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Introduction
Even though the patient never sets foot in the dental laboratory, the cases, if not properly disinfected, carry microorganisms that can contaminate the lab. The lab should set up a receiving area separate from the production area for all incoming cases. The countertop should be disinfected daily with an acceptable disinfectant according to the directions on the bottle.
Unless the technicians are certain that the case has been disinfected properly, they should disinfect each case as it is received. An EPA-registered hospital disinfectant (low to intermediate) should be used, written documentation of the disinfection method provided, and the item placed in a tamper-evident container before returning it to the dental office. If such documentation is not provided, the dental office is responsible for final disinfection procedures. Case containers should be disinfected also. Anyone receiving cases before their disinfection should wear a uniform or laboratory coat, a mask, protective eyewear, and disposable gloves. Utility gloves and other standard protective attire should be used when working with disinfectant chemicals.
All equipment and surfaces in the production area should be disinfected daily. Splash shields and equipment guards shall be used on dental laboratory lathes. Fresh pumice and a disinfected, sterilized, or new ragwheel shall be used for each patient. Ragwheels should be cleaned and autoclaved after each case. Dispense pumice in small individual amounts for each case, and discard all excess. Mix 5 parts sodium hypochlorite (bleach) with 100 parts distilled water and three parts soap with the pumice to provide a disinfectant effect. Devices used to polish, trim or adjust contaminated intraoral devices shall be disinfected or sterilized.
Instruments, attachments, and materials used on new prostheses should be kept separate from the ones used on an appliance that has contacted a patient's mouth. Intraoral items such as impressions, bite registrations, prosthetic and orthodontic appliances shall be cleaned and disinfected with an intermediate-level disinfectant before manipulation in the laboratory and before placement in the patient's mouth. Such items shall be thoroughly rinsed prior to placement in the patient's mouth. Clean and heat sterilize heat-tolerant items used in the mouth.
Disinfect cases before returning to the dental office. The dentist and laboratory should communicate with each other about proper infection control regarding all lab cases.
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