blood and other body fluids. Policies should be in place for the proper diagnosis, treatment, and management of these Table 3: Irritation Contact Dermatitis and Latex Allergies Irritation Contact Dermatitis
conditions. It may be necessary to limit patient care until the dermatitis is resolved.
Latex Allergy
Cause
Chemical or physical skin irritation in area of contact.
Exposure to chemicals used in the latex manufacturing process or other chemicals. May begin as a rash in the area of contact. However, symptoms can also include itching, cracking, swelling, scabbing, and blistering. On rare occasions, anaphylactic reactions may occur. Symptoms may require weeks to heal. Provide a latex-safe environment (use nonlatex gloves and other nonlatex materials or devices for patient care).
Onset of Symptoms Begin within minutes to several hours after contact and dissipate soon after the irritant is removed.
Prevention
Dry hands thoroughly after hand hygiene, use low irritancy soaps, and use compatible creams and lotions to keep skin moist and healthy.
Note . From Western Schools, 2017.
Respiratory hygiene/cough etiquette Respiratory hygiene and cough etiquette measures were added to Standard Precautions in 2007 and are designed to limit the transmission of respiratory pathogens spread by droplet or airborne routes. These measures may apply to the dental patient and/or individuals who accompany patients to the dental setting—who may have an undiagnosed transmissible respiratory infection. Signs of respiratory illness include cough, congestion, and runny nose. Key recommendations for respiratory hygiene/cough etiquette are listed below: 1. Implement measures to contain respiratory secretions of any individuals who have signs and symptoms of respiratory infection from point of entry to the dental facility, throughout the visit. These measures include posting Sharps safety All DHCPs, including dental hygienists, must try to avoid occupational exposure to potentially infectious body fluids, including blood. Many hygienists are now licensed to administer local anesthesia and their exposure risks due to needlestick injuries and other sharp objects are increasing. Exposure risks in dentistry are rare and for the most part preventable. Engineering and work- practice controls are in place to help the dental hygienist prevent exposure incidents. Engineering controls are generally technology based and incorporate safer designs of instruments and devices to prevent exposure to contaminated sharp instruments. Examples of engineering controls include anesthetic syringes with safety features, and special containers for contaminated sharp instruments. Work-practice controls are behavior based and focus on conducting tasks in ways that reduce the likelihood of exposure. Examples of work-practice controls include single- Safe injection practices Safe injection practices are intended to prevent transmission of infectious diseases between patients and/or dental personnel during the preparation and administration of parenteral (intravenous or intramuscular injection) medications. These practices are a set of measures that dental personnel should follow to perform injections in the safest possible manner for patients and personnel. Because of reports of transmission of infectious diseases by inappropriate handling of injectable medications, the CDC now considers safe injection practices to be a formal element of Standard Precautions. Key recommendations for safe injection practices in dental settings include: 1. Prepare injections using aseptic technique in a clean area. 2. Disinfect the rubber septum on the vial with alcohol before piercing. 3. Do not use needles or syringes for more than one patient.
signs for patients to cover mouth/nose when coughing or sneezing, recommending the use and disposal of tissues, and performing hand hygiene after hands have been in contact with secretions. 2. Provide tissues and no-touch receptacles for disposal. 3. Provide resources for performing hand hygiene. 4. Offer masks to coughing patients and visitors. 5. Provide space for symptomatic patients to sit as far away from others as possible. 6. Educate dental personnel on the importance of infection prevention measures to prevent the spread of respiratory pathogens. handed recapping of needles and retracting with a mouth mirror (instead of a finger) when administering anesthesia. Key recommendations for sharps safety in dental settings include: 1. Consider sharp items that are contaminated with patient blood and saliva as potentially infective and establish engineering controls and work practices to prevent injuries. 2. Do not recap used needles by using both hands. 3. Use either a one-handed scoop technique or mechanical device designed for holding the needle cap. 4. Place used disposable syringes and needles, scalpel blades, and other sharp items in an appropriate puncture-resistant container located as close as possible to the area where the item is used. (CDC, 2016) 4. Enter medication containers with a new needle and new syringe, even when obtaining additional doses for the same patient. 5. Use single-dose vials for parenteral medications when possible. 6. Do not use single-dose vials, ampules, and bags or bottles of intravenous solution for more than one patient. 7. Do not combine leftover contents of single-use vials for later use. 8. If multidose vials are used: a. Dedicate multidose vials to a single patient when possible. b. If multidose vials are used for more than one patient, they should be restricted to a centralized medication area and not enter the patient treatment area.
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