By Noel Brandon Kelsch, RDHAP, MS
Last month, we reviewed two new documents from the Centers for Disease Control and Prevention: "Infection Prevention Checklist for Dental Settings: Basic Expectations for Safe Care," a wonderful checklist of the basic things we should be doing to keep both the patient and the clinician safe, and "Summary of Infection Prevention Practices in Dental Settings: Basic expectations for Safe Care."
Although the 2003 CDC guidelines are still the go-to document for dental professionals, the two new documents provide professionals with tools that make their jobs easier and provide a great resource for learning. These documents do not contain new requirements. They give us greater understanding and resources for what we have already been asked to do.
In reading these documents, I love how they have shared the reason behind many of the recommendations. You can understand not just what you are doing but why you are doing it. They utilize notes, key recommendations, and check lists. Let's look at some key examples:
- Notes about handpieces: For many years, all slow- and high-speed handpieces have included in instructions for use (IFU) from the Food and Drug Administration that they must be heat sterilized between patients. IFUs are federal law and must be followed. Page 14 of the summary reminds us of the the why with this note:
"Dental handpieces and associated attachments, including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high-level or surface disinfected. Although these devices are considered semicritical, studies have shown that their internal surfaces can become contaminated with patient materials during use. If these devices are not properly cleaned and heat sterilized, the next patient may be exposed to potentially infectious materials."
- Key recommendations: Sometimes the dental setting can be overwhelming and busy. We have to stay on task properly. The key recommendations sections give you a simple to way to review what you are doing and make sure you are doing it right. An example is the sharps safety section. It takes you step-by-step through what compliance consists of (page 12 of summary).
As an example, the second recommendation states, "Do not recap used needles by using both hands or any other technique that involved directing the point of a needle toward any part of the body."
- Checklist: The checklist delineates what compliance consists of and has an interactive version that allows you to note areas where you need to improve. A great example is an often ignored area in dentistry-dental waterline quality. This area in the checklist (page 10) reminds us that we must maintain and monitor water quality, and use sterile water when surgical procedures are being performed. The note that came along with that section states: "Note: Examples of surgical procedures include biopsy, periodontal surgery, apical surgery, implant surgery, and surgical extractions of teeth." You must also have a program in place when a community boil water advisory is in place.
All dental offices should download and use these documents in their infection control program. Next month, we will look at the administration portions of these documents. Be ready. We are going to be asking you to assign someone to the role of infection control coordinator. To download these documents, as well as the "2003 Guidelines for Infection Control in the Dental Health-Care Setting," go to CDC.gov/oralhealth. RDH
NOEL BRANDON KELSCH, RDHAP, MS, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists' Association.
