INFECTION CONTROL

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One in nine dentists inspected by the health care watchdog were found to be in breach of strict guidelines on cleanliness and infection control designed to prevent the spread of conditions such as HIV, hepatitis and vCJD.
Under Freedom of Information laws, The Daily Telegraph obtained a copy of a database detailing the results of inspections by the Care Quality Commission (CQC), the healthcare regulator.
An analysis reveals that of the 1,667 dental practices inspected by the CQC last year, 189 were found to not be following Department of Health instructions on how to clean instruments and surgeries. Some 8,100 dentists are registered in England.
In order to prevent the spread of blood-borne disease, experts recommend instruments are prepared in a separate room to the dentist’s surgery. They should be scrubbed in one sink, rinsed in a second, inspected for any fragments under an microscope and processed through an ultrasonic bath or an autoclave steam cleaner.
They must then be stored for up to three weeks in sterile and dated packets.Some equipment cannot be cleaned and re-used safely and most be thrown away after each patient.
But dozens are practices are disregarding the rules, inspectors found.
At one “cluttered and dirty” practice in Haringey, North London, inspectors in February found staff could not tell the difference between single-use and re-usable equipment, and they “could not be sure” that equipment in drawers ready for use in surgery had been cleaned.
Inspectors found an opened intravenous needle kit and out-of-date medicine stored in a fridge alongside the staff’s packed lunches, while used gloves and tissues, and a packet of porridge oats, were stored on top of the sterilisation machine.
The practice has since been given a clean bill of health.
At Lydiate Dental Surgery, Merseyside, the autoclave used for sterilizing equipment was found to be “unclean, felt ‘oily’ and had debris on it”, inspectors wrote. They found dust, dirt and cobwebs and overflowing bins in the surgery.
A spokesman said the surgery was “very concerned” by the report and had “reviewed arrangements” as a result.
Inspectors found staff at Wilton Dental Practice, Wiltshire, attempting to sterilize and re-use equipment that was single-use only.The practice did not respond to requests for comment.
At ADP Dental Company’s branch in Bath, staff told inspectors that broken ultrasonic equipment meant they “could not clean the equipment quickly enough”. They admitted they did not use a magnifying light to check whether instruments were clean, and sometimes “did not bother” to wash their hands.
Inspectors warned: “People may not be fully protected against the risks of cross infection.”
A spokesman said: “The issues highlighted have been immediately addressed and rectified to the correct standards.
“We have also delivered additional training and checking mechanisms since the report was published to ensure we maintain the highest standards for all our patients."
The risk of patients catching blood-borne infections through inadequately sterilised equipment is low but not without precedent. In 2009 5,000 patients in Bristol and Bournemouth were offered blood tests for HIV and hepatitis after a dentist was found to have not sterilised equipment properly.
Katherine Murphy, chief executive of the charity The Patient’s Association, said: “Infection control practices in dentistry must be given the highest priority. All too often patients tell our helpline that they have concerns about cleanliness.”
Dr Martin Fallowfield, chair of the British Dental Association’s executive committee, which represents dentists, said earlier studies had shown around one in 17 practices were in breach of infection control rules. He added the sector had a better track record of infection control than that found in nursing homes and NHS hospitals.