Infection Control

Suction Backflow: What You Need to Know

By Jasmine Williams, RDH, BSDH, MHA on February, 25 2021
Suction Backflow: What You Need to Know
Jasmine Williams, RDH, BSDH, MHA

Jasmine is a traveling registered dental hygienist, clinical educator, speaker and influencer with a passion for inspiring, mentoring, and empowering current and future health care professionals.

As dental professionals, we should always be evaluating our processes and educating ourselves on current best practices. One area we should be focusing on is saliva ejectors.

While used in dental offices for decades, there are a number of reports that demonstrate the dangers associated with this common dental tool. Let’s take a look at some of the risks of using the saliva ejectors during treatment.

How serious is the issue?
Low-volume saliva ejectors may create unsanitary conditions by allowing a backflow of previous patients' waste material or substances from the tubing into a patient’s mouth. The risk of cross-contamination intensifies when the saliva ejector is offered to the patient from above so that the tip of the tube or the tubing itself is positioned higher than the mouth.

What the Centers for Disease Control and Prevention (CDC) says
According to the CDC, backflow can also occur when the pressure in a patient’s mouth, caused by closing their lips and forming a seal around the tip of the ejector, is less than the pressure in the saliva ejector. This action, said the agency, is similar to how liquid flows back into a cup after drinking through a straw.

Research has shown that backflow occurs in about one in five patients who close their lips around the saliva ejector tip. Backflow is also more likely to happen when a saliva ejector is used at the same time as high volume evacuation equipment.

How to prevent cross-contamination
Although no negative health effects have been reported from saliva ejector cross-contamination, it should be avoided at all costs. Here are a few tips for prevention:

• Do not instruct patients to close their lips tightly around the tip of the saliva ejector
• Review proper use and maintenance procedures with the manufacturer
• Clean and disinfect the tubing between patients

How to stop problems before they start
Being aware of the problem is the first step to protecting patients. As dental professionals, we must make sure that we correctly instruct our patients during treatment to avoid the tight seal with their lips. Instead just insert the tool in the mouth and move it around to suction saliva. Also, make sure the vacuum lines are fully flushed after each patient use.

Where to go from here
Bottom line: If you’re concerned about saliva ejector backflow, investigate other options. Some manufacturers have developed products to help prevent backflow issues, including equipment with anti-backflow devices.


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