Articles on dental public health

6 EASY Tips for Good Dental Health

Dr. Jitendra Khanna, Dentist
We all know that we need to brush our teeth at least twice a day, floss in between and visit our dentists for check up’s every 3 to 6 months. However, often times we take our dental health for granted and do not take care of our mouth’s the way they should be. Below are some great tips on what you could do to keep your mouth even healthier and stronger for years to come.Waterpicks:Waterjets, waterpicks or oral irrigators, can be used in addition to flossing. These devices deliver pressurized streams of water in areas that brushing and flossing cannot reach alone. Using a waterpick in addition to daily brushing and flossing can greatly reduce chances of cavities and gingivitis.Brushing:Although this seems very obvious, many people do not understand the importance of brushing teeth. It is vital to your dental health to thoroughly brush your teeth at least twice a day (especially after meals). Brushing is essential to removing bacteria and plaque that accumulate in our mouths. It is recommended to acquire a small headed brush that has soft bristles.brushing should be done twice daily but if you are not able to do it twice do not skip night time brushing as whole day whatever you are eating that keeps clinging to teeth all through the night, at night when we sleep the salivary flow is also low so the risk of aquiring DENTAL CARIES is maximum at that time so if you are not brushing at night ATLEAST USE MOUTHWASH..Mouthwash:Mouthwashes have antibacterial and anti-fungal effects and can help kill bad breath and keep our mouths squeaky clean.Flossing:Dental flossing is very important to reach areas in our mouths that brushing alone cannot get to. Flossing can help to remove the buildup of plaque in between our teeth and prevent cavities and other dental issues from forming.Avoid Dry Mouth:Saliva serves as a vital role in preserving dental health; it protects teeth against periodontal disease and tooth decay. Having a saliva deficiency can reduce oral immunity and cause many dental problems. If you are suffering from a dry mouth, it is best to consult with your dentist for options as to what you can do to fix it! there are few mouth rinses available in market which keep the mouth moist.White teeth:Not only does having whiter teeth usually mean you have a strong and healthy mouth, but it also can make us that much more confident when smiling and showing off our teeth. Avoid smoking, red wine and other tannin containing drinks and be sure to brush often.Eat Crunchy Foods:Eating crunchy or “detergent” foods can help to keep our mouths strong and healthy as well as cleaning teeth while they are being eaten. Think carrots, apples, and celery.

Myths and Facts About Dental Health

Dr. Vijita Mehta, Dentist
Myth: It’s none of the dentist’s concern whether a woman is pregnant.Fact: It’s important for your dentist and hygienist to know that you are pregnant or trying to become pregnant. You may be at risk for certain dental conditions, and your pregnancy may limit the treatment options available.Myth: Being pregnant doesn’t affect your mouth.Fact: Pregnant women are at greater risk for certain oral health conditions. These conditions include gum disease, also known as “pregnancy gingivitis,” and growths within the mouth, called “pregnancy tumours.” Both conditions are treatable, so make sure to visit your dentist.Myth: Your oral health doesn’t affect your baby.Fact: If you have moderate to severe gum disease, you may be at higher risk for delivering a per-term, low-birth weight baby.Myth: Pregnant women should avoid dental work.Fact: Everyone — and especially pregnant women — should visit the dentist. If you’re pregnant, you face a higher risk for gum disease, so make sure to visit your dentist for regular cleanings, exams and any other treatment needed.What about anesthesia?You should avoid procedure in which anesthesia is needed. If you need treatment requiring anesthesia, your dentist may recommend postponing the procedure until the second trimester.Myth: Never get a dental x-ray while pregnant.Fact: Dental x-rays are now considered safe during pregnancy. X-rays can be essential in detecting serious problems, such as hidden decay, bone loss and inflamed tooth pulp.Dentist can easily evalute whether there is need of X ray or not.Myth: Morning sickness is unpleasant but harmless for teeth.Fact: Repeated vomiting can cause serious damage to your teeth. Exposure to stomach  acid dissolves tooth enamel, weakening your teeth’s. If you suffer from morning sickness, talk to your dentist about ways to reduce the harm, such as using a mouth guard or rinsing with baking soda.

Myth vs Fact About Dental Health

Dr. Vijita Mehta, Dentist
Myth #1: I'll eventually get gum disease, since it's a natural part of aging. Fact: Gum disease is not an inevitable effect of aging. Gum disease is caused by a build up of dental plaque -- and that can happen to seniors and teens alike. Gum disease is more common in seniors who face changes such as receding gums and a faster build up of plaque. Other factors such as smoking, dry mouth and taking certain medications can increase the risk of periodontal disease in seniors even more. Myth #2: Gum disease isn't that serious and will go away on its own. Fact: Gum disease develops slowly over time and may not show symptoms along the way. But that doesn't make it any less serious for seniors. Plus, the disease will not resolve by itself. What starts with a little redness of the gums and bleeding can develop into pockets around the base of the teeth, which eventually become loose and fall out. The only way to remove plaque deep under the gums is with regular dental cleanings. Myth #3: I'll spot the signs of gum disease before it gets too severe. Fact: Gum disease isn't easy to detect, especially early on. In fact, many seniors don't know that they have periodontal disease because it has been developing slowly over time. That's why regular dental visits are so important. A professional deep cleaning will remove any plaque build up in places you might not be able to reach on your own. Myth #4: I shouldn't worry if my gums bleed when I brush my teeth. Fact: Your gums shouldn't bleed when you brush or floss. Bleeding gums are one of several signs of periodontal disease. Other signs include: - Red, swollen or tender gums- Sores in your mouth- Gums that are pulling away from the teeth- Persistent bad breath (halitosis)- Pus between your teeth and gums- Loose or separating teeth- Changes in the way your teeth fit together when you bite- Any change in the fit of partial dentures Myth #5: Gum disease doesn't have anything to do with the rest of my health.Fact: The bacteria released with chronic oral infections can spread and contribute to disease in other parts of the body. Gum disease is linked to several other health conditions in seniors, including coronary heart disease and stroke. Having periodontal disease makes it more difficult for people with diabetes to manage their blood sugar levels. It can also pose a threat to people with respiratory diseases or osteoporosis. 

How Diabetes Affects Your Oral and Dental Health

Dr. Prashant Ojha
Diabetes is term used to describe a group of metabolic disorders, distinguised by altered glucose tolerance and impaired carbohydrate metabolism.Oral and dental manifestation of diabetesEnlarge gingiva- The affected tissue may be inflamed, in which case the gums are red, soft, shiny and bleed easily. Gingivitis may be localised or generalised, and can be caused by systemic diseases especially diabetes.Mutiple periodontal abcess- Classic description of undiagnosed /poorly controlled diabetes patients is mutiple periodontal abcess, leading to rapid destruction of periodontal support. Case reports on life-threatening deep neck infection from a periodontal abscess and fatal palatal ulcers exemplify the severity of these conditions.Altered  taste sensation- Patients have a blunted taste response, which displays a degree of specificity to glucose, is partially reversed after correction of hyperglycemia, and is independent of somatic or autonomic nerve function. This taste abnormality may influence the premorbid choice of nutrients, with a preference for sweet-tasting foods, thereby exacerbating hyperglycemia.Alteration in microflora of oral cavity- Patients with diabetes are more susceptible to developing oral bacterial infections. They are well known to have an impaired defense mechanism hence considered to be immuno-compromised. Diabetics with diabetic complications and poor metabolic control are more prone to spreading and recurrent bacterial infectionIncreases dental caries- Few studies have reported on the incidence of root-surface caries as a significant problem in older patients with diabetes.It is well known that patients with diabetes are susceptible to oral infections that lead to tooth decay and loss.Salivary secretion dysfunction, periodontal and sensory disorders could increase the likelihood of developing new and recurrent dental caries and tooth lossDecreases salivary flowBurning mouth and tongue- Oral dysesthesia or burning mouth syndrome (BMS) is a painful condition affecting the oral cavity (palate, tongue, throat and gingivae). Other abnormal oral sensations may coexist with the burning mouth sensation such as tingling, numbness, dryness or sore mouth at the same time8.Increases chance of dry socket after dental extraction.Lichen planus- There are also indications that patients with elevated salivary glucose levels carry candida intraorally more often than those with lower glucose levels. The implication being that diabetes may be related to the pathogenesis of lichen planus. The evi-dence for an immunological defect  and deficient leukocyte functions superimposed on the metabolic abnormality of diabetes seems increasingly convincing.Impaired wound healing- Poor soft tissue regeneration and delayed osseous healing in patients with diabetes are known complications during oral surgery. Therefore, the management and treatment of patients with diabetes undergoing oral surgery is more complex. It was reported that delayed vascularisation, reduced blood flow, a decline in innate immunity, decreased growth factor production, and psychological stress may be involved in the protracted wound healing of the oral cavity mucosa in patients with diabetes.Median rhomboid glossites.Destructive periodontal diseases- Periodontal disease is the most prevalent oral complication in diabetes patients and has be enlabeled the "sixth complication of diabetes mellitus". Oral candidosis- is an opportunistic infection frequently caused by Candida albicans species. Many predisposing factors can lead to this infection; these include smoking, xerostomia and endocrine and metabolic diseases.There are several clinical implications. These include:A lack of awareness of oral complications among both diabetics and health providers. An understanding of the way diabetes affects oral health is necessary for both clinicians and patients, therefore research in this field should be encouraged.The need for regular follow-up of patients with diabetes mellitus by both dentist and physicians. The major role that dentists should play in recognising the signs and symptoms of diabetes and their oral complications.Advice and counselling for diabetic smokers regarding smoking cessation. Vigorous treatment of oral infection either bacterial or fungal in these patients, especially if they have poor glycaemic control.

Dental Health and a Child’s Development – Are They Related?

Dr. Vandana, Dentist
A child is the most innocent and beautiful creations of God. Innocent because they don’t think or act grey, its either black or white and anything so pure and unadulterated ought to be beautiful. They don’t know the little intricacies of smiling like we adults do, when to smile, when not to, formal smile, pleasing smile and sometimes even plastic smiles. A child’s smile is just that, sheer pleasure, fresh like dew drops and soothing like sunshine on a winter morning!!I have my little daughters, elder one being nearly 5 years old. Like any other child she is also not very regular with her brushing regime (ironically yes!!). Being a dentist myself, I tried to convince her of the bad effects not brushing can have on her teeth but she just gave me one of those ‘I don’t care’ smile and moved on. Initially I thought to just let it go for I was also tired at the end of day but then the consequences dawned upon me.I have seen many pediatric patients during my practicing years with lots of dental problems mainly decay and pain. One common thing which I noticed among all those children was a lack of confidence, and that pure, never caring, confident smile was missing. They were conscious of the fact that their teeth did not look good, social pressure you see! And the main motive behind coming to a dentist was to get appreciation from friends, teachers and peers. This all set me wondering what would be going on in their little heads to handle all that pressure at such young age. I realized that the dental problem is not only giving child a physical discomfort but also hampering their overall physical and mental growth. I would not let that happen to my child.I think it’s not their fault that they are suffering rather ours .We as parents should make that extra effort to give our child a helping hand to get through that 5 minute regime of brushing, morning and evening. Believe me these 10 minutes daily you put in with child, ignoring their tantrums will definitely add on to your child’s physical well being and developing her confidence and overall personality. In a way we would be helping our society and country prosper.A child should smile like one free, confident, fun and fresh!!Until next time smile healthy and live happily!!!

10 Important Dental Tips for a Great Smile

Dr. Suhani Talesara, Dentist
Everyone wants to have a great smile which is why good oral hygiene is important! Having poor oral hygiene can lead to a variety of dental and medical problems in the future such as gum disease, infection, bone loss, heart disease, strokes and more. Regular check ups and cleanings can prevent these problems as well as provide you with good oral hygiene.Here is a list of 10 Dental hygiene steps you can take to promote great oral hygiene.1. Proper BrushingOne of the easiest steps to do to help your teeth keep clean. When brushing your teeth, position the bristles at an angle of 45 degrees near the gum line. Both the gum line and the tooth surface should be in contact with the bristles. Brush the outer surfaces of the teeth using a back-and-forth, up-and-down motion, making sure to be done gently in order to avoid bleeding. To clean the inside surfaces of the teeth and gums, place the bristles at a 45-degree angle again and repeat the back-and-forth, up-and-down motion. Lastly, brush the surfaces of your tongue and the roof of your mouth to remove bacteria, which might cause bad breath.Try to brush at least twice a day to prevent acid buildup from the breakdown of food by bacteria. However, if your work or activities prevent you from doing this, thoroughly rinse your mouth with water after eating to minimize the amount of food that would serve as substrate for the bacteria.2. Flossing!We know, it’s a chore and alot of times forgetful after brushing if rushing out the door or heading to bed. However, flossing can help you remove food particles and other detrimental substances that brushing regularly cannot. Flossing allows you to reach deep between your teeth where the toothbrush bristles cannot reach or even mouthwash cannot wash away. We recommend flossing at least once a day.3. Avoid TobaccoThis will be a big favor to your teeth. One, it will save you from oral cancer and periodontal complications. Two, it will save you from the countless ill effects caused by the agents used to mask the smell of tobacco. For example, if you smoke a cigarette, you may use candies, tea or coffee to mask the smoky breath and odor. This doubles the amount of damage caused.4. Limit Sodas, Coffee and AlcoholAlthough these beverages contain a high level of phosphorous, which is a necessary mineral for a healthy mouth, too much phosphorous can deplete the body’s level of calcium. This causes dental hygiene problems such as tooth decay and gum disease. Beverages containing additives such as corn syrup and food dye can make pearly white teeth appear dull and discolored. Therefore, it is best to choose beverages like milk, which helps strengthen teeth and build stronger enamel, giving you a healthy, beautiful smile and water which hydrates your body longer than sugary drinks.5. Consume Calcium and other Vitamins that are good for the bodyYou need plenty of calcium for your teeth. It is essential for the teeth as well as your bones. It is better to drink milk, fortified orange juice and to eat yogurt, broccoli, cheese, and other dairy products. You can also take a calcium supplement, taking different doses according to your age and necessity as per prescription. Calcium and Vitamin D are necessary for maintaining the health of gums and teeth. Vitamin B complex is also essential for the protection of gums and teeth from cracking and bleeding. Copper, zinc, iodine, iron and potassium are also required for maintaining healthy dental hygiene.6. Visit Your DentistYou should visit your dentist at least twice a year to have a full hygiene treatment performed. Also at these appointments, a comprehensive exam is taken with x-rays to help detect and prevent future dental treatments from occurring.7. Use Mouthwash along side brushing and flossingMouthwash is not particularly necessary and not all mouthwashes are useful. Mouthwashes containing Listerine our chlorine dioxide are very helpful because they help to kill and maintain the bacteria in your mouth. It can help maintain good breath as well as help maintain strong teeth. Mouthwash cannot do all the work but if your are already brushing, flossing, visiting the dentist and eating well, mouthwash is the cherry on top that will make your dental health great. 8. Having a toothache or noticing other dental symptomsIf you are having tooth and jaw pain make an appointment  as soon as possible. Your dentist needs to diagnose the underlying cause and correct it before it turns into a greater problem.9. Look at the Big PictureEveryone understands that you should take care of your teeth to avoid toothaches, maintain your looks and keep dental bills at bay. Many people, however, don’t understand how crucial oral health is to our total health picture. Tooth problems can lead to diabetes, heart disease, systemic infections, an inability to eat or speak properly and other maladies – some life-threatening. Crooked or crowded teeth can contribute to gum disease that can eventually lead to tooth loss. Straight teeth are no longer just for looks. 10. Clean your tongueClean the surface of your tongue daily. By using a professional tongue cleaner you remove countless bacteria that otherwise live, particularly on the rougher top surface of your tongue. These can contribute to bad breath (halitosis) and negatively affect your dental health.Learn MoreDental ConsultationsRequest a FREE Consultation with Dr. Suhani for any dental concerns you may have. We guarantee the highest quality and care for all of our patients at Dr. Dentist Multispeciality Dental Clinic.Schedule Today!

Basic Knowledge of Infection Control in Dental Clinic

Dr. Yogesh Rao, Dentist
INTRODUCTION The unique nature of dental procedures, instrumentation and patient care settings require specific strategies directed to the prevention of transmission of diseases among dental health care workers and their patients.Dental practices should develop a written infection-control program to prevent or reduce the risk of disease transmission. The program should outline the policies, procedures, practices, technologies, and products used to prevent occupational injuries and illnesses among dental team members as well as healthcare-associated infections among patients.The practice setting should establish a working relationship with a qualified healthcare professional/facility to provide dental team members with appropriate occupational health services like vaccinations (hepatitis B, influenza, measles, mumps, rubella, tetanus, and varicellazoster) and postexposure evaluation and management.As a matter of fact, the dentist, dental assistant, dental hygienist and dental technician are at risk of exposure to disease agents through contact with blood or other potentially infectious materials. So by studying and by carefully following the infection control and safety guidelines, all the team work can minimize the risks of disease transmission to himself and to the patients in the dental office.Diseases Transmission in Dental Office;The dental office should have an infection control program to prevent the transmission of disease from the following :Patient to dental team Dental team to patient:Patient to patient:Dental office to community ( include dental team’s family ):Community to dental office to patient To prevent such infections, following is a list of all those procedures and precautions that together constitute infection control. These guidelines should be followed each time treatment is performed because we are never certain of the patient's status, either because they themselves do not know or because they have chosen not to inform their healthcare providers of their condition. Following these guidelines for every patient is called "Standard Precautions".StandardPrecautions1. IMMUNIZATION 2. PATIENT SCREENING 3. HAND WASHING 4. BARRIER TECHNIQUES - • Personal Protective Equipment (PPE)• Rubber dam, Pre-procedural rinsing5. NEEDLE & SHARP INSTRUMENT SAFETY • Occupational Exposure To Blood/Body Fluids7. SURFACE DISINFECTION8. radiographic asepsis 9. laboratory asepsis10. infectious dental waste management &disposalModes of Diseases Transmission :Direct contact with blood or body fluids:Indirect contact with a contaminated instrument or surface:Contact of mucosa of the eyes, nose, or mouth with droplets or spatter:Inhalation of airborne microorganisms Prepare personnel involved in patient care.An essential pretreatment procedure is the preparation of all personnel involved in patient care. This includes the utilization of personal protective equipment (gown, eyewear, mask and gloves) and hand hygienePersonal protective equipment ( PPE )    OSHA  requires the employer to provide employees with appropriate personal protective equipment . Examples of  PPE   1-  Protective clothing2-  Surgical masks3- Face shields4-  Protective eyewear5- Disposable patient treatment gloves , and 6- Heavy-duty utility glovesHandwashing and hand care :According to   the   U.S.  Centers    for   Disease   Control (CDC) , hand washing is the single most important procedure for preventing the spread of infection. So , you must wash your hands each time before you put on gloves and immediately after you remove gloves . Handwashing is also required if you touch contaminated instruments or surfaces during working .We should always use liquid soap during handwashing . Bar soap should never be used because it may transmit contamination.Guidelines for the use of protective clothing  1) It should not be worn out of the office for any reason .2) Change these work clothes at least daily, or more often if  soiled, especially if they become visiblycontaminated with blood.3) It must not be worn during eating or in resting rooms  .4) It should be washed and laundered separately . Protective clothing requirements : 1) Should be made of fluid-resistant material ( cotton , cotton/polyester, ordisposable jackets or gowns .2)  Clothing should have long sleeves and a high neckline to minimize the amount of uncovered skin .3) Must cover dental personnel at least to the knees when seated.Protective masks :Purpose :the mask worn over the nose and mouth to protect the person from inhaling infectious organisms spread by the aerosol spray of the handpiece or air-water syringe . Types : the two most common types of masks are the dome-shaped and flat types,dome shape and flat shapeGuidelines for the use of protective masks  :• Masks should be changed for every patient or more often, particularly if heavy spatter is generated during the treatment or if the mask becomes damp.• Masks should be handled by touching only the side edges to avoid contact with the more heavily contaminated body of the mask.• Masks should conform to the shape of the face .• Masks should not contact the mouth when being worn because the moisture generated will decrease the mask filtration efficiency .Requirements : masks should be at least with 95% filtration efficiency to remove particles 3 – 5 microns in diameter .Protective eyewear :Purpose  eyewear is worn to protect the eyes against damage from :   • Aerosolized pathogens .• Flying sharp debris such as scrap amalgam and tooth fragments .• Splattered solutions• Caustic chemicalsGuidelines for the use of protective eyewear  :1) OSHA  requires the use of eyewear with both front and side protection ( solid side shields ) .2) Members who wear correction glasses or contact lenses must wear protective eyewear with a side shields or a face shield . 3) It must be cleaned and decontaminated after each treatment or patient visitaccording to the manufacture’s instructions .Types  :Two types of protective eyewear used during patient care :1) Glasses with protective side shield , and2) Clear face shields .Face shields : a chin-length plastic  face shield that protects your eyes, nose, and mouth from spatter may be worn and replace the protective eyewear .However , a shield cannot replace the mask because it does not protect against inhalation of contaminated aerosolGloves  :  Purpose : Glovesmust be worn by the dentist , dental assistant , and dental hygienist during all dental treatment to avoid contact with the patient’s blood , saliva , or mucous membranes or with contaminated items or surfaces .Types  : The   type  of   gloves   used   in   dental   practice     should be determined by the various procedures that are performed in the practice as follow :1) Examination gloves  usually are latex or vinyl . These are the gloves most frequently worn by the dental team duringpatient care .2) Overgloves   are made of lightweight  , inexpensive , clear plastic . Overgloves may be worn over contaminated treatment gloves ( overgloving ) to prevent contamination of clean objects ( telephone , pen ,opening drawers and cabinets ) that may be handled during treatment . Overgloves are discarded after a single use .3) Sterile surgical gloves are used   during    surgical procedures such as oral surgery or periodontal treatment . Sterile surgical gloves   are supplied in specific sizes and prepackaged unites to maintain sterility before use4) Utility gloves  are made from a puncture-resistant , heavy  material which are not used for direct patient care . Utility gloves may be washed , disinfected , or sterilized and reused  and must be discarded when they become old .Managing contaminated sharps :Contaminated needles and other disposable sharps , such as scalpel blades , orthodontic wires , and broken glass must be placed into a sharps container .OSHA , CDC and the EPA classify sharps as infectious waste . According to OSHA regulations , disposable sharps must be placed in a puncture resistant , closable , and color-coded or labeled with the biohazard symbol container immediately after use .Proper processing of contaminated  dental instruments in a six-steps  process as : 1)  Transport :   transport contaminated instruments to the processing area .2)  Cleaning  :   clean instruments with a hand-free , mechanical process such as an ultrasonic cleaner or instrumentwasher.3)   Packing   :  warp/package instruments in appropriate materials containing an external process indicator .4)  Sterilization : place the packages in a single layers or in  racks to increase circulation of the sterilizing agentaround the instruments . Operate the sterilizer according to the manufacture’s instructions . Allow packages to cool before removing them from the sterilizer .5)  Storage:  Store instruments in  a clean , dry environment  in a manner that maintains the integrity of the  package.Rotate   packages so   that those with the oldest sterilization date will be used first .6) Delivery : deliver packages to point of use in a manner that maintains sterility of the instruments  until  they are   used . Inspect each package for damage .Impressions and appliances should be rinsed thoroughly to remove all visible blood and debris. Gloves should be worn when handling impressions and pouring models. Certain types of impression material (silicone, polysulphur) can be disinfected by total immersion in glutaraldehyde (2%) or sodium hypochlorite (0.1%). Other materials (alginate, polyether) may be disinfected by submerging for several seconds in sodium hypochlorite (0.1%), which should then be wrapped in a hypochlorite saturated paper towel and kept in a closed container for the recommended disinfectant time.Packaging  instruments: Before sterilization the instruments must be packaged to protect them from becoming contaminated after sterilization .They can be contaminated by aerosols in the air , dust , or contact with nonsterile surfaces . An additional advantage to packaging instruments is that they can be grouped into special setups .Sterilization in the dental office : The three most common forms of heat sterilization in the dental office are : :Steam sterilization,:Chemical vapor sterilization, and :Dry heat sterilizationSterilization of hand pieces is recommended whenever possible : Hand pieces that are designed for steam sterilization between uses are preferred. When a hand piece cannot be heat or steam sterilized, chemical disinfection can be used as an alternativeMicroorganisms in WaterlinesThe primary source of microorganisms in dental waterlines is the public water supply It is possible that saliva may be retracted back into the waterlines during the treatment . This process is called suck back''Anti-retraction valves on dental units and thorough flushing of the dental lines between patients minimize the chance of this occurring.  Entering public water source has a colony forming units (CFU) count of less than 500; once that water enters the dental waterlines and colonizes within the bio-film, the CFU count skyrockets. There are two “communities” of bacteria in dental unit waterlines: One bacterial community exists in the water itself and is referred to as planktonic (free floating). The other exists in the bio-film attached to the walls of the waterlinesMethods to Reduce ContaminationSelf-contained water reservoirsChemical treatment regimens Micro-filtration Daily Draining and drying of linesSurface disinfectionSurfaces that are likely to become contaminated may be de-contaminated after treatment or protected with disposable coverings before they become contaminated. Effective cross-infection control is aided by a strict system of zoning and the use of sterilizable trays. Procedures should be adopted which limit the areas touched and contaminated each time a patient is treated.Between clinical sessions, work surfaces should be thoroughly cleaned and decontaminated with ethyl alcohol (70%). If there is visible blood or pus, the surface should be cleaned and disinfected with sodium hypochorite (0.5%), followed by water rinse. Protective gloves should be worn and care taken to minimise direct skin, mucosal or eye contact with these disinfectants.