When a practitioner has an assistant, hygiene is easy to shape. The assistant mixes the alginate with bare (by definition non-contaminated hands) and on a clean spatula the material is handed in one portion to the gloved therapist. The appropriate impression trays are ready on the treatment tray. The spatula becomes dirty from the handling by the practitioner and also by the stripping at the edge of the appropriate tray. The next portion of alginate is therefore always offered with a next clean spatula. So there are as many spatulas as the number of portions that is needed.
A somewhat more complicated situation arises when printing without assistance. Such a situation often occurs in orthodontic practices, but dentistry assistants frequently also produce alginate prints in regular dental care without the support of a colleague assistant. It is then important to draw up a well-fitting hygiene protocol and follow it strictly during printing.
First of all, it is a good practice to disinfect hands in the presence and also in the patient's view, before putting materials ready. This removes all possible doubts from patients about the hygienic basis of action. Perhaps it is an addition to say out loud during the hand disinfection that the hands are disinfected to keep the materials clean and therefore safe during use. This will focus the patient's attention on the actions, so that a feeling of good care can unconsciously arise.
The order and method of action are free for every practitioner, provided that the end result leads to good prints and a safe working method during the procedure. As a basis and basis for different practical situations, the following hygiene protocol can be used in case alginate prints are taken without assistance:
A. Preparing at the mixing location with bare, disinfected hands:
- Customized portions of alginate in mixing cup / mixing cup;
- Water meters (preferably filled already filled), Spatulas (plural!), In addition to the worktop next to the treatment chair:
- Plastic bag, opened on the worktop;
- Examination gloves, preferably one size too large (see method at f);
- When using plastic impression trays: adhesive varnish, hands-free opening bake disinfectant (eg with worktop tweezers to flip off the lid) and tissue to dry disinfected impression tray.
B. Fit spoons:
- preferably with the touch-free technique; important (!) condition is that the hands are disinfected, in the view of the patient. The impression tray is held by the handle during fitting, without making contact with the patient. Use a mouth mirror to pull the corner of the mouth aside when inserting the spoon.
The touch-free fitting of impression trays saves examination gloves and makes a conscious method extra necessary. If working with bare hands is not desired by practitioner or patient (?) Then it is to consider using the (very) short duration of the spoons cheap 'gas pump gloves' to use or as a last choice still a pair of real examination gloves to use. However, this is in fact unnecessarily costly and improper use of expensive goods.
- Metal impression trays: after fitting, place the patient tray in anticipation of the print.
- Plastic impression trays: (use of adhesive varnish is indicated!). Hold the impression tray by the clean handle and immediately rinse under running water, disinfect with alcohol, dry with tissue. Open the bottle of adhesive lacquer with bare hands and coat the spoon above the worktop with adhesive lacquer. Place the smeared spoons on the treatment tray to allow the adhesive lacquer to dry, while waiting for printing. Close bottle immediately after use.
When a mixing machine is outside the treatment room, an alternative is to place the impression trays on the patient tray after fitting. Then, in the mixing room, take new spoons of the same size to fill the machine. Disadvantages are that the filled spoon and the spatula with the 'pre-grease' must then be transported over the corridor and should preferably be covered in the corridor. In addition, it is cumbersome because the double set of impression trays generates extra work in the sterilization space and also occupies (unnecessary) space (capacity) in the thermodisinfector. When using plastic impression trays, this method can obviously not be used, because they are made for single-use, and therefore can not be reconditioned.
C. Generate alginate with bare, so clean (!) Hands;
Mixing with bare hands forms the basis for good infection prevention and could therefore be applied as a standard. After all, it is always good, regardless of whether it will be mixed manually or mechanically and regardless of where it is mixed.
D. Pour alginate mixture into nap / mixing cup together with a clean spatula to the patient;
E. Scrape the alginate on the spatula, leave the full spatula in the tray (on treatment tray) and finally place mixing bowl / mixing cup on a clean part of the worktop (to keep it clean);
F. Put on gloves. In order to ensure that this operation does not cause too much delay, preferably take a (too) large size of gloves;
G. Fill the spoon and strip the last bit of alginate with a finger of spatula to pre-grease the occlusal surfaces or the palate;
The spatula has been contaminated by contact with the plate spoon and must be put away on the (dirty) treatment tray. Even if plastic impression trays are used which have been (chemically) disinfected before the adhesive varnish is applied, the spatula is stored as standard on the dirty tray for the sake of simplicity of understanding and unambiguous handling, and with a clean spatula with each subsequent serving of alginate. worked. Hence the preparation of spatulas (mv) instead of just one spatula.
H. Remove the printout and rinse under running water and inspect the quality of the print. With a suitable result, take out one glove and with that pick up the open plastic bag and push the print in without contamination of the outside of the bag. Put the filled bag back on the worktop. Take off the second glove and discard it;
In the case of a rejected print, remove the alginate in the treatment room from the spoon following the inspection. Return the spoon onto the treatment tray for the repeat print, remove both gloves and repeat the procedure from the alginate preparation. Think of a clean spatula for this extra print!
I. The technique voucher (order form) is written in an administrative environment, not in the treatment room, this is a critical space where in principle no administrative actions are performed.