Oral Health Topics
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.
Frequently Asked Questions (FAQ)
- I've heard about universal precautions. Can you tell me what they are?
- Do you sterilize the instruments including the handpiece (drill) after each patient?
- How do you sterilize the instruments? Can you show me how it's done?
- How do you clean and disinfect the examining room, and how often is this done?
- Are there other safety guidelines that dentists must follow?
- What are the things to look for?
I've heard about universal precautions. Can you tell me what they are?
Universal precautions are safety procedures established by the Centers for Disease Control and Prevention and the American Dental Association. They are used for each and every patient to prevent the transmission of the AIDS virus and other infectious diseases. These precautions require all dental staff involved in patient care to use appropriate protective garb such as gloves, and sometimes masks and eyewear. After each patient visit, the gloves are discarded, hands are washed and a new pair of gloves is used for the next patient.
Do you sterilize the instruments including the handpiece (drill) after each patient?
According to a recent study in the journal of the American Dental Association, virtually all dentists sterilize their handpiece (drill) between patients. Dental offices follow specific heat sterilization procedures which are outlined by the Centers for Disease Control and Prevention and the American Dental Association. Disposable items, such as needles and saliva ejectors, cannot be sterilized and are discarded in special containers.
How do you sterilize the instruments? Can you show me how it's done?
Dental instruments are cleaned and sterilized at very high temperatures after each time they are used on a patient. Recommended sterilization methods include: an autoclave (steam under pressure), a dry heat oven, or chemical vapor (commonly called a chemiclave). The sterilization equipment usually is not in the treatment room, but if you'd like to see how and where it's done, ask the dental staff to show you.
How do you clean and disinfect the examining room, and how often is this done?
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. Sharp items and anything contaminated with blood or saliva are disposed of in special containers.
Are there other safety guidelines that dentists must follow?
Yes. OSHA, the federal Occupational Safety and Health Administration, has specific regulations that protect employees from injury and illness in the work place. These "safe workplace" regulations pertain to occupational settings, including dental offices with one or more employees. While the primary purpose of the regulations is to safeguard employees, these procedures also protect the patient. For example, gloves provide protection for both you and the dental team.
Don't let uncertainty about safety keep you away from the dentist's office, or cause anxiety while you're there, when a few minutes of conversation with your dentist can set your mind at ease.
Your dental health is too important to neglect. Remember to learn the facts about your dentist's infection control procedures by starting with a little heart-to-heart.
If you don't have a dentist, you can obtain ADA referrals by contacting your local dental society. The local dental society is usually listed in the telephone directory under "dentist" or "association."
What are the things to look for?
- Is the dental office clean and orderly?
- Is the dental staff helpful and willing to answer your questions?
- Do the dentist and staff wear gloves and other appropriate protective gear during all actual patient treatment?
- Do the dentist and staff wash their hands before donning a clean pair of gloves?
- Do all surfaces and equipment in the treatment room appear clean?
- Are needles and other sharp items disposed of in special puncture-resistant containers?
- Is everything that is used in the patient's mouth either heat sterilized or disposable?
Additional Resources
Overview
The CDC Guidelines for Infection Control in Dental Health Care Settings—2003 are the standard of care for infection control in dentistry. This report provides recommendations 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).
Additional Resources
The CDC website has a section on infection control that is designed for dental professionals. Below are links to information from the CDC and other agencies and organizations. The American Dental Association did not produce the material you will find on these sites, and presence of a link here does not imply or constitute ADA endorsement. We also have provided links to additional resources developed by the ADA.
- CDC Boil water advisories
- Cleaning and disinfecting environmental work surfaces (PDF)
- Dental unit waterlines, biofilm and water quality
- Engineering and work practice controls, including safe use of needles and other sharps
- Hand Hygiene (PDF)
- Handling Extracted Teeth (PDF)
- Immunization Programs (PDF)
- Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 MMWR August 6, 2010; Volume 59, No. RR 08
- CDC Vaccination Recommendations for Healthcare Personnel (2009)
- Employee Vaccination Record (PDF)
- Hepatitis B Vaccine Information (PDF)
- Latex hypersensitivity
- Personal Protective Equipment (PDF)
- Postexposure obligations, protocols, resources (for needlesticks and other sharps injuries)
- Post-Exposure Evaluation and Follow-Up Requirements Under OSHA's Standard for Occupational Exposure to Bloodborne Pathogens: A Guide to Dental Employer Obligations
- U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis
- U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
- National HIV/AIDS Clinicians’ Consultation Center
- Radiography: An Update on Radiographic Practices: Information and Recommendations
- Sterilization and disinfection of patient care items
- Tuberculosis
