Tufts University researchers have identified yet another reason to be anxious about a visit to the dentist: Analyses of dental bib clips found that a significant proportion can harbor bacteria from patients, dental clinicians, and the environment, even after they’ve undergone standard disinfection procedures in a hygiene clinic.
The study, by the Tufts School of Dental Medicine and the Forsyth Institute, determined 40 percent of bib clips retained aerobic bacteria, while a whopping 70 percent retained anaerobic bacteria after disinfection.
The scope of the analysis, published as a supplement to the Compendium of Continuing Education in Dentistry, was small — involving the clips on 20 dental bib holders after they had been used on patients treated in a dental hygiene clinic. But lead researcher Addy Alt-Holland, an assistant professor at Tufts, said the findings have wide-ranging implications about the effectiveness of dental cleaning standards.
"The study of bib clips from the hygiene clinic demonstrates that with the current disinfection protocol, specific aerobic and anaerobic bacteria can remain viable on the surfaces of bib clips immediately after disinfection," said Alt-Holland. "Although actual transmission to patients was not demonstrated, some of the ubiquitous bacteria found may potentially become opportunistic pathogens in appropriate physical conditions, such as in susceptible patients or clinicians."
For the study, researchers sampled the bib clips for traces of 300 of common oral bacteria immediately after patient dental treatments and again after they were cleaned using disinfecting, alcohol-containing wipes, as recommended by the manufacturer instructions and the clinic's disinfection protocol.
Although the cleaning eliminated the majority of the thousands of bacteria found on the bib clips immediately after treatment, researchers found:
- Immediately after treatment and before the clips were disinfected, oral bacteria associated with periodontitis were found on 65 percent of the clips.
- About 40 percent of aerobic bacteria and 70 percent of anaerobic bacteria survived the cleaning processes.
- After disinfection, three of the bib clips (15 percent) still had anaerobic Streptococcus bacteria from the oral cavity and upper respiratory tract. Five percent (5 percent) of the clips still harbored at least one bacteria from the Staphylococcus, Prevotella and Neisseria species.
- After disinfection, nine clips (45 percent) retained at least one anaerobic bacterial agent from skin.
Researchers suggested the bacteria found on bib clips stemmed from oral bacteria present in patients’ saliva and the spray or spatter produced during dental treatments and been transferred from the gloved hands of dental practitioners to the clips or by patients’ hands.
"The results of our analysis show that there is indeed a risk of cross-contamination from dental bib clips. The previous patient's oral bacteria could potentially still be on the clip and the new patient has a chance of being exposed to infection by using that same bib clip," said co-researcher Bruce Paster, chair of the Department of Microbiology at the Forsyth Institute.
"It is important to the clinician and the patient that the dental environment be as sterile as possible; thus it's concerning that we found bacteria on the clips after disinfection. This situation can be avoided by thoroughly sterilizing the clips between each patient or by using disposable bib holders."
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