10 November 2021

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Importance of uniform management in infection control

Katherine E. Pfaff

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When we think of a doctor—or in our case of a dentist—we always think of him/her dressed in a uniform, that according to their area, can be scrubs or a business-style top and trousers. Due to the general low price of a uniform, it is never considered as a specific invoice item in the practice costs, but usually it is inserted among various items. 

Recently, the needs of greater protection in the medical field arose from the necessity of carefully checking this aspect of daily practice.  In the last year, we discovered as we never had before, how different the safety rules are in different countries and even in different areas. We also learned how difficult and stressful it can be to adapt to the different guidelines, and to change behaviors. 

Unfortunately, especially in dentistry, there is a lack of shared and specific laws related to uniforms. And when some tips or suggestions are given, they may not be heeded for many different reasons. 

In Europe, the uniform must be a PPE Class 1. The medical practice owner is obliged to provide this protection for the staff to mitigate minor risks. However, the uniforms are most often not PPE, with operators simply wearing a polo or t-shirt. In central and northern Europe, short sleeves are mostly worn, “assuming that the operators will disinfect the arms between patients.”  Meanwhile, in the US, OSHA recommends long sleeves and a closed collar.  

Worldwide, the most common style is medical scrubs sometimes covered by a lab coat. In some European countries, medical scrubs are banned in order to prevent the transfer from contaminated surface to the face of a practitioner. This practice is in contrast with the use of double-faced medical scrubs available on the market which are simply reversed during the day when showing some spots. 

Also, there are almost no specific rules on proper maintenance; this process is mostly left to the individual’s practice of washing at home.  In years past in the UK, there was discussion of disinfecting uniforms with 30 minutes of heating at a minimum of 60°C /140°F, and then keeping them separate from other clothes. In Germany, it had been common practice to wash uniforms at 90°C /194°F for the same reason, however it is more common now to carry out a quick wash at 30°C, sometimes adding a disinfectant.

These practices and local rules were put in place to prevent the spread of infection, and to protect the operators from the risks inherent in the dental profession. 

Recently, many countries adopted infection protocols which would create meaningful protection in a dental practice setting. So, while the PPE helps to protect the person who wears it, additional medical devices help to protect the patient. It is important to underline that before the pandemic there were few options to find a cloth able to grant both practitioner and patient with a total barrier. 

And almost everyone, when they adopt a total barrier mask, they discovered how uncomfortable it is. In fact, this medical device was created for particular use in the operating room, and not for being used all day long in the dental field.

It must be said that the dentist is left alone to find a reasonable solution for his/her specific needs, to study and understand the different certifications and finally to analyze the difference between marketing claims and useful characteristics. It is quite obvious that the time and energy spent evaluating a simple uniform might not be the preferred way to use that time rather than on other medical devices, instruments, and products. 

Generally, a dental uniform is needed to prevent organic or chemical material from contaminating clothing or the skin. But we also know that more often, the uniform is part of conveying a recognizable image to various components of the staff. So, in this case it would be important to start to evaluate it as a filter that maintains the operator’s and the patient’s health.  

In this regard, when we speak about non-disposable clothes, a strict maintenance and usage process should be applied inside an individual practice based on the operation and level of risk. 

Obviously, a practice specialized in periodontology will present a higher risk than one specialized in orthodontics, but a problem may arise inside practices that offer the whole range of specialities. 

In the last case, adopting a PPE uniform covered by a sterilized disposable or reusable cloth, when needed, may be a simple and inexpensive solution, provided that the cloth is changed with each patient, and the uniform replaced with each shift, or if it is contaminated.  The uniform should also undergo a thorough disinfection, or even better, a sterilization process.  That may seem obvious, but the difference between what is self-evident and what is common practice is significant, so that it is still necessary to give such advice. 

In the end, the cost of protection inside the practice should be evaluated, and if the is too high, the importance of the uniform in maintaining the health of both the dentist and the patient should be communicated to the patient. This will help the patient understand the high level of attention the doctor/dentist has paid to the safety of the staff and his/her clients. The patient will likely view this positively and it may reflect in reviews.

About Gianna Pamich

As CEO of Pastelli, Gianna Pamich leads the company with the same values as when it was founded in 1978: to offer a line of healthcare apparel based on absolutely innovative concepts, extremely high quality and elegant pieces, original and with great attention to detail, for optimal comfort and high performance.

She entered the family business at a very young age, where she immediately took care of the management and growth of the company, following an exemplary generational transition.

Convinced of the importance of continuous improvement and the power of communication, she attended Neuro-Linguistic Programming and Marketing course.

Since 2000 she has been working closely with her husband, Piero Del Fabbro, who joined the company with the same passion for innovation and continuous research and improvement. 

In 2008 she entered the UNIDI (the Italian Dental Industry Association) board, where she served as President for four years until the end of 2019.

In 2019 she joined the board of Presidency of CONFAPI (the Italian Confederation of Small and Medium Industry). 

Gianna Pamich holds a degree in psychology.

About Pastelli

Pastelli is a family linked by a conductive thread that unites three generations. We aim to create medical clothing that fully reflects the professionalism of our customers. Quality is a must, and our company's sartorial history has led us to a continuous search for high-level solutions suitable to reflect the importance of the medical profession. All exclusively made in Italy.

For more information, please visit www.pastelli.com