________________________________________________________ Infection Control for Dental Professionals
• Prioritize cleaning and disinfection of patient rooms and contact surfaces, focusing on frequently touched surfaces and equipment and objects in the immediate vicinity of the patient. DROPLET PRECAUTIONS Use Droplet Precautions for patients that are known or sus- pected to be infected with pathogens transmitted by respiratory droplets. Droplet Precautions requires that one [24]: • Source control by putting a mask on the patient to prevent respiratory droplets from spreading. • Ensure appropriate patient placement to lessen risk for other patients or employees. • Use PPE appropriately, including gloves and a gown. Donning PPE upon rom entry and properly discarding before exiting the patient room is recommended to contain pathogens. • Limit transport and movement of patients outside of the room, and if movement is necessary, instruct patient to wear a mask and follow Respiratory Hygiene/Cough Etiquette. AIRBORNE PRECAUTIONS Airborne Precautions are used when patients are known or suspected to be infected with pathogens transmitted by airborne or aerosol route. Airborne pathogens include TB, measles, chickenpox, and herpes zoster. Airborne Precautions require [24]: • Source control by putting a mask on the patient to prevent respiratory droplets from spreading. • Ensure appropriate patient placement in an airborne infection isolation room (AIIR) constructed according to the CDC’s Guideline for Isolation Precautions. In settings where Airborne Precautions cannot be implemented due to limited engineering resources, masking the patient and placing the patient in a private room with the door closed will reduce the likelihood of airborne transmission until the patient is either transferred to a facility with an AIIR or returned home. • Restrict susceptible healthcare personnel from entering the room of patients known or suspected to have measles, chickenpox, disseminated zoster, or smallpox if other immune healthcare personnel are available. • Use PPE appropriately, including a fit-tested NIOSH- approved N95 or higher level respirator for healthcare personnel. • Limit transport and movement of patients outside of the room, and if movement is necessary, instruct patient to wear a surgical mask and observe Respiratory Hygiene/Cough Etiquette. Healthcare personnel transporting patients who are on Airborne
Precautions do not need to wear a mask or respirator during transport if the patient is wearing a mask and infectious skin lesions are covered. • Immunize susceptible persons as soon as possible
following unprotected contact with vaccine- preventable infections (e.g., measles, varicella or smallpox).
PROTECTING DENTAL HEALTHCARE WORKERS Protecting dental professionals is an integral part of every dental organization’s general program for infection prevention and control. The objectives usually include [5]: • Educating personnel about the principles of infection control and emphasizing individual responsibility • Providing care to personnel for work-related illnesses or exposures • Identifying work-related infection risks and implementing appropriate preventive measures • Containing costs by preventing infectious diseases that result in absenteeism and disability OCCUPATIONAL EXPOSURES An occupational exposure is defined as a percutaneous injury or contact of mucous membrane or nonintact skin with blood, tissue, or OPIM, most commonly a needlestick injury. The risk of infection depends on several factors, including [27]: • Whether the exposure was from a hollow-bore needle or other sharp instrument • Whether the exposure was to nonintact skin or mucous membranes • The amount of blood involved • The amount of contagion present in the source person’s blood If a sharps injury occurs, wash the exposed area with soap and water. Do not “milk” or squeeze the wound. There is no evidence that using antiseptics will reduce the risk of trans- mission for any bloodborne pathogens; however, the use of antiseptics is not contraindicated. In the event that the wound needs suturing, emergency treatment should be obtained. The risk of contracting HIV from this type of exposure is extremely rare. There are no documented cases of a dental healthcare professional contracting HIV from an occupational exposure. OSHA requires dental employers of an individual with an occupational exposure to a bloodborne pathogen to arrange a confidential medical evaluation and follow-up for any employee reporting an exposure incident [3]. An exposure incident is any eye, mouth, mucous membrane, nonintact skin, or other parenteral contact with blood or OPIM. Saliva in dental pro- cedures is treated as potentially infectious material.
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