Healthcare Consideration: The Summary is not considered a replacement for the 2003 guidelines, and readers are urged to consult the full 2003 guidelines for additional background, rationale, and scientific evidence behind each recommendation. CDC guidelines and Summary complement each other, and the dental hygienist should be familiar with both. The Summary is available in digital format, or a printed version may be ordered free of charge (CDC, 2016d). CDC guidance for COVID-19 While the federal COVID-19 public health emergency
Healthcare Considerations: Frequently Asked Questions
expired in May 2023 (CDC, 2023a), dental hygienists (and all dental team members) must remain aware and vigilant that patients and those accompanying them to the dental facility may arrive with respiratory symptoms, and dental personnel may continue to be exposed to respiratory illnesses— including COVID-19. As of May 2023, CDC has discontinued its dedicated web page for COVID-19 for Oral Health Care Providers. Instead, infection control recommendations for COVID-19 in dentistry are incorporated within the CDC web page “Recommendations for Healthcare Personnel During the Coronavirus Disease Pandemic” (CDC, 2023b). This guidance is applicable to all U.S. settings where healthcare is delivered, including dental facilities. Healthcare Considerations: It may be daunting to obtain quick and easy access to principal CDC documents and updated information regarding COVID-19. Tip : The CDC mobile application “CDC DentalCheck” is available for free download (CDC, 2021a). DentalCheck provides basic infection prevention principles and recommendations for dental healthcare settings and allows dental personnel access to an interactive version of the checklist in a portable, easy-to-use, and streamlined format. App users check “Yes/No” to acknowledge compliance with a list of administrative policies or observed practices, and results may be exported to facilitate records management. The app provides links to key CDC documents and selected references and resources by topic area— including up-to-date infection prevention and control of COVID-19. Dental hygienists may use DentalCheck as a tool to periodically assess practices in their facility and ensure they are meeting the minimum expectations for safe care. Administrative measures Administrative controls are policies and protocols that are incorporated in the day-to-day operations of every dental setting to protect both dental personnel and patients from infection transmission. Administrative policies should be tailored to the individual practice setting, reassessed at least annually, and should be in alignment with state and federal requirements. These policies and protocols should be written into an individualized office compliance manual. Key administrative recommendations for the dental setting include: 1. Develop and maintain infection prevention and occupational health programs. 2. Provide supplies necessary for adherence to standard precautions (e.g., hand hygiene products, safer devices to reduce percutaneous injuries, personal protective equipment). 3. Assign at least one individual trained in infection prevention responsibility for coordinating the program. 4. Develop and maintain written infection prevention policies and procedures appropriate for the services provided by the facility and based on evidence-based guidelines, regulations, or standards.
During the pandemic, we needed to implement “universal source control” where our entire dental team needed to be always masked and our patients required masking when entering the dental facility. Will we ever be required to implement universal source control again? Answer During the global pandemic (prior to March 2023), CDC based the universal masking policy (CDC, 2021b) upon on community-specific data relayed via the CDC COVID Data Tracker website. Community transmission levels for SARS- CoV-2 information (and other detailed COVID-related information) was conveyed on this website and updated weekly. Prior to March 2023, it was recommended that healthcare facilities use this as a tool for up-to-date COVID-19 data in their county or territory and base their infection control practices upon this data. However, now that the global pandemic has been rescinded, CDC no longer provides detailed county-wide metrics. Instead, CDC provides nation-wide COVID metrics (CDC, 2024b). Thus, healthcare facilities are recommended to follow their own state and local health department metrics to determine levels of community transmission. In addition, dental personnel should also regularly consult their state dental board for updates. Healthcare Consideration: Tip : CDC provides a Health Alert Network (HAN) as a method of sharing information about urgent public health threats including COVID-19 with public health officers and practitioners and clinicians. Dental hygienists may sign up to receive these health alerts via email as a surveillance tool (CDC, 2022a). 5. Facility has system for early detection and management of potentially infectious persons at initial points of patient encounter. The trained person in infection prevention is termed the “infection control coordinator.” This person has a leadership role within the facility and should be responsible for overseeing the entire infection control program. This person should be responsible for the development and maintenance of written infection control policies and procedures based upon evidence-based guidelines, regulations, or standards; ensure that adequate supplies and equipment are available related to infection control; and coordinate education and training to team members. Since dental hygiene education typically includes rigorous education and training in infection prevention, the dental hygienist may be an ideal candidate as the infection control coordinator. While a specific person is responsible for instituting the program, all team members should be accountable and responsible for implementing the infection control program.
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