What about MRSAs in Dentistry?

Feb. 12, 2008
Leslie Canham, CDA, RDA, talks about educating patients about MRSAs.

There is much concern about MRSAs today. MRSA, pronounced MERSA, stands for Methicillin-resistant Staphylococcus aureus. When patients ask the dental team about staph infections and MRSAs, they are looking for information and confirmation that they won't get an infection from being treated in our office. We can use this opportunity to tell patients about our infection control procedures and assure them that they are safe in our office.

To respond to patient's questions about MRSAs, it is important to be knowledgeable on the subject. An accurate, reliable source for information about MRSAs is the Centers for Disease Control and Prevention (CDC) Web site at Centers for Disease Control and Prevention.

MRSA is the term used to describe a number of strains of the bacteria Staphylococcus aureus that are resistant to a number of antibiotics, including methicillin and other common antibiotics. Staphylococcus aureus, often referred to as "staph," are bacteria commonly carried on the skin or in the nose of healthy people. Approximately 25 percent to 30 percent of the population is colonized in the nose with staph bacteria. Sometimes staph can cause an infection.

Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor, such as pimples and boils, and can be treated without antibiotics. However, staph bacteria can also cause serious infections, such as surgical wound infections, bloodstream infections, and pneumonia.

Health-care Associated MRSA (HA-MRSA) infections

The estimated number of people developing a serious MRSA infection in 2005 was about 94,360, and approximately 18,650 persons died during a hospital stay related to these serious infections. According to the CDC, staph infections, including MRSAs, occur most frequently among persons in hospitals and health care facilities, such as nursing homes and dialysis centers, who may have weakened immune systems. These types of infections are called Health-care Associated MRSA (HA-MRSA) infections.

How is MRSA spread in a Health-care facility?

According to the CDC, patients who already have a MRSA infection or who carry the bacteria on their bodies but have no symptoms are the most common sources of transmission in health-care facilities. The main mode of transmission to other patients is through human hands, especially health-care workers' hands. Hands may become contaminated with MRSA bacteria through contact with infected or colonized patients. If appropriate hand hygiene such as washing with soap and water is not performed, the bacteria can be spread when the health-care worker touches other patients.

How else is MRSA spread?

If a person who has not been hospitalized or had medical procedures within the last 12 months develops a staph or MRSA infection, it is likely the result of a Community-Acquired MRSA (CA-MRSA) infection. CA-MRSA is spread by skin-to-skin contact or contact with items or surfaces that have come into contact with someone else's infection.

According to the CDC, MRSA infections can occur anywhere. Certain settings have factors that make it easier for MRSA to be transmitted, including schools, dormitories, military barracks, households, correctional facilities, and day care centers. Patients who are parents of school age children may ask dental professionals questions about MRSAs and staph infections. It is important to acknowledge their concerns and respond with accurate information. A helpful resource for parents to refer to is the CDC Web site at Centers for Disease Control and Prevention.

Discuss MRSA infections with the entire dental team

As dental health-care professionals, our patients expect us to be well informed when it comes to their safety in our dental offices. Since most patients don't know what effective infection control is, they have to trust that we are doing everything we can to protect them from patient-to-patient disease transmission.

Everyone on the dental team should be able to answer simple questions from patients about MRSA infections and infection control.

You can hold a staff meeting or have a brief discussion at your morning huddle about MRSAs. You can print out a MRSA fact sheet from the CDC Web site and review the key points so that everyone is well informed. Make sure that surface disinfectants are used appropriately and barriers are placed on surfaces that are difficult to clean. Review proper sterilization techniques for patient care items and discuss proper hand hygiene procedures. With on-going training and resources from the CDC Web site, dental professionals can reassure patients that infection prevention is top priority.

References available upon request.

Leslie Canham is a dental speaker and consultant specializing in Infection Control and OSHA compliance. She has over 36 years of experience in dentistry Leslie is the founder of Leslie Canham Seminars providing in-office training, mock-inspections, consulting and online seminars and webinars to help the dental team navigate the sea of state and federal regulations. Leslie's fast paced and entertaining seminars have earned her the reputation as an outstanding speaker in dentistry. Leslie is recognized as a continuing education provider by Academy of General Dentistry, the California Dental Board, and is authorized by the Department of Labor as an OSHA Outreach Trainer in General Industry Standards.

You may reach Leslie at www.LeslieCanham.com. If you would like a complimentary copy of an Instrument Processing Protocol, you may request it from Leslie by email at Leslie Canham.