HIV POSITIVE Occupational Exposure
Oral Health Program

Barrier Precautions

The following information summarizes the use of gloves, masks, protective eyewear, gowns, and the protection of equipment that is hard to disinfect.

  • During dental procedures, dental health-care workers must wear gloves when they put their hands into any patient's mouth, and change these gloves between patients. They should also wear gloves when they touch instruments, equipment, or surfaces that may be contaminated with blood or saliva.

  • Hands must be washed and regloved before performing procedures on another patient. Repeated use of a single pair of gloves or washing of gloves between patients is not recommended, since such practice is likely to produce defects in the glove material, which will diminish its value as an effective barrier.

  • Surgical masks and protective eyewear or chin-length plastic face shields must be worn when splashing or spattering of blood, saliva, or oral secretions is likely, as is common during dental procedures.

  • Reusable or disposable gowns, laboratory coats, or uniforms must be worn when clothing is likely to be soiled with blood, saliva, or oral secretions. If reusable gowns are worn, they should be washed, using a normal laundry cycle. Gowns should be changed at least daily or when visibly soiled with blood.

  • Disposable waterproof coverings such as impervious-backed paper, aluminum foil, or clear plastic wrap may be used to wrap hard-to-clean surfaces such as light handles or x-ray unit heads, etc. These surfaces may be contaminated by blood or saliva and are difficult or impossible to clean and disinfect. To replace the covering between patients, the coverings should be removed with gloved hands and discarded. Then, after removing the soiled gloves, the coverings can be replaced with clean material.

GLOVES

You are most likely to contact blood with your hands. If the skin of your hands is intact, it provides good protection from microorganisms that may be in blood. Frequently, however, there may be small unapparent breaks in the skin on your hands.

Wearing gloves will provide an extra barrier against the entry of microorganisms through any breaks in your skin.

Wear gloves whenever you put your hands into any patient's mouth or touch instruments, equipment, or surfaces that may be contaminated with blood. Use a new pair of gloves for every patient.

Three types of gloves are commonly available:

  • Disposable examination gloves made of either vinyl or latex for procedures involving contact with oral mucous membranes.

  • Sterile disposable gloves for use when sterility is necessary, such as during surgical procedures.

  • General purpose utility gloves for use when cleaning instruments, equipment, and contaminated surfaces. Rubber household gloves are suitable, and can be decontaminated and reused.

NEVER reuse surgical or examination gloves. Washing these gloves may damage them and actually cause "wicking," which increases the flow of liquid through undetected holes in the gloves.

Utility gloves may be reused if they are not punctured or torn. They should be properly decontaminated before reuse.

If your gloves are torn, cut, or punctured, remove then immediately and dispose of them properly. Then wash your hands thoroughly with soap and water and put on a new pair of gloves.

As a barrier, there is no difference between an intact vinyl glove and an intact latex glove. However, any type of glove may be defective. It would be prudent, therefore, to make sure your gloves are intact before using them.

As a public health measure, it is not necessary to double-glove, as long as the glove is intact.

EYEWEAR

Wear either a mask and protective glasses or goggles, or a chin-length face shield that protects your eyes, nose, and mouth from spatter. Wear facial protection whenever blood or oral fluids contaminated by blood may be spattered, for example during patient treatment, while cleaning instruments, or when disposing of contaminated fluids.

Use a new surgical mask for every patient. If the mask becomes wet during the single treatment of a patient, the mask should be replaced.

Wash nondisposable facial protective equipment with detergent and water between patients and disinfect it with a tuberculocidal "hospital disinfectant" that is registered with the Environmental Protection Agency (EPA).

GOWNS

Protect your street clothes from contamination by covering them with a gown or coat or wearing a uniform. The sleeve length of these work clothes may be long, medium, or short. Long sleeves will provide the most protection, but may become soiled and need to be changed more often during the course of the work day. If medium or short sleeves are used, be sure to wash your arms up to the sleeve length, while washing your hands before gloving.

Change these work clothes at least daily, or more often if soiled, especially if they become visibly contaminated with blood.

Work clothes soiled by blood, saliva, or oral secretions should be placed and transported in bags that prevent leakage. Wash soiled linens in hot or cold water with detergent and, if possible, chlorine bleach. Normal washing and drying cycles will remove or kill potentially harmful micro-organisms, including viruses. Be sure to follow the instructions of the detergent and machine manufacturers.

Source: The Centers for Disease Control and Prevention

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