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newSchoolWorks.com › VoTechWorks › Health & Personal Services › Dental Assisting › Infection Control for Dental Assisting › Lesson 3
HLT-DENT40-04 · Lesson 3 · 20 clock hours · demo

Personal Protective Equipment: Selection, Fit, and Donning/Doffing

Objective. The student will select appropriate PPE for a given dental procedure and demonstrate the correct sequence for donning and doffing gloves, mask, protective eyewear, and gown without self-contamination.

⚠ Pending professional review

This lesson, its worked examples and its practice questions has not yet been verified by a licensed clinician in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it to make decisions about any patient or medication. Always follow your instructor, your supervising professional, and current official references and regulations.

VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.

Why PPE Matters in Dental Assisting

Dental procedures generate aerosols, splatter, and direct contact with blood and saliva. Without proper personal protective equipment (PPE), pathogens such as bloodborne viruses and bacteria can transfer from the patient to you, from you to the patient, or to coworkers and surfaces. OSHA's Bloodborne Pathogens Standard and CDC infection-control guidelines both require that dental healthcare personnel (DHCP) select and use PPE appropriate to the anticipated exposure. Selecting the wrong PPE, or removing it incorrectly, defeats its entire purpose.

Selecting the Right PPE for Each Procedure

Not every procedure carries the same exposure risk. Your PPE selection must match the level of anticipated contact with blood, saliva, aerosols, and chemicals.

Gloves are required whenever you touch mucous membranes, non-intact skin, blood, saliva, or contaminated instruments. Nitrile exam gloves are the standard choice for most clinical tasks and for personnel with latex allergies or sensitivities. Never reuse single-use exam gloves, and replace gloves immediately if they tear.

Masks protect your mucous membranes from splatter and droplets. A standard surgical or procedure mask is appropriate for most restorative and hygiene procedures. When aerosol-generating procedures create very small airborne particles — for example, use of a high-speed handpiece, ultrasonic scaler, or air-water syringe in a non-evacuated field — an NIOSH-approved N95 respirator provides a higher level of protection. An N95 must be fit-tested to the individual user before clinical use.

Protective eyewear shields the eyes from splatter and projectiles. Safety glasses with solid side shields or a full face shield must be worn during any procedure with splatter potential. A face shield worn alone does not fully protect mucous membranes at all angles; pair it with a mask or respirator.

Gowns protect skin and personal clothing. A fluid-resistant or impermeable gown is required when splatter of blood or other potentially infectious materials (OPIM) is anticipated. Long sleeves and a closed front are standard. Cloth scrubs alone are not classified as PPE.

Procedure-level guide (general principles):

The Donning Sequence

The order in which you put on PPE matters. Contaminating the outside of a glove with bare-hand contact before patient care is a critical error. The standard recommended sequence is:

1. Wash hands thoroughly for at least 20 seconds and dry completely.

2. Don the gown — fasten at the neck and waist so the front and sleeves fully cover skin and clothing.

3. Don the mask or respirator — position over the nose and chin; pinch the nose wire to conform to your face; for an N95, perform a user seal check.

4. Don protective eyewear or face shield — ensure full coverage of eyes and sides.

5. Don gloves — pull cuffs over the gown sleeves so no skin gap is exposed at the wrist.

The Doffing Sequence

Doffing (removal) carries the highest contamination risk. The outside of every PPE item is considered contaminated. Never touch your face or unprotected skin with a gloved or potentially contaminated hand.

1. Remove gloves first — grasp the outside of one glove at the wrist and peel it off, turning it inside out. Hold it in the gloved hand. Slide two fingers of the bare hand under the cuff of the remaining glove and peel it off, enclosing the first glove inside. Discard in a waste container.

2. Perform hand hygiene immediately after glove removal.

3. Remove the gown — unfasten ties, roll the gown away from the body with the contaminated outside folded inward; discard.

4. Perform hand hygiene again.

5. Remove protective eyewear or face shield — grasp by the earpieces or headband only (not the front lens); place in the designated reprocessing container.

6. Remove the mask — grasp only the ties or ear loops, never the front of the mask; discard.

7. Perform hand hygiene a final time.

Safety Points to Remember

Connecting to Your Credentials

Both the DANB CDA examination and State Dental Radiology licensure assess your understanding of infection-control principles. Proper PPE use is foundational to safe practice and is a core competency tested in clinical skills evaluations. Employers, regulators, and patients expect dental assistants to perform correct donning and doffing reflexively, every time.

Key terms8

PPE (Personal Protective Equipment)Specialized clothing or equipment worn to protect the dental healthcare worker from exposure to blood, saliva, aerosols, and other potentially infectious materials.
OPIM (Other Potentially Infectious Materials)Body fluids and tissues other than blood — including saliva in the dental context — that can transmit pathogens and are regulated under OSHA's Bloodborne Pathogens Standard.
DonningThe process of putting on PPE in a specific, prescribed order to avoid contaminating the equipment or yourself before patient contact.
DoffingThe process of removing PPE in a specific, prescribed order to prevent transferring contamination from the outside of PPE to skin, clothing, or the environment.
N95 RespiratorA NIOSH-approved tight-fitting respirator that filters at least 95% of airborne particles; requires individual fit-testing before clinical use and provides greater protection than a standard surgical mask against aerosols.
Fit TestingA required procedure confirming that a specific N95 respirator model creates an adequate seal against an individual worker's face; must be completed before the respirator is used clinically.
Fluid-Resistant GownA clinical garment constructed to resist penetration by blood and other body fluids; required PPE when splatter is anticipated during dental procedures.
Critical Error (in PPE competency)Any step or action during donning or doffing that results in, or creates a significant risk of, self-contamination or contamination of the environment.
In class: Instructor-led demonstration: instructor performs correct donning and doffing sequence, narrating each decision point; students complete an observation checklist, noting any sequence steps they would question. · Paired practice with GloGerm: students don PPE, dip gloved hands in GloGerm lotion, and perform a mock patient-care task; after doffing, UV light reveals contamination errors on skin or clothing, which are photographed and debriefed. · Scenario cards: each student draws a procedure card (e.g., surgical extraction, digital radiograph, oral prophylaxis) and assembles the correct PPE ensemble from the supply cart, explaining aloud the rationale for each item selected.
Materials: Nitrile exam gloves (multiple sizes), surgical masks, N95 respirators, face shields, protective eyewear, fluid-resistant gowns, GloGerm lotion and UV lamp, PPE donning/doffing competency checklist, OSHA PPE fact sheet
Check: Skills checklist observation by instructor: student must complete all 14 donning/doffing steps in correct order with zero critical errors (steps that would cause self-contamination) to pass.

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.

Infection Control
1. A dental assistant is about to assist with an oral prophylaxis that includes ultrasonic scaling. Which combination of PPE is most appropriate?
Infection Control
2. During doffing, which item should be removed FIRST?
Infection Control
3. A student doffs her gloves correctly but then touches the front of her mask with bare hands before removing it. This is best described as a:
Infection Control
4. Why must hand hygiene be performed immediately AFTER removing gloves and again after removing the gown, rather than only at the very end of the doffing sequence?
Infection Control
5. Which statement about N95 respirators in the dental setting is correct?
Infection Control
6. A dental assistant is setting up for a surgical extraction. The student selects nitrile gloves and a surgical mask but forgets a gown. The instructor asks the student to reconsider. What is the primary reason a gown is required for this procedure?
Infection Control
7. During the GloGerm activity, a student's wrist shows fluorescent contamination under UV light after doffing. What is the most likely cause?
Infection Control
8. A dental assistant's glove tears during a restorative procedure. What is the correct immediate action?
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