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Inside Dental Hygiene
August 2023

Breaking the Chain of Infection

Combining Innovation and Technology Is Key to Success

Cindy Rogers, RDH

As a hygienist, understanding the chain of infection and knowing your role in breaking this chain is imperative to the safety of your patients, your coworkers, and yourself. Integrating innovation and technology into your infection control program will provide you with the tools to break the chain.

The Chain of Infection

Infectious agent

The first link in the chain is the pathogenic agent that causes infection or disease. Infectious agents include viruses, bacteria, parasites, and fungi.


The next link is the reservoir, which is the place in the environment where pathogens live. A few examples of places where pathogens may be living in the dental office include people, dental units, and waterlines.

Portal of exit

A portal of exit is the way in which the pathogen leaves the reservoir. Portals of exit in your operatory include—to name a few—aerosols, blood splatter, and saliva.

Mode of transmission

Mode of transmission is the way the pathogen is transferred to another person. Modes of transmission during hygiene procedures include unsafe sharps use, inhalation, and direct contact.

Portal of entry

The portal of entry is the way the pathogen enters a new host. This portal of entry can be a person's respiratory tract, skin if it has cuts or abrasions, and the eyes.

Susceptible host

The last link in the chain of events is a susceptible host. This is an immunocompromised person or someone without a strong immune system or antibodies against the pathogen.

Integrating Innovation and Technology


On average, healthcare professionals do not clean their hands as thoroughly as they should or as often as they should. Manual handwashing with soap and water or the use of an alcohol-based rub is effective only if performed properly.

Consider adding an automatic hand washing machine that cleans both hands effectively. This creates more compliance because machines can take less than 10 seconds, leaving your hands not only clean but moisturized as well. They can be invaluable tools in the prevention of infection. There are many different models available.

Education and training

Cross-contamination is real, so it is critical that all team members receive adequate training in infection prevention and safety measures. Training should be conducted at least annually and upon adding additional duties. Attending training together as a team is best, so that everyone is on the same page.

Technology has made it easier when getting together in person is not an option. You can sign up for a virtual live team training or choose an online course that you can take together. Or, as a last option, take classes individually.

Policies and procedures

Have solid standard operating procedures (SOPs) that all team members are trained in.

Creating SOPs does not have to be daunting. There are apps and templates available to help you write your custom SOPs.

Screening patients

Infectious patients should not be allowed to enter the front door unless your clinic specifically treats them.

Using a HIPAA-compliant patient messaging system will allow your scheduling coordinator to send out prewritten questions asking patients if they have any symptoms of an infectious disease. Always let your patients know that they must call you to reschedule if they develop any symptoms up to their appointment time.

Stay home

If all else fails and you yourself develop symptoms, you should not enter the front door either.

Have a policy in place so that you know how to notify the practice that you will be keeping them safe by staying home.

Having a policy that includes the use of text messaging or other messaging apps will allow you to notify your co-workers promptly and allow you to rest. They will also be aware to look out for symptoms themselves.


The infection cycle is a chain of circumstances that must be present for an infection to spread. By adding technology and innovation, you can break the chain and prevent infectious diseases from reaching your operatory.

About the Author

Cindy Rogers, RDH, is a healthcare compliance consultant and speaker who specializes in dental infection control and team culture. She joined the dental profession in 1998 and has been practicing dental hygiene for the past 10 years. Rogers is also the host of the Dental Alements Podcast. Visit her website for information about future courses:


1. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. Standard precautions: summary of infection prevention practices in dental settings. CDC website. Revised June 18, 2018. Accessed June 8, 2023.

2. Occupational Safety and Health Administration. Healthcare: infectious diseases. OSHA website. Accessed June 8, 2023.

3. Occupational Safety and Health Administration. Occupational safety and health standards: 1910.1030 - bloodborne pathogens. OSHA website. Revised May 14, 2019. Accessed June 8, 2023.

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