Dental Bib Chains are Potential Source for Infection and Disease

Wet, used towels left in the gym. Dirty tissues discarded by someone suffering from a nasty cold. A toothbrush discovered in a hotel room. Most of us would never use or even touch these items. But without knowing it, we may be sharing something that could be just as disgusting and potentially dangerous. When we visit a dental office and a bib chain that is not sterilized between patients is placed around our neck, we may be unwittingly exposed to pseudomonas, E. coli and S. aureus the most common cause of staph infections and a potential "superbug."

Noel Kelsch, a national infection control columnist, Registered Dental Hygienist and former President of the California Dental Hygienists' Association, conducted a study on various types of dental chains and clips after seeing debris falling from a chain she had planned to use to protect her uniform at lunch. What she found led her to pen a column titled "Don't Clip that Crud on Me" for RDH Magazine, a trade publication for dental hygienists.

"The more crevices and indentations on a clip or a chain, the higher the contaminant count," she says. As expected, disposable clips and holders opened fresh for each patient, were free from contaminants and posed no cross-contamination threats. "As an advocate for patient safety within our profession, I think it's very important to take whatever steps we can to eliminate sources of potential harm for our patients."

Her findings echoed a study conducted by the University of North Carolina at Chapel Hill's School of Dentistry Oral Microbiology Lab that found bib chains and clips are potential sources of contamination. In sampling 50 bib clips from various hygiene and dental operations, researchers discovered one in five bib clips were contaminated with "significant microorganisms," according to Dental Health Magazine.

In a supplement to the March 2011 issue of Dimensions of Dental Hygiene titled "Infection Control Update," Dr. John Molinari, an international expert in the areas of infection control and infectious disease in dentistry, referenced a study he conducted that looked at the presence and composition of bacterial contaminants on patient bib chains before and after patient care appointments. His results showed that microbial contamination was present on both metal and coiled plastic bib chains after use during patient care, with the highest bacteria levels found on bib chains that were not cleaned between patient uses.

"Society is putting an emphasis on healthier living," Kelsch says. "We're seeing an increased awareness of infection control and disease prevention everywhere we look. Grocery stores provide hand sanitizer or disinfectant wipes for cart handles; health clubs provide disinfectant sprays so you can clean up equipment after you've used it. If you take the trouble to do those things then one simple solution to protect yourself from dirty bib chains is to insist on disposable bib holders."

In addition to providing patients with a safer dental visit, Kelsch notes that disposable dental bib holders are critical tools in the fight against the creation of more "superbugs."

"If the infection route dirty dental chains is destroyed, the infection is not spread," she says. "No infection means no antibiotics, and the improper use of antibiotics is what contributes to the creation of superbugs."