Infection Control Q & A

The Centers for Disease Control and Prevention (CDC) recently updated its recommendations for infection control in dental settings. These comprehensive guidelines provide dental health care personnel with extensive background information and scientific rationale for each topic. It also answers many commonly asked questions.

Q: How and why did CDC rank its recommendations?

A: Rankings were based on existing scientific data, theoretical rationale and applicability. Actions CDC strongly recommends and that are strongly supported by well-designed experimental, clinical or epidemiological studies received the highest rankings. CDC made no recommendations for actions that lack supporting evidence or for which no professional consensus on efficacy has been reached. CDC developed its ranking system to ensure the infection-control practices are based on the best available scientific data, thus giving dentists higher confidence in the practices’ effectiveness.

Q: How often should infectious waste be collected?

A: With the exception of used sharps, infectious waste may be stored for no more than 30 days at room temperature or in a refrigerator, or for up to 90 days in a freezer. Store used sharps in a puncture-resistant container until the container is full.

Q: What is the difference between standard and universal precautions?

A: Universal precautions were developed to guard against unprotected contact with blood or body fluids containing blood. These precautions assume that all blood is infected with bloodborne pathogens. Standard precautions expand upon this assumption to include all body fluid secretions and excretions (except sweat), non-intact skin and mucous membranes regardless of the presence of blood. Standard precautions were developed to protect health care professionals against exposure to diseases — like TB, influenza and SARS — that transmit via airborne, droplet or contact methods.

Q: What are biofilms?

A: Microorganisms, such as naturally occurring water bacteria, protozoa or fungi, colonize and replicate on the interior surface of waterline tubing to form a slime layer called biofilm. Biofilms can form in any type of waterline tubing, such as grocery store misters, showerheads, faucets and dental handpieces. Please note that scientific reports have not linked illness to dental unit waterlines. However, patients with already-compromised immune systems may have difficulty fighting off these germs. 

Q: Will continuing education or retraining be necessary?

A: Dentists should compare their annual training program for employees to the new guidelines and provide employees with additional training on new topics.

Q: Since CDC is not a regulatory agency, why should a dentist comply with its recommendations?

A: Many dental licensing boards use the CDC’s infection control guidelines as the standards for dental practice. OSHA frequently refers to CDC’s recommendations as the basis for regulations to protect employees against occupational hazards. Therefore, PDA strongly encourages its members to follow CDC’s infection control recommendations.

Q: I have misplaced my copy or never received the updated guidelines. How do I obtain a copy?

A: Download an electronic PDF version of the entire document from the ADA website. Contact CDC’s Division of Oral Health at (770) 488-6054 to request additional paper copies. 

Source: ADA News, Vol. 34, No. 18, October 6, 2003