Preprocedural mouthrinse always helps reducing the number of microorganisms that may escape patients' mouth during dental treatment through direct contact, spatter, and also through aerosols. Through direct contact operator may get skin infection and likewise spatter may takes infection to operator's eyes or oro-nasal cavities. Aerosols are more produced during oral prophylaxis, use of polishing cups/brushes, air rotors or any of such rotatory equipment in patient's mouth. These aerosols when inhaled may carry infection to operator's lungs. Use of the mouthwash can reduce the load of bacteria produced in the aerosols during dental procedures, and thereby reducing the operator’s chance of receiving pathogenic organisms from his patient while providing treatment. Hence, this method prevents or reduces disease transmission from patients to staff and to other patients, and can serve an important function in infection control management in dental clinics.
In various published research papers, it has been found that only two-minutes of mouthrinsing, with chlorhexidine mouthwashe significantly reduced bacteria in aerosols produced by ultrasonic scalers. A preprocedural mouthrinse can be used before any dental procedure, but its bacteria-inhibiting properties may be most beneficial before prophylaxis with a prophy cup or ultrasonic scaler, since rubber dam cannot be used and, unless a hygienist works with an assistant, high-volume evacuation is not commonly employed.
In selecting an antiseptic mouthrinse for preprocedural rinsing, residual activity is an important consideration, as the agent must be capable of reducing microbial levels throughout the length of the appointment. Mouthrinses lacking, this substantivity could allow oral microorganisms to return to their original levels before some dental procedures are completed, which would limit their infection control value.
Few of the readily available mouthwashes which can be used in the clinical setup for preprocedural mouthrinses are chlorhexidine, 1% betadine etc.
Usually 10 to 20 ml of mouthwash is enough for therapeutic purposes. Rinsing with water or drinking immediately after rinsing should be avoided to prevent clearance of the antimicrobial agent from the mouth, which could reduce antimicrobial effectiveness. Mouthrinses often are not prescribed for young patients because of their tendency to swallow some of the rinse. In addition, reduced doses may be considered for geriatric patients, patients with serious illness or disability, and patients with medical conditions.
Although important but still mouthrinses remain only one small part of an effective in-operatory infection control management. To be 100% protected the dental operators must wear full-protection eyewear, high-filtration masks, and quality gloves. The patient’s eyes also should be protected during spatter- or debris-generating procedures. To minimize spatter, appropriate long-sleeved, high-neck protective garments are always required during spatter-producing procedures. Thorough between-patient hand washing with antimicrobial handwash helps reducing the spread of infection among the patients. The spread of contamination can also be limited by avoiding contact between the hands and nose, face, and hair as well as unnecessary contact with operatory surfaces such as the mobile, switches, operator’s chair etc.
Now you all know the importance of preprocedural mouthrinsing. All of my dentist friends should start practicing this and always stay safe.
Dr. Arun Bhatia
5J/19, NIT Faridabad
Phone: 9899907997
Email: drarunbhbatia@gmail.com
Website: www.arundentalclinic.in
Facebook page: @arundentalclinic.in