A case study of evacuation valves reveals hidden danger to dental patients

I was asked to perform an informal case study on dental office evacuation valves. This was a challenge in many ways. Several offices I contacted were leery to allow swab testing in their offices even though they said they felt confident of their disinfection process.

My infection control flag went up many times in those practices. If they felt confident, why are they leery of doing a simple swab test? What was the risk to them? One office wanted to check with his lawyer, wanted my license number, and much more seemingly ridiculous information. The offices that were welcoming wanted to know how they could improve their infection prevention protocol. A big benefit was they received bags of disposable valves for allowing testing of their disinfected valves.

A test of evacuation valves confirms need to protect patients from microbial debris

Testing was done to determine if the valves were contaminated even after disinfection. What are the consequences of the unknown invisible organic matter? What pathogens are nesting here? When disinfected, what pathogens are being reduced or present?

As an experienced infection prevention and safety specialist, I performed the swab-testing. After reviewing the results, I was glad I had donned the appropriate PPE. Maybe I should have worn a hazmat suit!

The Down and Dirty Results

I processed 212 valve surfaces and determined they were, yes, contaminated after a routine disinfecting protocol. Discovering the bacterial load on dental unit vacuum valves left me with an uneasy feeling. Are we creating a healthy environment for our patients? Occupational Safety, Asepsis and Prevention (OSAP) has repeatedly stated that dental patients should be in a safe dental environment, which includes the entire dental facility and all the processes.