Personal Protective Equipment (PPE)

Clinical members of the dental team should be trained in proper use and selection of PPE required during clinical work and instrument decontamination.

Personal Protective Equipment (PPE)

PPE is part of Standard Precautions for infection prevention and control in the dental surgery.

Whilst protecting the dental team from exposure to infections at work, PPE should not be relied on for sole protection. PPE should be used in combination with other preventive measures such as safe working practices, adequate surgery ventilation and immunisation.

According to HCAI Code of Practice, clinical members of the dental team should be trained in proper use and selection of PPE required during clinical work and instrument decontamination.

PPE used in dentistry is required to be CE marked as this guarantees appropriate functional performance.

Used PPE is disposed of as hazardous clinical waste. 

Gloves

Gloves do not prevent sharps injuries, but the wiping effect of the glove reduces the risk of contamination of the puncture wound.

Gloves are recommended for all dental treatment but should not be worn as an alternative to hand washing. They are single use items and are donned at the start of the treatment and removed at the end of the procedure.

To avoid contaminating oneself, remove gloves aseptically so that the outside of the glove is not touched with the bare hand. Note that gloves can develop tears during use and may leak, so hands are cleaned after disposing of gloves.  

Gloves made of nitrile or neoprene are preferred over latex gloves as both staff and patients can become sensitised to latex and accelerators used in glove manufacture.

Sterile gloves should always be used for invasive surgery.

Heavy duty gloves rather than examination gloves are worn for cleaning of dental instruments as they are less likely to be punctured by sharp instruments and protect hands from irritant chemicals.

Eyewear (Goggles and Visors)

Goggles or visors should be worn during all types of dental treatment or when manually cleaning instruments.

Eyewear protects against splatter and foreign bodies such as amalgam fragments.

Spectacles do not provide sufficient eye protection as they lack side protection. Visors can be worn over spectacles and loupes.

Visors have the added advantage of preventing touching of the face with contaminated gloved hands.  

Masks and Respiratory Masks

Masks are single use PPE and recommended for all dental procedures.

The main function of a mask is to provide barrier protection against splatter. Most masks produce a poor facial seal and therefore do not protect the wearer effectively from aerosol inhalation.

Some multi-layered masks with metal nose strips if adapted closely to the face will provide up to 70% air filtration.

Try to avoid touching the outer surface of the mask, which may be contaminated.

Remove the mask at the end of the patient’s treatment by breaking or undoing the straps and lifting over the ears.

Never wear the mask under your chin as you will contaminate your skin and clothes. 

Respirator Masks

Respirator masks are recommended to be worn whilst treating patients with infections that are spread through the air such as measles, influenza and TB.

Unlike conventional masks, particulate respirator masks filter the inhaled air and remove microbes. They do not filter out gases. When fitted and worn correctly, they seal firmly to the face reducing the risk of air leakage. They can provide up to 98% filtering protection (FFP3 mask).

Instructions for fit testing carried out by the wearer may vary, and are supplied by the manufacturer.

Aprons and Gowns

Uniforms are not usually made of materials that are impermeable to body fluids and are therefore not considered PPE.

The choice of wearing a plastic apron or gown is based on the risk.

Wear a single use plastic apron if there is a risk that clothing may be exposed to blood or saliva such as during aerosol generating procedures, or scaling & root planning when there is likely to be excessive bleeding. Wearing a plastic apron is advised when performing instrument decontamination.

Remove the apron by breaking the neck straps and folding the apron in on itself. Be careful to only touch the inner surface as the outer surface is likely to be heavily contaminated. Store stocks of aprons away from potential contamination.

Wear a single use, long-sleeved, fluid-repellent gown if there is a risk of extensive splashing of blood and body fluids onto skin or clothing such as during MOS, periodontal or implant surgery.

Gloves are worn over the cuff of the gown sleeve to reduce contamination and wetting. To ensure compliance with the guidance that hand hygiene is carried out “bare below the elbow”, this should be carried out before donning the gown.

PPE should be removed in the following order to prevent contaminating oneself and the surrounding surgery environment: 

  • Gloves.
  • Plastic apron or gown (if worn).
  • Mask (or respirator mask ) or a visor if worn and then the mask.
  • Protective eyewear (goggles).
  • Followed by hand hygiene.