infection control guidelines for dentists

III. Hand Hygiene

A. General Considerations

1. Perform hand hygiene with either a nonantimicrobial or antimicrobial soap and water when hands are visibly dirty or contaminated with blood or other potentially infectious material. If hands are not visibly soiled, an alcohol-based hand rub can also be used. Follow the manufacturer’s instructions (IA).
2. Indications for hand hygiene include
    a. when hands are visibly soiled (IA, IC);
    b. after barehanded touching of inanimate objects likely to be contaminated by blood, saliva, or respiratory secretions
    (IA, IC);
    c. before and after treating each patient (IB);
    d. before donning gloves (IB); and
    e. immediately after removing gloves (IB, IC).
3. For oral surgical procedures, perform surgical hand antisepsis before donning sterile surgeon’s gloves. Follow the manufacturer’s instructions by using either an antimicrobial soap and water, or soap and water followed by drying hands and application of an alcohol-based surgical hand-scrub product with persistent activity (IB).
4. Store liquid hand-care products in either disposable closed containers or closed containers that can be washed and dried before refilling. Do not add soap or lotion to (i.e., top off) a partially empty dispenser (IA).

B. Special Considerations for Hand Hygiene and Glove Use

1. Use hand lotions to prevent skin dryness associated with handwashing (IA).
2. Consider the compatibility of lotion and antiseptic products and the effect of petroleum or other oil emollients on the integrity of gloves during product selection and glove use (IB).
3. Keep fingernails short with smooth, filed edges to allow thorough cleaning and prevent glove tears (II).
4. Do not wear artificial fingernails or extenders when having direct contact with patients at high risk (e.g., those in intensive care units or operating rooms) (IA).
5. Use of artificial fingernails is usually not recommended (II).

6. Do not wear hand or nail jewelry if it makes donning gloves more difficult or compromises the fit and integrity of the glove (II).