By Lee Slaton, Vice President of Healthcare; Smart Training

Two questions from our compliance inspection checklist often draw blank stares from clinical staff.

  1. Do you flush your air/water syringes at least 20 seconds between patients?
  2. Do you ask your patients to close their lips around the saliva ejector?

Most clinicians we ask (the first time) don’t know what the Center for Disease Control and Prevention (CDC)’s related recommendations are or the answers to those questions. Here they are.

Flush dental devices at least 20 seconds between patients.

“Dental devices that are connected to the dental water system and that enter the patient’s mouth (e.g., handpieces, ultrasonic scalers, or air/water syringes) should be operated to discharge water and air for a minimum of 20-30 seconds after each patient. This procedure is intended to physically flush out patient material that might have entered the turbine, air, or waterlines.”1

Don’t advise patients to close their lips around the saliva ejector tip.

“When patients close their lips and form a seal around the tip of the ejector, a partial vacuum is created. Research suggests that in these situations, previously suctioned fluids might be retracted into the patient’s mouth.

Furthermore, studies have shown that gravity pulls fluid back toward the patient’s mouth whenever a length of the suction tubing holding the tip is positioned above the patient’s mouth or when a saliva injector is used at the same time as other evacuation (high volume) equipment.

Although no adverse health effects associated with the saliva ejector have been reported, dental health care personnel should be aware that backflow could occur when they use a saliva ejector.

[In a nutshell], Practitioners should not advise patients to close their lips tightly around the tip of the saliva ejector to evacuate oral fluids.”2

A hygienist (who was a long-time professional) once chastised me for not closing my lips around the saliva ejector while my teeth were being cleaned. It was clear we both read CDC’s related recommendation, but she felt she knew more about infection control than the CDC. That was the last time I sat in her chair.

More related advice from the CDC

Suction lines should be disinfected daily. Dentists should contact the manufacturer of the dental unit to review proper use and maintenance procedures including appropriate disinfection methods.”2

CDC recommendations are made by professionals and are science and evidence-based. Ignore them at your own—and your patients’—peril.


You can write Lee Slaton at Smart Training is in the business of making dental practices safe for staff and patients. If you’re not sure how your practice stacks up regarding OSHA and HIPAA compliance, you can contact Smart Training. TDA members receive discounts when they mention “TDA Perks.”