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Hand Hygiene

What is hand hygiene?

Hand hygiene is a way of cleaning one’s hands that substantially reduces potential pathogens (harmful microorganisms) on the hands. Hand hygiene is considered a primary measure for reducing the risk of transmitting infection among patients and health care personnel. Hand hygiene procedures include the use of alcohol-based hand rubs (containing 60%–95% alcohol) and hand washing with soap and water. For routine dental examinations and nonsurgical procedures, use an alcohol-based hand rub or use water and plain or antimicrobial soap specific for health care settings. Although alcohol-based hand rubs are effective for hand hygiene in health care settings, when hands are visibly soiled (e.g., dirt, blood, body fluids), soap and water should be used. For surgical procedures, perform a surgical hand scrub before putting on sterile surgeon’s gloves.

When should I perform hand hygiene?

Always perform hand hygiene in the following situations:

  • Before and after treating each patient (e.g., before and after gloving).
  • After touching with bare hands instruments, equipment, materials, and other objects that are likely to be contaminated by blood, saliva, or respiratory secretions.
  • Before leaving the dental treatment area.
  • When hands are visibly soiled.
  • Before regloving and after removing gloves that are torn, cut, or punctured.

How do I perform hand hygiene?

Using alcohol-based hand rub (follow manufacturer directions):

  • Dispense the recommended amount of product
  • Apply product to the palm of one hand
  • Rub hands together, making sure that all surfaces of hands and fingers are covered until they are dry (no rinsing is required)

Hand washing with soap and water:

  • Wet hands first with water (do not use hot water)
  • Apply soap to hands
  • Rub hands vigorously for at least 15 seconds, covering all surfaces of hands and fingers
  • Rinse hands with water and dry thoroughly with a paper towel
  • Use a paper towel to turn off the water faucet

Surgical hand hygiene/antisepsis:

  • Use either an antimicrobial soap or alcohol-based surgical hand-scrub product with continuous activity
  • Antimicrobial soap: scrub hands and forearms for length of time recommended by manufacturer
  • Alcohol-based surgical hand-scrub product: follow manufacturer’s recommendations. Before applying, wash hands and forearms with a non-antimicrobial soap

How should hand care products be stored?

Store and dispense products according to manufacturer's instructions. Products such as liquid soaps and lotions can become contaminated with bacteria or other microorganisms. Liquid products should be stored in closed containers and dispensed from either disposable containers or containers that are washed and dried thoroughly before refilling. Soap should not be added to a partially empty dispenser; the practice of "topping off" might lead to bacterial contamination of soap and cancel the beneficial effect of hand cleaning and disinfection.

Do hand lotions affect the integrity of gloves?

Yes, certain types of lotions such as those that contain petroleum can weaken latex gloves and increase porousness. If using lotions during the workday, select a water-based product. Lotions that contain petroleum or other oil emollients should only be used at the end of the workday. When choosing a lotion to use in the dental office, get information from the manufacturer about interaction between gloves, lotions, dental materials, and antimicrobial products.

Selected References and Additional Resources 

CDC. Guideline for hand hygiene in health care settings: Recommendations of the Health Care Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002;51(No. RR-16). Available at: www.cdc.gov/mmwr/PDF/rr/rr5116.pdf [PDF-1.2M]. Accessed June 27, 2015.

CDC. Guidelines for infection control in dental health-care settings – 2003. MMWR 2003; 52(No. RR-17):1–66. Available at: www.cdc.gov/mmwr/PDF/rr/rr5217.pdf [PDF-1.5M]. Accessed June 27, 2015.

CDC. Hand Hygiene in Healthcare Settings Educational Material https://www.cdc.gov/handhygiene/

Ellingson K, et. Al. Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. A Compendium of Strategies to Prevent Healthcare-associated Infections in Acute care Hospitals: 2014 Updates.Infect Control and Hospital Epidemiol 2014;35 No. S2: S155-S178.

Momeni, SS, Tomlin N, Ruby JD. Isolation of Raoultella planticola from refillable antimicrobial liquid soap dispensers in a dental setting. J Am Dent Assoc 2015;146:241–245.

Myers R, Larson E, Cheng B, Schwartz A, Da Silva K, Kunzel C. Hand hygiene among general practice dentists a survey of knowledge, attitudes and practices. J Am Dent Assoc 2008;139:948–957.

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