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. 2015 Jan 5;129(11):1567–1577. doi: 10.14219/jada.archive.1998.0103

USING A BIOLOGICAL INDICATOR TO DETECT POTENTIAL SOURCES OF CROSS-CONTAMINATION IN THE DENTAL OPERATORY

RAYMOND W HACKNEY JR 1,*, JAMES J CRAWFORD 2, JERRY J TULIS 3
PMCID: PMC7119380  PMID: 9818574

Abstract

The authors conducted a study using surveillance monitoring methodology to identify operatory contamination and to evaluate the effectiveness of infection control procedures. Viridans streptococci were evaluated as biological indicators of oral contamination. Viridans streptococci, abundant in human saliva, were detected on operatory surfaces after dental treatments were finished and surfaces were disinfected. The findings validate current concepts of infection control as demonstrated in barrier methods.

Footnotes

The authors acknowledge the assistance of Cindy Broderius, MT (ASCP), Clinical Oral Microbiology Laboratory, University of North Carolina at Chapel Hill, School of Dentistry, for her technical support; and Gary D. Gaddy, Coordinator of Statistical Consulting, Institute for Research in Social Science, University of North Carolina at Chapel Hill, for his help with the statistical analysis of the data. The University of North Carolina Sterilization Monitoring Service provided partial support for this project.

References

  • 1.American Dental Association. Seven out of ten visit dentist annually. ADA News. 1990;21:1. [Google Scholar]
  • 2.Occupational Safety and Health Administration. Standard, Occupational exposure to bloodborne pathogens. 1030 Federal Register: 64004–64182(1991) (codified at 29 CFR 1910).
  • 3.Centers for Disease Control. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR. 1991;4(RR-8):1–9. [PubMed] [Google Scholar]
  • 4.The Public Health and Welfare Act, 42 USC §300, ee-2(1991).
  • 5.Council on Scientific Affairs and ADA Council on Dental Practice. Infection control recommendations for the dental office and dental laboratory. JADA. 1996;127(5):672–680. doi: 10.14219/jada.archive.1996.0280. [DOI] [PubMed] [Google Scholar]
  • 6.Centers for Disease Control. Recommended infection-control practices for dentistry. MMWR. 1993;41(RR-8):1–12. [PubMed] [Google Scholar]
  • 7.Burkhart NW, Crawford JJ. Critical steps after cleaning: removing debris after sonication. JADA. 1997;128:456–463. doi: 10.14219/jada.archive.1997.0230. [DOI] [PubMed] [Google Scholar]
  • 8.Miller CH, Palenik CJ. Surface and equipment asepsis. In: Miller CH, Palenik CJ, editors. Infection control and management of hazardous materials for the dental team. Mosby; St. Louis: 1994. pp. 172–186. [Google Scholar]
  • 9.Molinari JA. How to choose and use environmental surface disinfectants. In: Cottone JA, Terezhalmy GT, Molinari JA, editors. Practical infection control in dentistry. 2nd ed. Williams & Wilkins; Baltimore: 1996. [Google Scholar]
  • 10.Hackney RW. Oral bacteria as biological indicators for dental asepsis (dissertation) University of North Carolina at Chapel Hill; Chapel Hill, N.C.: 1989. [Google Scholar]
  • 11.Crawford J. J. Infection control. In: Sturdevant CM, Roberson TM, Heymann HO, editors. The art and science of operative dentistry. Mosby; St. Louis: 1995. pp. 129–167. [Google Scholar]
  • 12.Ahtone JA, Goodman A. Hepatitis B and dental personnel: transmission to patients and prevention issues. JADA. 1983;106:219–222. doi: 10.14219/jada.archive.1983.0416. [DOI] [PubMed] [Google Scholar]
  • 13.Caldon W, Dasher D, Mayhew R, Houston G, Herbold J. Infectious disease transmission within the dental office: realistic measures for control. Wilford Hall USAF Medical Center and Office of the Assistant Secretary of Defense; Washington, D.C.: 1985. [Google Scholar]
  • 14.Crawford JJ. New light on the transmissibility of viral hepatitis in dental practice and its control. JADA. 1975;91(4):829–835. doi: 10.14219/jada.archive.1975.0447. [DOI] [PubMed] [Google Scholar]
  • 15.Hendley JO, Wenzel RP, Gwaltney JM., Jr Transmission of rhinovirus colds by self-inoculation. N Engl J Med. 1973;228(26):1361–1364. doi: 10.1056/NEJM197306282882601. [DOI] [PubMed] [Google Scholar]
  • 16.Klein RS, Phelan JA, Freeman K. Low occupational risk of human immunodeficiency virus infection among dental professionals. N Engl J Med. 1988;318(2):86–90. doi: 10.1056/NEJM198801143180205. [DOI] [PubMed] [Google Scholar]
  • 17.Manzella JP, McConville JH, Valenti W, Menegus MA, Swierkosz EM, Arens M. An outbreak of herpes simplex virus type I gingivostomatitis in a dental hygiene practice. JAMA. 1984;252(15):2019–2022. [PubMed] [Google Scholar]
  • 18.Merchant VA, Molinari JA, Sabes WR. Herpetic whitlow: report of a case with multiple recurrences. Oral Surg Oral Med Oral Pathol. 1983;55(6):568–571. doi: 10.1016/0030-4220(83)90372-9. [DOI] [PubMed] [Google Scholar]
  • 19.Mosley JW, Edwards VM, Casey G, Redeker AG, White E. Hepatitis B virus infections in dentists. N Engl J Med. 1975;293:729–734. doi: 10.1056/NEJM197510092931501. [DOI] [PubMed] [Google Scholar]
  • 20.Centers for Disease Control. Recommendations for prevention of HIV transmission in health-care settings. MMWR. 1987;36:10–11. (suppl) [PubMed] [Google Scholar]
  • 21.Bond WW, Favero MS, Petersen NJ, Gravelle CR, Ebert JW, Maynard JE. Survival of hepatitis B virus after drying and storage for one week. Lancet. 1981:50–51. doi: 10.1016/s0140-6736(81)92877-4. March 7. [DOI] [PubMed] [Google Scholar]
  • 22.Getchell-White SI, Donowitz LG, Groschel DHM. The inanimate environment of an intensive care unit as a potential source of nosocomial bacteria: evidence for long survival of Acinetobacter calcoaceticus. Infect Control Hosp Epidemiol. 1989;10(9):402–407. doi: 10.1086/646061. [DOI] [PubMed] [Google Scholar]
  • 23.Thomas LE, 3rd, Sydiskis RJ, DeVore DT, Krywolap GN. Survival of herpes simplex virus and other selected microorganisms on patient charts: potential source of infection. JADA. 1985;111(3):461–464. doi: 10.14219/jada.archive.1985.0138. [DOI] [PubMed] [Google Scholar]
  • 24.White SC, Glaze S. Interpatient microbiological cross-contamination after dental radiographic examination. JADA. 1978;96:801–804. doi: 10.14219/jada.archive.1978.0207. [DOI] [PubMed] [Google Scholar]
  • 25.Joklik WK, Willett HP, Amos DB, Wilfert CM, editors. 20th ed. Appleton & Lange; Norwalk, Conn.: 1992. p. 501. (Zinsser microbiology). [Google Scholar]
  • 26.Crawford JJ. Sterilization, disinfection, and asepsis in dentistry. In: Block SS, editor. Disinfection, sterilization, and preservation. Lea & Febiger; Philadelphia: 1983. pp. 505–523. [Google Scholar]
  • 27.Miller CH, Palenik CJ. Infection control and management of hazardous materials for the dental team. Mosby; St. Louis: 1994. [Google Scholar]
  • 28.Autio KL, Rosen S, Reynolds NJ, Bright JS. Studies on cross-contamination in the dental clinic. JADA. 1980;100:358–362. doi: 10.14219/jada.archive.1980.0092. [DOI] [PubMed] [Google Scholar]
  • 29.Crawford JJ. Barriers can minimize occupational exposure risks to contagions. Dentistry Today. 1987;6(6):28–31. [Google Scholar]
  • 30.Crawford JJ. Clinical asepsis in dentistry. 3rd ed. RA Kolstad; Mesquite, Texas: 1986. [Google Scholar]
  • 31.Bentley CD, Burkhart NW, Crawford JJ. Evaluation of spatter and aerosol contamination during dental procedures. JADA. 1994;125:579–584. doi: 10.14219/jada.archive.1994.0093. [DOI] [PubMed] [Google Scholar]
  • 32.Crawford JJ. State of the art: practical infection control in dentistry. JADA. 1985;110(4):629–633. doi: 10.1016/s0002-8177(15)30014-3. [DOI] [PubMed] [Google Scholar]
  • 33.Council on Dental Materials and Devices and Council on Dental Therapeutics. Infection control in the dental office. JADA. 1978;97(4):673–677. [PubMed] [Google Scholar]
  • 34.Cottone JA, Terezhalmy GT, Molinari JA, editors. Williams & Wilkins; Baltimore: 1996. (Practical infection control in dentistry). [Google Scholar]
  • 35.Crawford JJ. Sterilization, disinfection, and asepsis in dentistry. In: McGhee JR, Michalek SM, Cassell GH, editors. Dental microbiology. Harper & Row; Philadelphia: 1982. pp. 189–208. [Google Scholar]
  • 36.Wood PR. Cross infection control in dentistry: A practical illustrated guide. Wolfe Publishing; London: 1992. pp. 75–97. [Google Scholar]
  • 37.Nolte WA. Oral microbiology. C.V. Mosby; St. Louis: 1982. pp. 193–228. [Google Scholar]
  • 38.Richardson RL, Jones M. A bacteriologic census of human saliva. J Dent Res. 1958;37:697–709. doi: 10.1177/00220345580370041701. [DOI] [PubMed] [Google Scholar]
  • 39.Williams N, Shay DE, Hasler JF. Indications of the sanitation level in a dental clinic. J Baltimore Coll Dent Surg. 1976;31(1):18–34. [PubMed] [Google Scholar]
  • 40.Facklam RR. Physiological differentiation of viridans streptococci. J Clin Microbiol. 1977;5(2):184–201. doi: 10.1128/jcm.5.2.184-201.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.American Industrial Hygiene Association, Biosafety Committee. Biosafety reference manual. 2nd ed. American Industrial Hygiene Association; Fairfax, Va.: 1995. [Google Scholar]
  • 42.Angelotti R, Foter MJ, Busch KA, Lewis KH. A comparative evaluation of methods for determining the bacterial contamination of surfaces. Food Res. 1958;23:175–185. [Google Scholar]
  • 43.Angelotti R, Wilson JL, Litsky W, Walter W. Comparative evaluation of the cotton swab and RODAC methods for the recovery of Bacillus subtilis spore contamination from stainless steel surfaces. Health Lab Science. 1964;1:289–296. [PubMed] [Google Scholar]
  • 44.Facklam RR, Carey RB. Streptococci and aerococci. In: Lennette EH, Balows A, Hausler WJ, Shadomy HJ, editors. Manual of clinical microbiology. American Society for Microbiology; Washington, D.C.: 1985. pp. 154–175. [Google Scholar]
  • 45.MacKinnon IH. The use of inactivators in the evaluation of disinfectants. J Hyg (London) 1974;73(2):189–195. doi: 10.1017/s0022172400024013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Schaub IG, Mazeika I, Lee R, Dunn MT, Lachaine R, Price WH. Ecologic studies of rheumatic fever and rheumatic heart disease. I. Procedure for isolating beta hemolytic streptococci. Am J Hyg. 1957;67(1):46–56. doi: 10.1093/oxfordjournals.aje.a119918. [DOI] [PubMed] [Google Scholar]
  • 47.Taranta A, Moody MD. Diagnosis of streptococcal pharyngitis and rheumatic fever. Pediatr Clin North Am. 1971;18(1):125–143. doi: 10.1016/s0031-3955(16)32527-5. [DOI] [PubMed] [Google Scholar]
  • 48.Michalek SM, McGhee JR. Oral streptococci with emphasis on Streptococcus mutans. In: McGhee JR, Michalek SM, Cassell GH, editors. Dental microbiology. Harper & Row; Philadelphia: 1982. pp. 679–690. [Google Scholar]
  • 49.Molinari JA, Gleason M, Cottone JA, Barrett ED. Comparison of dental surface disinfectants. Gen Dent. 1987;35(3):171–175. [PubMed] [Google Scholar]
  • 50.Council on Dental Materials and Devices and Council on Dental Therapeutics. Current status of sterilization instruments, devices, and methods for dental office. JADA. 1989;102:683–689. doi: 10.14219/jada.archive.1981.0185. [DOI] [PubMed] [Google Scholar]
  • 51.Whitacre RJ. Dental asepsis. Stoma Press; Seattle: 1979. pp. 10–43. 52–105. [Google Scholar]

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