DANB ICE Personal Protective Equipment (PPE) Usage 2 — Questions and Answers
Question 1: When must dental healthcare workers change their gloves during patient care?
- Only after completing treatment on each patient
- Between patients, after touching contaminated objects, and when gloves are torn or punctured (Correct answer)
- Only when visibly soiled with blood
- At the end of each shift
Correct answer: Between patients, after touching contaminated objects, and when gloves are torn or punctured
Gloves must be changed between patients, when torn/punctured, when moving from contaminated to clean areas, and after touching non-patient surfaces.
Change points: between every patient (with hand hygiene), when torn/cut/punctured, when touching non-patient items with contaminated gloves, and when moving from contaminated to cleaner area on the same patient. Gloves should never be washed and reused as washing degrades the material creating micro-perforations.
Question 2: What level of eye protection is required during dental procedures generating spatter or aerosols?
- Regular prescription eyeglasses
- Safety glasses with solid side shields, or a full face shield (Correct answer)
- Eye protection is optional with a dental mask
- Only prescription safety lenses with anti-fog coating
Correct answer: Safety glasses with solid side shields, or a full face shield
OSHA requires eye protection with solid side shields or full face shields during any procedure likely to generate splashes, sprays, or aerosols.
Regular prescription glasses lack side shields, leaving lateral eye area exposed. Acceptable: safety glasses with solid side shields, protective goggles sealing around eyes, or full face shields extending below chin. Face shields protect the entire face but don't replace masks. Eyewear must be cleaned between patients. Contact lenses provide no protection.
Question 3: What is the correct sequence for donning PPE before a dental procedure?
- Gloves, Gown, Mask, Eye protection
- Gown, Mask, Eye protection, Gloves (Correct answer)
- Mask, Gloves, Gown, Eye protection
- Eye protection, Mask, Gown, Gloves
Correct answer: Gown, Mask, Eye protection, Gloves
The correct order: gown first, then mask, then eye protection over the mask, and gloves last to cover gown cuffs.
Gown provides the base layer. Mask must be fitted before eye protection goes over it. Gloves go last, pulling cuffs over gown sleeves for continuous barrier. Doffing reverses contamination logic: gloves first (most contaminated), gown, eye protection, mask—with hand hygiene between steps and after.
Question 4: Under what circumstances must a dental worker wear a protective gown or jacket?
- Only during oral surgery
- When there is potential for clothing contamination by blood, saliva, or OPIM (Correct answer)
- Only when requested by the patient
- Gowns are recommended but never required
Correct answer: When there is potential for clothing contamination by blood, saliva, or OPIM
Protective clothing must be worn whenever there is potential for contamination with blood, saliva, or OPIM during any dental procedure.
OSHA requires protective clothing that covers personal clothing and exposed skin, removed before leaving the clinical area, and laundered by the employer. Long-sleeved gowns with tight cuffs covered by gloves provide best protection. Change daily and when contaminated. Fluid-resistant gowns for high-spatter procedures. Never wear clinical gowns in reception areas or during breaks.
Question 5: What respiratory protection is required for patients with suspected active tuberculosis?
- Standard surgical mask
- NIOSH-certified N95 or higher respirator that has been fit-tested (Correct answer)
- Cloth face covering
- No additional protection beyond standard dental mask
Correct answer: NIOSH-certified N95 or higher respirator that has been fit-tested
N95 or higher respirators are required because surgical masks cannot filter the small droplet nuclei (<5 μm) that carry airborne pathogens.
N95 filters at least 95% of particles 0.3 μm or larger. Requirements: NIOSH certification, annual fit testing, user seal check each donning, and training. OSHA's Respiratory Protection Standard requires a written program. Ideally, patients with suspected active TB should not receive elective dental treatment.
Question 6: Why must latex-free alternatives be available for dental PPE?
- Latex-free products are cheaper
- To accommodate Type I latex hypersensitivity which can cause severe allergic reactions including anaphylaxis (Correct answer)
- Latex provides inferior barrier protection
- Latex-free is required by OSHA for all procedures
Correct answer: To accommodate Type I latex hypersensitivity which can cause severe allergic reactions including anaphylaxis
Type I latex hypersensitivity is IgE-mediated, ranging from urticaria to life-threatening anaphylaxis. Nitrile gloves are the most common alternative.
Latex sensitivity prevalence in dental workers is 6-12%, higher than general population from repeated exposure. Practices must screen patients and staff, maintain nitrile alternatives, prepare for anaphylaxis (emergency kit with epinephrine), and consider latex-safe environments. NIOSH recommends reduced-protein, powder-free gloves if latex is used, as powder carries proteins into the air.
DANB ICE Personal Protective Equipment (PPE) Usage 2
When must dental healthcare workers change their gloves during patient care?