Hand Hygiene for the Dental Team

For dental professionals, effective hand hygiene is critical for reducing the risk of transmitting organisms. Clean hands protect you and your patients.

Hand hygiene is a general term that applies to:

  • routine hand washing with plain soap and water
  • washing with water and an antimicrobial soap
  • cleaning hands with an antiseptic alcohol-based hand rub
  • surgical antisepsis

In keeping with infection control procedures in the dental office, remove all jewelry, including watches. Keep fingernail tips trimmed to about one quarter inch, and they should be neatly filed with no sharp edges.

When should hand hygiene be performed?

The Centers for Disease Control and Prevention (CDC), recommends that hand hygiene be performed:

  • before and after treating patients
  • before leaving the dental operatory
  • after touching objects contaminated by blood, saliva or other secretions
  • when hands are visibly soiled
  • after removing gloves that are torn, cut or punctured
  • and before replacing gloves

When handling contaminated instruments for instrument processing, always wear utility gloves. Never use bare hands.

What products can be used? For routine, non-surgical procedures, hand hygiene can be performed with:

  • plain soap and water
  • an antimicrobial soap and water
  • or an alcohol-based hand rub, that has an alcohol concentration of 60-90%
Table from CDC Hand Hygiene Interactive Education showing proper hand hygiene for routine dental procedures.

Hand Hygiene for Routine Dental Procedures
Source: CDC Hand Hygiene Interactive Education

Washing with soap and water If your hands are visibly soiled, they must be washed with soap and water. First, wet your hands and apply a small amount of liquid soap onto one palm.

Then, rub vigorously until lather appears and continue rubbing for at least 15 seconds. Scrub between your fingers, under your fingernails, the back of your hands, and your palms up to your wrists.

Then, rinse your hands under running water. Dry your hands completely with a disposable towel. If the faucet doesn’t have foot pedal or automatic shut off, use the towel as a barrier to turn off the faucet.

Cleaning hands with an alcohol-based hand rub

To clean your hands with an alcohol-based hand rub, check the manufacturer’s instructions for how much product you should apply. Some manufacturers simply state: to wet hands thoroughly with the product. Dispense the alcohol-based hand rub on the palm and rub your hands together covering all surfaces and fingers until your hands are dry. If your hands feel dry after rubbing them together for 10-15 seconds, you most likely have not applied enough product.

Is soap and water better than an alcohol-based hand rub?

According to the CDC’s recommendations for infection control in dental settings, either product can be used for routine hand hygiene provided that there is no visible contamination on the hands. Alcohol-based hand rubs that have an alcohol concentration between 60-95% is more effective at killing germs. Also, while alcohol-based handrubs can inactivate many types of microbes, they must be used correctly to be effective.

Table from CDC Hand Hygiene Interactive Education showing proper hand hygiene for surgical procedures.

Hand Hygiene for Surgical Procedures
Source: CDC Hand Hygiene Interactive Education

Alcohol-based hand rubs are useful when hand washing facilities are not available or feasible. For example, when you are working at a:

  • mobile dental clinic
  • dental screenings at a school
  • boil water advisory
  • hands are not visibly soiled

Alcohol hand rubs are also helpful for reducing skin dryness and irritation.

Image from CDC Hand Hygiene Interactive Education showing efficacy of hand hygiene preparations in reducing bacteria.

Efficacy of Hand Hygiene Preparations in Reducing Bacteria
Source: CDC Hand Hygiene Interactive Education

A reminder about gloves Regardless of which hand hygiene product you use, your hands should be completely free of moisture before putting on your gloves. Dry hands help reduce skin irritation. Remember that if you applying lotion throughout the workday, use water-based lotion. Lotion that is petroleum-based can weaken latex gloves.

Good hand hygiene, combined with wearing gloves, are essential elements of infection control. Hand hygiene protects you, your staff and your patient.

How does your practice measure up?

Fill out the CDC’s Infection Prevention Checklist and see if you and your staff are following patient-care procedures correctly.


CDC’s Frequently Asked Questions on Infection Control in Dental Settings

CDC Statement for Healthcare Personnel on Hand Hygiene during the Response to the International Emergence of COVID-19

CDC recommendations reflect the important role of hand hygiene for preventing the transmission of pathogens in healthcare settings for a wide range of pathogens. The ability of hand hygiene, including hand washing or the use of alcohol-based hand sanitizers to prevent infections is related to reductions in the number of viable pathogens that transiently contaminate the hands. Hand washing mechanically removes pathogens, while laboratory data demonstrate that 60% ethanol and 70% isopropanol, the active ingredients in CDC-recommended alcohol-based hand sanitizers, inactivates viruses that are genetically related to, and with similar physical properties as, the 2019-nCoV.

While the exact role of direct and indirect spread of coronaviruses between people that could be reduced by hand hygiene is unknown at this time, hand hygiene for infection prevention is an important part of the U.S. response to the international emergence of COVID-19.

CDC recommends the use of alcohol-based hand sanitizers with greater than 60% ethanol or 70% isopropanol as the preferred form of hand hygiene in healthcare settings, based upon greater access to hand sanitizer. Health care providers who use alcohol-based hand sanitizers as part of their hand hygiene routine can inform patients that they are following CDC guidelines.

Source: CDC's Hand Hygiene in Healthcare Settings