governor appoints many board members, but the legislature makes appointments as well. State law requires board members within the California Department of Consumer Affairs to Dental Board of California The Dental Board of California (the Board) is part of the California Department of Consumer Affairs. The stated mission of the Board is to “protect and promote the health and safety of consumers in the State of California” (Dental Board of California, 2021). The Board licenses qualified dental healthcare professionals, takes actions to enforce compliance with the Dental Practice Act and other laws of the State of California, and strives to enhance the education of consumers and licensees. The Board regulates licensed dentists, registered dental assistants (RDAs), and registered dental assistants in extended functions (RDAEFs). It also delineates each group’s scope of practice, including any required levels of supervision or any restrictions on the settings in which they may work. Other areas Dental Hygiene Board of California Whereas the Board regulates licensed dentists, RDAs, and RDAEFs, the Dental Hygiene Board of California (formerly the Dental Hygiene Committee of California) now oversees all functions and requirements of all categories of RDHs (California Dental Practice Act, 2019b). The responsibilities of the Dental California regulatory agencies Currently, regulations exist that govern infection control in dentistry specific to the state of California. These regulations are contained within the California Code of Regulations (CCR), Title 16, Professional and Vocational Regulations: Division 10, Dental Board of California, Chapter 1, Article 1, Section 1005 Minimum Standards for Infection Control. Compliance is mandatory for all dental healthcare personnel (DHCP) in California (California Code of Regulations, 2011). DHCP include “all paid and non-paid personnel in the dental health care setting who might be occupationally exposed to infectious materials, including body substances and contaminated supplies, equipment, environmental surfaces, water, or air. DHCP include dentists, dental hygienists, dental assistants, dental laboratory technicians (in-office and commercial), students and trainees, contractual personnel, and other persons not directly involved in patient care but potentially exposed to infectious agents (e.g., administrative, clerical, housekeeping, maintenance, or volunteer personnel)” (California Code of Regulations, 2011). These
complete orientation and training in several important areas, including ethics, conflict of interest laws, and sexual harassment prevention.
of the Board’s concern include licensing, examinations, and continuing education (CE) requirements. The Board also sets fees for dentists and for all dental auxiliaries, including fees in connection with initial licensure and license renewal, permits and permit renewals, and examinations. These regulations are set forth for dentists and dental auxiliaries in the CCR (Sections 1021 and 1022, respectively). The Board may inspect the books, records, and premises of any licensed dentist, as well as the licensing documents, records, and premises of any dental assistant in response to a complaint that either entity has violated a law or regulation constituting grounds for disciplinary action. The Board may employ inspectors for this purpose (California Dental Practice Act, 2019a). Hygiene Board include determining the scope of practice for all dental hygienists; issuing, reviewing, and revoking licenses; and developing and administering examinations. Additional functions include adopting regulations and determining fees and CE requirements for all hygiene licensure categories. regulations are enforced by the Dental Board of California. California licensees must strictly adhere to the guidelines or they may be subject to penalties. In addition to the Minimum Standards for Infection Control mandated by the Dental Board of California, the California Division of Occupational Safety and Health (Cal/OSHA) enforces infection control requirements through the Bloodborne Pathogens Rule from Title 8, Section 5193 of the California Code of Regulations (California Code of Regulations, 2015). Another regulatory agency that impacts the dental healthcare setting is the California Department of Public Health (CDPH). CDPH regulates the collection, storage, transport, and disposal of contaminated solid waste (California Health and Safety Code, 2017). DHCP should familiarize themselves with all of the regulations that pertain to dental practice on the federal, state, and local level. This course is limited to the Dental Board of California Minimum Standards for Infection Control.
PATHOGENS OF CONCERN IN DENTAL SETTINGS AND STANDARD PRECAUTIONS Infection control in the dental setting is a serious concern because patients may harbor drug-resistant infections, such as methicillin-resistant Staphylococcus aureus (MRSA), or infections that may not produce symptoms, such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), making clinical detection impossible through examination or medical history alone. Hepatitis B among adults is largely an acute disease. may occur through unsafe injections (such as sharing needles), needlestick-type injuries in healthcare settings, from an HCV- infected mother to her child during birth, and rarely, through donated blood, blood products, and organs (CDC, 2019). Fortunately, HCV today is a curable infection with medication taken daily for 2-6 months. However, many people with chronic HCV may not be aware of their infection or have not yet received treatment, making transmission risk in healthcare settings a continued concern.
Approximately 95% of all adults who are infected with HBV recover, and within a few months of initial infection no longer show signs of active infections and no longer pose a risk of transmission to others. However, the remaining 5% of those infected with HBV as adults develop chronic infection and can continue to pose a risk of transmission to others since the virus continues to replicate in the liver and circulate in body fluids, including blood and saliva (CDC, 2019). Estimates for the total number of persons living with chronic HBV in the United States range from 730,000 to 2.2 million people (CDC, 2019). Hepatitis C virus (HCV) is nearly always a chronic infection, with 75% to 85% of those who are infected becoming chronic carriers. The CDC estimates that 2.4 million people in the United States have chronic HCV infections. Hepatitis C is transmitted through percutaneous contact with infected body fluids. This
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). The CDC estimated that in 2019, an estimated that 1,189,700 people in the United States had HIV. Approximately 13% of people with HIV are unaware of their infection (CDC, 2021). According to Section 1005, Minimum Standards for Infection Control, standard precautions (SP), “are a group of infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status, in any setting in which health care is delivered. These include: hand hygiene, use of gloves, gown, mask, eye protection, or face shield, depending on the anticipated exposure, and safe handling of sharps.”
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