Coronavirus Pandemic has surely put forward the importance of Personal protection in Dental clinics, so knowing the proper way to wear and remove a PPE Kit in your dental clinic is of utmost importance if you want to protect yourself and your dental staff from any infection. PPE or Personal Protection Equipment in Dentistry consists of many items which are components which are aimed at protecting you or isolating the Dentist or Dental assistant wearing it from the surroundings preventing any contact with either droplets or Aerosols which are known to be the major carrier of Coronavirus and many other microorganisms as well. In a Dental clinic, personal protection is very important because of the Aerosol producing procedures which are performed using an Aerator or even a three way syringe when used can produce aerosols or droplets in the vicinity.

Not just purchasing a PPE Kit and wearing and removing it as you wish can rather increase the chances of infection, so it is important to know How to Wear and How to remove a PPE kit properly along with knowing how to dispose off the PPE kit in your dental clinic.

How to Put on or Donning a PPE Kit properly:

In Hospital or medical terms, the process of putting on a PPE is termed as Donning a PPE for OR or OT, let us look at how to put on a PPE kit in the correct order step by step.

Step 1: Put on the Scrubs: These are the clothes which you wear on you which will be under the PPE kit, there is no particular way to put them on. You can normally wear them as a normal shirt and pant. Make sure that these are not the clothes which you have worn at home.

Step 2: Put on Shoe Covers: Put on your Shoe covers over your slippers of shoes.

Step 3: Wash your Hands: You need to wash your hands properly upto the elbows with a Hand Sanitizer (Alcohol based) or Hand wash.

Step 6: Put on your N95 Mask: Now put on your Surgical N95 Respirator mask with your hands. Hold the Mouth mask on the outer side with your hand and place it against your face, now with the other hand hold the elastic or strings and put it behind your head.

Step 5: Put on a Head Cap: Wear the head cap over the N 95 elastics of threads covering your complete head, in case of Females, your hair should be tied in such a way (bun shape) that it can be accommodated inside the head cap.

How to remove a PPE Kite properly in Dental clinic

Image Credits: Well Cornell Medicine

Step 6: Put on your Surgical Mask: Now put on your Surgical Mouth Mask or 3-ply Surgical mask with your hands. Hold the Mouth mask on the outer side with your hand and place it against your face over the N 95 mask which you put on earlier, now with the other hand hold the elastic or strings and put it behind your head over the Head Cap.

Step 7: Put on the Googles and Face Shield: The Googles should be put on properly and in case of any aerosol producing procedures Face Shield should also be worn over the Googles to prevent any splatter or droplets from touching your face or skin.

Step 8: Scrub your Hands till Elbows: Using a Hand wash, scrub your hands up to the elbows to make sure the exposed skin surface is properly sterilized.

Step 9: Put on the Gown or Overall: Without touching anything you need to put on the gown either by yourself of with someones help to make sure that you do not contaminate the surface by touching infected surfaces like door handles etc.

Step 10: Put on Surgical Gloves: With the help of your attender, after asking them to tear open the seal of Surgical gloves, put on the gloves without infecting them

Step 11: Put on a Second pair of Surgical Gloves: It is important to put on a second pair of Surgical Gloves over your gloves to be sure of protecting your hands from any contamination due to damage to the gloves as we use sharp instruments in our practice.

How to Remove or Doffing a PPE in Dental clinic:

Removing a PPE after use is of utmost importance at the PPE is now contaminated as is a potential source of infection if not handled properly. Removing and disposing off a PPE after use should be done with utmost care to prevent every person in your Dental clinic from being infected. So lets see How to remove a PPE in a step by step manner after use.

Note: It is important to have a separate room if possible or a specified area of the clinic where you remove the PPE kit and sanitize everytime after removal of a PPE, this prevents contamination of the other areas of the clinic. 

Step 1: Remove Gown and Gloves: Remove the Gown along with your gloves together in a single go making sure not to touch your scrub or face with your gloves or hands. In case only one pair of gloves come off, you need to follows step number 6 – Removes gloves by touching the outer surface of the gloves with another glove and remove it, now put your finger under the glove without touching the outer surface and remove the glove with your finger and discard it.

Step 2/3: Wear Examination Gloves: Wear Examination gloves to complete the rest of the process of Doffing PPE in Dental clinic

Step 4: Remove Shoe Covers: With the examination gloves remove your shoe covers and dispose them off in the designated bin

Step 5/6: Remove Examination Gloves: Remove the gloves which were used to remove the Shoe covers without removing any head gear like mask, head cap or N 95 mask until you are out of the Surgical room. This prevents any Aerosols which might be suspended in the air from being inhaled or swallowed.

How to remove PPE Kit properly in Dental clinic

Image Credits: Well Cornell Medicine

Step 7: Sanitize or Wash Hands: Use a Alcohol based sanitizer or Hand wash to Scrub your hand properly after exiting the Surgical area or Room.

Step 8: Wear new Examination Gloves: Wear new set of Examination gloves after exiting the Surgical room.

Step 9: Remove the Googles, Surgical Mask and Head Cap: Remove the Surgical mask, Googles and Head cap and dispose off in a bin designated for it.

Step 10: Remove N95 Mask: By holding the outer surface of the N 95 mask with one hand remove the elastics with other hand and move the mask away from your face and dispose off properly.

Step 11: Sanitize or Wash your hands: Lastly Sanitize your hands with a Alcohol based sanitizer and put on a new Face mask before moving on to other room for either talking to the patients or to check a new patient.

Reference:

  • Image Credits: Well Cornell Medicine
  • WHO