Infection Control in the Dental Office: A Review for a National Infection Control Exam (AGD 148)
Presenter: Original Authors: Eve Cuny, MS, RDA and Charles J. Palenik, PhD, MS, MBA. Reviewed and Revised by ADAA Council on Education and Professional Development Members: Tracey A. Green, BS, CDA; Christina Ross, MS, EDFA, CDA; and Roxanne Terranova, MSM, CDA, RDA
Human health and safety including infection control is essential to every dental practice. The well being of dental practitioners, patients and the surrounding community is very important. These areas are in constant flux. New products, equipment and processes seemingly appear on a daily basis. In addition, governmental agencies and professional associations regularly release new rules, regulations and recommendations.
Dental practices must comply with certain requirements, but the methods involved often seem complex, time consuming and relatively expensive. However, there really is no alternative to an effective workplace health and safety program. Each dental practice must make the commitment to establish and maintain a safe work and treatment environment.
In December of 2003, the Center for Disease Control and Prevention (CDC) released an extensive review and set of recommendations regarding infection control in dental environments. This document as well as others will serve as “guiding lights” for this course. The guidelines update previous CDC recommendations, incorporating relevant infection control measures, and discuss a number of concerns not previously addressed in dentistry.
Every dental practice should have a copy of the 2003 CDC infection control guidelines for dentistry. Every person having a dental license received a copy. Electronic copies also are available at www.cdc.gov/mmwr/PDF/RR/RR5217.pdf.
One effective way dental practices can improve and maintain compliant health and safety programs is through the appointment of a safety coordinator (compliance officer). The CDC indicates that a knowledgeable infection control coordinator (a member of the practice team) or a person willing to be trained should be given the responsibility for coordinating the program. The educated dental assistant should be readily capable of performing the tasks required.
Eve Cuny, MS, RDA
Eve Cuny is the Director of Environmental Health and Safety and Assistant Professor in the department of Pathology and Medicine at the University of the Pacific School of Dentistry. She is a nationally recognized expert in infection control in dentistry, publishing and lecturing widely throughout North America. She was a member of the working group that developed the 2003 CDC Infection Control Guidelines for Dentistry and acts as an advisor for numerous regulatory agencies. She is past chairperson of OSAP and currently serves on its board of directors.
Charles J. Palenik, PhD, MS, MBA
Charles J. Palenik has held over the last 30 years a number of academic and administrative positions at Indiana University School of Dentistry. These include Professor of Oral Microbiology, Director/Human Health & Safety, Director/Central Sterilization Services, Director/Dental Informatics and Chairman/Infection Control and Hazardous Materials Management Committees. Currently he is Director/Infection Control Research & Services. Dr. Palenik has published 160 articles, over 300 monographs, three books and seven book chapters, the majority of which involve infection control and human safety and health. In addition, he has provided 120 continuing education courses throughout the United States and nine foreign countries. He is past chairperson of OSAP and currently serves on its board of directors.
This course was reviewed and revised by ADAA Council on Education and Professional Development Members: Tracey A. Green, BS, CDA; Christina Ross, MS, EDFA, CDA; and Roxanne Terranova, MSM, CDA, RDA
After completing this course, the dental professional should be able to:
• List and describe microorganisms present in the oral cavity and body fluids.
• Describe how disease can be transmitted within dental environments.
• Identify methods and materials that will best assure sterilization of reusable dental instruments and equipment.
• Identify methods and materials that will best protect or decontaminate clinical contact surfaces.
• Identify methods and materials that will best protect both staff and patients from disease transmission in dental environments.
• List and describe important elements of an effective dental practice health and safety program.
• Demonstrate an ability to locate and use correctly information concerning practice health and safety.
• Describe the importance of microbiology in relation to infection control.
• Describe the natural defenses of the human body against infection.
• Identify the three modes of infectious disease transmission in the dental office and give examples of each.
• List and identify the ways that pathogens may enter the body (portals of entry).
• Identify infectious diseases that are relevant to dentistry and give their modes of transmission.
• Describe the purpose of personal protective equipment (PPE) and the various types of PPE available.
• Explain how to determine when and what type of personal protective equipment to use.
• State the role of handwashing in infection control procedures and describe when handwashing should take place.
• Differentiate between routine handwashing and surgical hand hygiene.
• Explain an employer's responsibilities regarding the hepatitis B vaccination.
• Define the term "exposure incident".
• Describe first aid procedures after an exposure incident.
• Compare the use of barriers with the processes of cleaning and disinfection.
• Differentiate between a guidance agency and a regulatory agency.
• Name various guidance agencies and regulatory agencies that affect the field of dentistry and describe the role each plays in infection control procedures in the dental office.
• Identify the steps a dental office must follow in order to comply with OSHA's Hazard Communication Standard.
• Describe the purpose of the hazardous chemical list.
• Demonstrate the ability to read and use a Safety Data Sheet.
• Prepare the appropriate product label when using the Safety Data Sheet for a particular product.
• State the purpose of engineering controls and identify various engineering controls used in the dental office.
• State the purpose of work practice controls and identify various work practice controls used in the dental office.
• Explain the employer's responsibilities regarding contaminated waste.
• Define medical waste and give examples.
• Explain the purpose and scope of employee training regarding the Hazard Communication Standard and the Bloodborne Pathogens Standard.
• Differentiate between immersion, disinfection and environmental surface disinfection.
• Describe the purpose and use of barriers in the dental office.
• Describe the procedures to verify effective sterilization, as well as other methods used to monitor sterilization processes.
• Differentiate between critical, semi-critical and non-critical items in the dental office and give examples of each.
• Describe steps to minimize the risk for cross-contamination from dental unit water lines.
• Explain the procedures used for processing hand instruments; including holding, cleaning, packaging, sterilizing and storing.
• Describe infection control procedures for radiographic procedures.
• Describe infection control procedures for the dental laboratory.
• Describe to the dental patient the importance of infection control.
CONTINUING EDUCATION CREDIT
The ADAA has an obligation to disseminate knowledge in the field of dentistry. Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.
The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.
Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.
CONCERNS OR HELP
If the participant has concerns about the presentation, please contact our Education Department at CESupport@adaausa.org. If the participant has questions on how to view the presentation, please contact Tech Support at TechSupport@adaausa.org.
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