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Personal Protective Equipment

What is the purpose of personal protective equipment (PPE)?

PPE are special coverings designed to protect dental health care personnel (DHCP) from exposure to or contact with infectious agents. These include gloves, face masks, protective eyewear, face shields, and protective clothing (e.g., reusable or disposable gown, jacket, lab coat). PPE can also prevent microorganisms from spreading from DHCP to patients. For guidance on how to choose and use PPE in health care settings, see CDC’s Protecting Healthcare Personnel.

When should a surgical mask be worn?

Dental health care personnel should wear a surgical mask that covers both their nose and mouth during procedures that are likely to generate splashes or sprays of blood or body fluids and while manually cleaning instruments. A surgical mask also protects the patient from microorganisms generated by the wearer. When a surgical mask is used, it should be changed between patients or during patient treatment if it becomes wet.

When should protective eyewear be worn?

Dental health care personnel should wear protective eyewear with solid side shields or a face shield during procedures likely to generate splashes or sprays of blood or body fluids or the spatter of debris. Reusable protective eyewear should be cleaned with soap and water, and when visibly soiled, disinfected between patients.

When should protective clothing be worn?

Dental health care personnel (DHCP) should wear protective clothing (e.g., gowns, jackets) to prevent contamination of street clothing and to protect the skin from exposure to blood and body fluids. Sleeves should be long enough to protect the forearms. Protective clothing should be changed when it becomes visibly soiled by blood or other body fluids. DHCP should remove protective clothing before leaving the work area.

Why should dental health care personnel wear gloves?

Dental health care personnel wear gloves to prevent contamination of their hands when touching mucous membranes, blood, saliva, or other potentially infectious materials and to reduce the likelihood that microorganisms on their hands will be transmitted to patients during patient care. Gloves should be used for one patient only and discarded appropriately after use. Gloves should not be washed for reuse. Always perform hand hygiene immediately after glove removal. Glove users should consult the glove manufacturer about the compatibility of glove material with various chemicals.

Does wearing gloves replace the need for handwashing?

No. Gloves may have small defects that are hard to see or may be torn during use, and hands can become contaminated during removal of gloves. In addition, bacteria can multiply rapidly in moist environments underneath gloves; thus, dental health care personnel should make sure hands are dry before putting on gloves. Hand hygiene should be performed immediately before after removing gloves. If the integrity of a glove is compromised (e.g., if the glove is punctured), the glove should be changed as soon as possible.

What kinds of gloves are used for what purposes?

The type of glove used should be based on the type of procedure to be performed (e.g., surgical vs. nonsurgical, housekeeping procedures). Medical-grade nonsterile examination gloves and sterile surgical gloves are regulated by the Food and Drug Administration (FDA) as medical devices. Sterile surgical gloves must meet FDA standards for sterility assurance and are less likely than nonsterile examination gloves to harbor pathogens that may contaminate an operative wound. General purpose utility gloves are not regulated by FDA because they are not promoted for medical use.

Glove Type Indications Comments Common Examples of Glove Materials
Patient examination gloves Patient care, examinations, and other nonsurgical procedures involving contact with mucous membranes; laboratory procedures
  • Medical device regulated by FDA
  • Nonsterile and sterile, single-use disposable. Use for one patient and discard appropriately.
  • Natural rubber latex
  • Nitrile
  • Polyvinyl chloride (vinyl) and other synthetics
  • Polyethylene (plastic)
Surgeon’s gloves Surgical procedures
  • Medical device regulated by FDA
  • Sterile and single-use disposable.
  • Use for one patient and discard appropriately.
  • Natural rubber latex
  • Nitrile
  • Combinations of latex and/or synthetics
Nonmedical gloves
  • Housekeeping procedures (e.g., cleaning, disinfection)
  • Handling contaminated sharps or chemicals
  • Not for use during patient care
  • Not a medical device regulated by FDA
  • General purpose utility gloves that are puncture or chemical resistant
  • Sanitize after use
  • Natural rubber latex and nitrile or chloroprene blends
  • Neoprene
  • Nitrile
  • Butyl rubber

Modified from Miller CH and Palenik CJ (2010).

References

CDC. Basic Expectations for Safe Care Training Module 3 – Personal Protective Equipment. Available at: https://www.cdc.gov/oralhealth/infectioncontrol/safe-care-modules.htm. Accessed May 8, 2018.

CDC. Guidance for the Selection and Use of Personal Protective Equipment in Healthcare Settings: Slides and Posters. Available at: https://www.cdc.gov/hai/prevent/ppe.html. Accessed March 18, 2016.

CDC. Guidelines for infection control in dental health-care settings – 2003. MMWR 2003; 52(No. RR-17):1–66. Available at: https://www.cdc.gov/mmwr/PDF/rr/rr5217.pdf [PDF-1.2M]. Accessed March 18, 2016.

CDC. Summary of infection prevention practices in dental settings: basic expectations for safe care. Available at: https://www.cdc.gov/oralhealth/infectioncontrol/guidelines/index.htm.

Harte JA, Molinari JA. Personal Protective Equipment. In: Molinari JA, Harte JA, eds. Cottone’s Practical Infection Control in Dentistry, 3rd ed. Baltimore: Lippincott Williams & Wilkins, 2010;101–119.

Miller CH, Palenik CJ. Protective Barriers. In: Miller CH, Palenik DJ, eds. Infection Control and Management of Hazardous Materials for the Dental Team, 4th ed St. Louis: Mosby, 2010:115–134.

Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings 2007:1–219. Available at: https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines.pdf [PDF – 1 M]. Accessed March 18, 2016.

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