Oral Health Topics
CDC Guidelines for Infection Control
Overview
Infection control procedures are precautions taken in healthcare settings to prevent the spread of disease. The Centers for Disease Control and Prevention (CDC), working with the ADA, has developed special recommendations for use in dental offices.
Before you enter the examining room, all surfaces, such as the dental chair, dental light, drawer handles and countertops have been cleaned and decontaminated. Some offices may cover this equipment with protective covers, which are replaced after each patient.
Non-disposable items like the dental tools or handpieces are cleaned and sterilized between patients. You may not be aware that sterilization and other infection control precautions take place before your dental visit because many of these procedures occur in another area of the dental office. Disposable items like needles or gauze are placed in special bags or containers.
Infection control precautions also require all dental staff involved in patient care to use appropriate protective garb such as gloves, and sometimes masks, gowns and eyewear. After each patient, disposable wear like the gloves and masks are discarded. Before seeing the next patient, the treatment team washes their hands and put on a new pair of gloves.
Additional Resources
- CDC Guidelines for Infection Control in Dental Health Care Settings—2003
- ADA Roadmap to CDC Guidelines 2003
- The Journal of the American Dental Association
CDC Guidelines for Infection Control in Dental Health Care Settings—2003
This report consolidates previous recommendations and adds new ones for infection control in dental settings. Recommendations are provided regarding 1) educating and protecting dental health-care personnel; 2) preventing transmission of bloodborne pathogens; 3) hand hygiene; 4) personal protective equipment; 5) contact dermatitis and latex hypersensitivity; 6) sterilization and disinfection of patient-care items; 7) environmental infection control; 8) dental unit waterlines, biofilm, and water quality; and 9) special considerations (e.g., dental handpieces and other devices, radiology, parenteral medications, oral surgical procedures, and dental laboratories). These recommendations were developed in collaboration with and after review by authorities on infection control from CDC and other public agencies, academia, and private and professional organizations.
ADA Roadmap to CDC Guidelines for Infection Control in Dental Health-Care Settings
Itinerary. This Roadmap will lead you through the new Centers for Disease Control and Prevention (CDC) Guidelines for Infection Control in Dental Health-Care Settings, 2003. The CDC published the Guidelines in December 2003 in the official publication known as the Morbidity and Mortality Weekly Report (MMWR). In addition, the CDC is mailing a copy of the 2003 CDC Guidelines to all practicing dentists.
What to Expect. The new Guidelines replace the version published by the CDC in 1993. Much of what they contain is the same. However, there have been a few important changes based on advances in infection control knowledge and technology over the last 10 years. This is what to expect:
- The Guidelines are comprehensive. The new Guidelines incorporate relevant recommendations that were previously scattered throughout several other CDC publications. An example is the hand hygiene recommendations, which CDC published as a separate document last year. Another example is the CDC's recommendations for preventing needlesticks in healthcare settings. The CDC has adapted these in the new Guidelines specifically to dental settings.
- The Guidelines are in two parts. Part I is a comprehensive review of the science related to dental infection control and is by far the largest part of the Guidelines. Part II is the CDC's recommended infection control practices for dental offices. Most of these recommendations will be familiar to you from previous CDC and ADA publications. Examples are the routine use of personal protective equipment, such as gowns, gloves, masks and/or protective eyewear; and hepatitis B immunization of every dental care worker exposed to potentially infectious materials.
- The Guidelines update and review previous CDC recommendations in some areas. An example is cleaning and disinfecting clinical contact surfaces.
- The Guidelines include several new recommendations. Perhaps the most significant are in the area of maintaining dental unit water quality.
- The recommendations in Part II are categorized based on the strength of the scientific evidence supporting their use. They range from practices that are strongly recommended and supported by well-designed experimental, clinical, or epidemiologic studies to recommendations that are simply suggested for implementation based on a theoretical rationale.
Topics Covered in Part II. Recommendations
Below is a list of topics covered in Part II. Recommendations of the CDC Guidelines. Most of these topics will be very familiar to you. A few are new to the CDC's recommendations for dentistry or have been modified. One or two are completely new. We have marked with an asterisk (*) those topics that may involve the most significant changes in your current office procedures. Links are provided to existing articles, statements and other resources on these topics. Keep checking this site for updates.
- Education and training of dental health-care workers
- Immunization programs:
Immunization Programs (PDF)
Employee Vaccination Record (PDF)
Hepatitis B Vaccine Information (PDF)
Updated Recommendations for Mumps Vaccination (June 2006)
Post-Exposure Evaluation and Follow-Up Requirements Under OSHA's Standard for Occupational Exposure to Bloodborne Pathogens: A Guide to Dental Employer Obligations - Medical conditions, work-related illness and work restrictions
- Maintenance of records, data management and confidentiality:
Oral Health Topic: Health Insurance Portability and Accountability Act (HIPAA) - Hepatitis B Vaccine Information(PDF)
- Engineering and work practice controls, including safe use of needles and other sharps:
CDC Sample Screening and Device Evaluation
NIOSH Safer Medical Device Implementation in Health Care Facilities
OSHA etools
Blunt-Tip Suture Needles - Hand Hygiene (PDF)
- Personal Protective Equipment (PDF)
- Sterilization and disinfection of patient care items:
Oral Health Topic: Infection Control: Monitoring Sterilizers
Sterilization and Disinfection of Dental Instruments (PDF) (Updated 07/31/09)
Safe Use of Glutaraldehyde (PDF)
Sterilization and Disinfection Table (PDF) - Cleaning and disinfecting environmental work surfaces:
Sterilization and Disinfection Table (PDF) - Medical waste
- Dental unit waterlines, biofilm and water quality:
Oral Health Topic: Dental Unit Waterlines - Cleaning and sterilizing dental handpieces:
Sterilization and Disinfection of Dental Instruments (PDF) (Updated 07/31/09) - Dental radiology
JADA: An Update on Radiographic Practices: Information and Recommendations - Aseptic techniques for parenteral medications
- Single-use disposable devices
- Oral surgical procedures
- Handling Extracted Teeth (PDF)
- Dental laboratory
- Oral Health Topic: Tuberculosis
