An Infection Control Update For A Dentistry Practice

The CDC Supplement is here.  This guide is titled “Summary of Infection Prevention Practices in Dental Settings – Basic Expectations for Safe Care”.

“Transmission of infectious agents among patients and dental healthcare personnel in dental settings is rare.  However, from 2003 to 2015, transmission have been documented. . . .The information presented is based primarily upon the recommendations from 2003 guideline and represents infection prevention expectations for safe care in dental settings. . . .Additional topics and information relevant to dental infection prevention and control published by CDC since 2003 in this document can be found.”

This supplement is divided into 5 main sections:

Administrative Measures  –  Policies and Procedures tailored to dental setting and reassessed annually
Proper supplies and equipment available that are necessary to adhere to standard precautions

Education and training   –  should be provided during orientation, when new tasks or procedures are introduced and at least annually.  Training is to be site specific. Don’t forget about your temporary employees or students.  They also need to be trained with the focus on site specific items.

Respiratory Hygiene/Cough Etiquette  – measures designed to limit the transmission of respiratory pathogens spread by droplet or airborne routes.

Post signs at entrances with instructions to patients with symptoms of respiratory infections
-cover mouth/nose when sneezing/coughing
-use and dispose of tissues
-preform hand hygiene after hands in contact with respiratory secretions
-provide tissue and no-touch receptacles for disposal of tissue
-provide resources for preforming hand hygiene in or near waiting room
-offer mask to coughing patients

Safe Injection – Backing up OSHA’s sharp safety device evaluation which is required annually

Instrument Reprocessing – Sterilization and disinfection of patient care items and devices:
-manufacturers’ instructions for reprocessing reusable dental instruments and
equipment should be readily available. If there are no reprocessing instructions, it is a
SINGLE use device.
-use single-use devices for one patient only and dispose of appropriately

Dental handpieces and associated attachments including low-speed motors and reusable prophy angles, should always be heat sterilized between patients and NOT high-level or surface disinfected.

–Most everything we use in the dental office has to have FDA clearance as a medical device.  The FDA approves label information with part of this being adequate reprocessing instructions to be considered multi-use.  They are considering requiring manufacturers to have a 3rd party test their reprocessing before approval would be granted.  There are several items they are looking at for example; shade guides, impression guns, composite delivery guns, cerec scanner, multi-use composite & etch syringes, barriers, etc…. and the list goes on.

Burs and Endo file manufacturers also must have adequate reprocessing information and FDA has not seen any so are considered disposable.  The instructions need to indicate temperature and type of sterilizer (dynamic air or gravity).  Something to look at when purchasing equipment.  Would you be able to properly sterilize it?

Back to the slow speed motors.  Manufacturers have been instructing us for a long time to sterilize after each use.  We have just been ignoring them so the CDC is reinforcing this.

Dental unit water quality – During surgical procedures use only sterile solutions as a coolant/irrigate using an appropriate delivery device, such as a sterile bulb syringe, sterile tubing that bypasses dental unit waterlines, or sterile single-use device.

Remember….Minnesota Rule 3100.6300 REQUIRES all dental health care providers to comply with the CDC guidelines for infection control in a dental setting.

–The new CDC Supplement has a checklist that can be used to access your practice.  You can print off the checklist online as a pdf.

This is a great tool to catch deficiencies before any agency does.

Leanne M. Mathieu Kramer, LDA, CDA, CDPMA

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