Notes to Reader, Suggested Citation, and Introduction
This document is a summary guide of basic infection prevention recommendations for all dental health care settings. These include traditional settings such as private dental practices, dental clinics, dental schools and educational programs (including dental assisting, dental hygiene, and laboratory) and nontraditional settings that often use portable dental equipment such as clinics held in schools for sealant and fluoride placement and in other sites for humanitarian dental missions.
While the information included in this document reflects existing evidence-based guidelines produced by the Centers for Disease Control and Prevention (CDC), it is not intended as a replacement for more extensive guidelines. This summary guide is based primarily upon elements of Standard Precautions and represents a summary of basic infection prevention expectations for safe care in dental settings as recommended in the Guidelines for Infection Control in Dental Health-Care Settings — 2003. Readers are urged to use the Infection Prevention Checklist for Dental Settings (Appendix A), a companion to the summary; and to consult the full guidelines for additional background, rationale, and scientific evidence behind each recommendation.
Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; October 2016.
Adapted from: Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care https://www.cdc.gov/hai/settings/outpatient/outpatient-care-guidelines.html
Transmission of infectious agents among patients and dental health care personnel (DHCP) in dental settings is rare. However, from 2003 to 2015, transmissions in dental settings, including patient-to-patient transmissions, have been documented.1 – 4 In most cases, investigators failed to link a specific lapse of infection prevention and control with a particular transmission. However, reported breakdowns in basic infection prevention procedures included unsafe injection practices, failure to heat sterilize dental handpieces between patients, and failure to monitor (e.g., conduct spore testing) autoclaves.2,3 These reports highlight the need for comprehensive training to improve understanding of underlying principles, recommended practices, their implementation, and the conditions that have to be met for disease transmission.
All dental settings, regardless of the level of care provided, must make infection prevention a priority and should be equipped to observe Standard Precautions and other infection prevention recommendations contained in CDC’s Guidelines for Infection Control in Dental Health-Care Settings — 2003.5 The Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care summarizes current infection prevention recommendations and includes a checklist (Appendix A) that can be used to evaluate compliance.
The information presented here is based primarily upon the recommendations from the 2003 guideline and represents infection prevention expectations for safe care in dental settings. It is intended for use by anyone needing information about basic infection prevention measures in dental health care settings, but is not a replacement for the more extensive guidelines. Readers are urged to consult the full guidelines for additional background, rationale, and scientific evidence behind each recommendation. Additional topics and information relevant to dental infection prevention and control published by CDC since 2003 in this document can be found in Appendix B including
- Infection prevention program administrative measures.
- Infection prevention education and training.
- Respiratory hygiene and cough etiquette.
- Updated safe injection practices.
- Administrative measures for instrument processing.
For the purposes of this document, DHCP refers to all paid and unpaid personnel in the dental health care setting who might be occupationally exposed to infectious materials, including body substances and contaminated supplies, equipment, environmental surfaces, water, or air. This includes
- Dental hygienists.
- Dental assistants.
- Dental laboratory technicians
(in-office and commercial).
- Students and trainees.
- Contractual personnel.
- Other persons not directly involved in patient care but potentially exposed to infectious agents (e.g., administrative, clerical, housekeeping, maintenance, or volunteer personnel).5