2) (range: 2.9-16.0), with, on average, 63% of the room used for work surfaces. This survey suggests that the historical location of dental surgeries in converted residential properties places many restrictions on appropriate design for healthcare premises.

[1]  W Hamula Orthodontic office design. Planning a sterilization area. , 1991, Journal of clinical orthodontics : JCO.

[2]  J. Cleveland,et al.  Guidelines for infection control in dental health-care settings--2003. , 2003, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[3]  C. Pankhurst,et al.  Evaluation of the Potential Risk of Occupational Asthma in Dentists Exposed to Contaminated Dental Unit Waterlines , 2005, Primary dental care : journal of the Faculty of General Dental Practitioners.

[4]  D. Lovelock Cross-infection control in dental practice' , 1988, British Dental Journal.

[5]  A. Rawlinson,et al.  The effect of cleaning on blood contamination in the dental surgery following periodontal procedures. , 1998, Australian dental journal.

[6]  S. Rosen,et al.  Studies on cross-contamination in the dental clinic. , 1980, Journal of the American Dental Association.

[7]  J. Bagg,et al.  A method for surveying instrument decontamination procedures in general dental practice , 2007, BDJ.

[8]  E. McColl,et al.  The detection of blood on dental surgery surfaces and equipment following dental hygiene treatment , 1994, British Dental Journal.

[9]  H. Kurita,et al.  Nosocomial transmission of methicillin-resistant Staphylococcus aureus via the surfaces of the dental operatory , 2006, British Dental Journal.

[10]  Scotland , 1914, The Hospital.

[11]  E. Prospero,et al.  Microbial Aerosol Contamination of Dental Healthcare Workers' Faces and Other Surfaces in Dental Practice , 2003, Infection Control & Hospital Epidemiology.

[12]  B Mayhew Tray systems, colour coding and storage/sterilising area. , 1974, Dental update.

[13]  Building new hospitals: a UK infection control perspective. , 2006, The Journal of hospital infection.

[14]  J. Cleveland,et al.  Guidelines for infection control in dental health-care settings--2003. , 2003, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[15]  A. Bennett,et al.  Microbial aerosols in general dental practice. , 2000, British dental journal.

[16]  M. Martín,et al.  Two cases of oral infection by methicillin-resistant Staphylococcus aureus , 1991, British Dental Journal.

[17]  G. McDonnell,et al.  Sterilization and Disinfection , 2009 .

[18]  M. Samadpour,et al.  Outbreak of Pseudomonas aeruginosa infections caused by commercial piercing of upper ear cartilage. , 2004, JAMA.

[19]  M Schumacher,et al.  Does the Architecture of Hospital Facilities Influence Nosocomial Infection Rates? A Systematic Review , 2004, Infection Control & Hospital Epidemiology.

[20]  G L Ridgway,et al.  Reducing hospital-acquired infection by design: the new University College London Hospital. , 2006, The Journal of hospital infection.

[21]  Nhs Estates Ventilation in Healthcare Premises , 1994 .

[22]  D. Grenier Quantitative analysis of bacterial aerosols in two different dental clinic environments , 1995, Applied and environmental microbiology.

[23]  L. Samaranayake The significance of the bacterial contamination of dental unit water systems' , 1987, British Dental Journal.

[24]  Gee Am Basic elements of dental office design. , 1966 .