Safe Injection Practices in Dentistry
Safe injection practices are a set of measures that clinicians should follow
to perform injections in an optimally safe manner for patients, health care
personnel, and others.
The Standard Precautions section of CDC's
2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious
Agents in Healthcare Settings provides evidence-based recommendations
for safe injection practices and reflects the minimum standards that health care
personnel should follow to prevent transmission of infections in health care
Dental health care professionals frequently handle parenteral medications;
some use fluid infusion systems (e.g., for patients undergoing conscious
CDC Guidelines for Infection Control in Dental Health-Care Settings, 2003
provides evidence-based recommendations on Aseptic Technique for Parenteral
Medications and Single-use or Disposable Devices that reflect the minimum
standards dental health care personnel should follow to prevent transmission of
infections in dental settings. Additionally, safe injection practices are
typically part of state professional licensing-board regulations for dental
health care staff and their practices.
Despite these recommendations and guidelines, there are ongoing reports of
adverse events, including patient notifications, resulting from health care and
dental personnel failing to adhere to Standard Precautions and basic infection
control practices. In dental settings, failures include reuse of disposable
needles and syringes used for IV sedation.
Although there have been no recent confirmed transmissions of infection in
dentistry resulting from unsafe injection practices, numerous outbreaks have
been reported in other health care settings. Unsafe injection practices that
have resulted in disease transmission have most commonly included—
- Using the same syringe to administer medication to more than one
patient, even if the needle was changed or the injection was administered
through an intervening length of intravenous (IV) tubing.
- Accessing a medication vial or bag with a syringe that has already
been used to administer medication to a patient, then reusing contents from
that vial or bag for another patient.
- Using medications packaged as single-dose or single-use for more
than one patient.
- Failing to use aseptic technique when preparing and administering
injections. Outbreaks related to unsafe injection practices indicate that
some health care personnel are unaware of, do not understand, or do not
adhere to basic principles of infection control and aseptic technique
(specific practices and procedures performed under carefully controlled
conditions to minimize contamination by microorganisms).
For these reasons, CDC reminds dental practitioners of the following
practices that are critical for patient safety:
- Never administer medications from the same syringe to more than one
patient, even if the needle is changed or if you are injecting through an
intervening length of IV tubing.
- After a syringe or needle has been used to enter or connect to
a patient's IV, it is contaminated and should not be used on another
patient or to enter a medication vial.
- Never enter a medication vial, bag, or bottle with a used syringe
- Never use medications packaged as single-dose or single-use for
more than one patient—this includes ampoules, cartridges, and bags or
bottles of intravenous solutions.
- Assign medications packaged as multi-dose vials to a single
patient whenever possible.
- Never use bags or bottles of intravenous solution as a common
source of supply for more than one patient.
- Follow proper infection control practices during the
preparation and administration of injected medications.
- Never combine the leftover contents of a syringe or single-use
vials for later use.
CDC's Injection Safety
CDC's Safe Injection Practices to Prevent Transmission of Infections to
Page last reviewed: November 2, 2012
Page last modified: November 2, 2012
Division of Oral Health,
National Center for Chronic Disease Prevention and