Dental healthcare personnel should also be screened for tuberculosis upon hire (CDC, 2022h). Annual TB testing of healthcare personnel is not recommended unless there is known exposure or ongoing transmission in your community. Post-exposure management Post-exposure management is an essential component of a complete infection control program. Written post-exposure policies should describe the types of contact with blood or other potentially infectious materials that can place a DHCP at risk for infection and promptly reporting and evaluating exposures and identify a healthcare professional who is qualified to provide counseling and perform all medical evaluations and procedures including post-exposure prophylaxis when indicated. An exposure incident results when blood or other potentially infectious material contacts nonintact skin, tissue (through parenteral contact), or the eye, mouth, or other mucous membrane (NIOSH, 2007). If an exposure Program evaluation Routine evaluation of the infection prevention program, including evaluation of adherence to the infection prevention practices of all dental healthcare personnel is recommended. The success of a program depends upon developing standard operating procedures, evaluating practices, and providing feedback to dental personnel, Hand hygiene Routine hand hygiene is considered the single most effective measure for reducing the risk of transmitting infections to patients and dental personnel. Noncompliance with hand hygiene is strongly linked to the increased risk of healthcare-associated infections, spread of resistant organisms, and outbreaks of infectious diseases. Throughout the workday, dental hygienists typically visit several rooms within the dental office. If proper hand hygiene is not performed, hands become a mode of cross contamination. Newly washed hands are not a substitute for gloves, and it is not sufficient to wash hands only when they are visibly soiled (CDC, 2023c). General recommendations for hang hygiene in the dental setting include performing hand hygiene when hands are visibly soiled and after barehanded touching of instruments, equipment, materials, and other objects likely to be contaminated by blood, saliva, or respiratory secretions. In addition, hand hygiene should be performed before and after treating each patient, before putting on gloves, and Personal protective equipment Splashing and spattering of blood and other body fluids commonly occurs during dental hygiene procedures and other tasks such as instrument reprocessing, environmental cleaning. All dental personnel at risk for exposure to potentially infectious materials must wear personal protective equipment (PPE), including protective eyewear, surgical masks, protective apparel, and gloves. Dental facilities must ensure that sufficient and appropriate PPE is available and accessible to dental personnel. Team members should be educated on proper selection and use of PPE. Protective clothing should be worn that covers the skin and personal clothing during patient care or when contact with blood, saliva, or other potentially infectious material is anticipated. Mouth, nose, and eye protection should be worn during procedures that are likely to generate splashes or spattering of blood or other body fluids. All personal protective equipment should be removed prior to leaving the work area. In addition, dental
CDC provides detailed information regarding TB screening and testing of healthcare personnel and diagnosis (CDC, 2023e; CDC, 2022d).
incident occurs, first aid should first be administered as necessary. The incident should be reported to the infection control coordinator, who should document the incident on appropriate forms and then refer the exposed DHCP to a qualified healthcare professional for immediate and appropriate care (CDC, 2019c). Details of the occupational exposure should be reported in compliance with the OSHA Bloodborne Pathogens Standard and evaluated individually, and the risk for infection and need for follow-up care should be evaluated. Confidentiality of the exposed person must be ensured. CDC provides additional information on exposure incidents and post-exposure prophylaxis (PEP) [CDC, 2022g]. documenting adverse outcomes such as occupational exposures, and work-related illnesses in dental personnel. The CDC Summary provides a two-part checklist that may be used as a tool to evaluate the infection prevention program (CDC, 2016). immediately after removing gloves. Soap and water should be used when hands are visibly soiled (e.g., blood, body fluids) otherwise, an alcohol-based hand rub may be used (CDC, 2020a). For surgical procedures, surgical hand antisepsis should be performed before donning sterile surgical gloves. Liquid hand-care products should be stored in either disposable closed containers or containers that can be washed and dried before refilling. Lotions are recommended to prevent skin dryness associated with handwashing, and all products should be used that are compatible with integrity of gloves. Since most home use lotions contain petroleum or other oil emollients, it is recommended that facility approved lotions are used. Fingernails should be short and smooth with filed edges to prevent glove tears and artificial fingernails are not recommended. Hand or nail jewelry should not be worn if it makes donning gloves more difficult or compromises the integrity of the gloves. personnel should follow the correct sequence for donning and doffing PPE to avoid cross contamination (CDC, n.d.a). During the COVID-19 global pandemic, it was recommended that dental personnel wear specific combinations of PPE depending upon their community transmission of COVID-19 and whether an aerosol generating procedure was being performed (CDC 2022d; CDC, 2020b). While the public health emergency has rescinded, these combinations of PPE are still recommended, and OSHA provides precise recommendations for PPE ensembles for dentistry (OSHA, n.d.a). Protective eyewear Protective eyewear protects the eyes from exposure to microorganisms caused by spatter and from physical injury from particulate debris. Proper eyewear should be impact- resistant and have side coverage around the eyes. It may be disposable or reusable. Personal eyeglasses generally
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