Rings and watches: should they be removed prior to operative dental procedures?

There is no clear evidence to support the recommendation that rings and watches should be removed prior to operative dental procedures. The aim of this study was to measure and identify the bacteria isolated from the skin under rings and watches worn by a group of dental surgeons and to compare the results with a group of non-clinical staff.

Forty volunteers participated in the study; of these 20 were dental surgeons and 20 were non-clinical staff. Four skin sites were sampled for each volunteer; the skin directly under the ring and on the same finger of the other hand and the skin under the watch face and wrist of the control hand. Bacteria on the swabs were dispersed and inoculated onto plates, which were incubated aerobically for 24 h at 37 degrees C.

In both groups of volunteers there was a significantly greater number of bacteria isolated from under rings and watches compared with control sites. Few qualitative differences were found between the microflora found on the skin under rings and watches in the two volunteer groups.

The bacterial flora isolated from volunteers do not commonly cause oral infections but could pose a threat to the immunocompromised patient, particularly in the event of gloves becoming torn or perforated. Effective hand disinfection is difficult to achieve if ring and watches are not removed; they should therefore be removed prior to hand disinfection and donning of gloves.