Summary of CDC Regulations

This document updates previously published CDC recommendations for infection-control practices in dentistry to reflect new data, materials, technology, and equipment. When implemented, these recommendations should reduce the risk of disease transmission in the dental environment, from patient to dental health-care worker (DHCW), from DHCW to patient, and from patient to patient. Based on principles of infection control, the document delineates specific recommendations related to vaccination of DHCWs; protective attire and barrier techniques; handwashing and care of hands; the use and care of sharp instruments and needles; sterilization or disinfection of instruments; cleaning and disinfection of the dental unit and environmental surfaces; disinfection and the dental laboratory; use and care of handpieces, antiretraction valves, and other intraoral dental devices attached to air and water lines of dental units; single-use disposable instruments; the handling of biopsy specimens; use of extracted teeth in dental educational settings; disposal of waste materials; and implementation of recommendations.

Although the principles of infection control remain unchanged, new technologies, materials, equipment, and data require continuous evaluation of current infection-control practices. The unique nature of most dental procedures, instrumentation, and patient-care settings also may require specific strategies directed to the prevention of transmission of pathogens among DHCWs and their patients. Recommended infection-control practices are applicable to all settings in which dental treatment is provided. These recommended practices should be observed in addition to the practices and procedures for worker protection required by the Occupational Safety and Health Administration (OSHA) final rule on Occupational Exposure to Bloodborne Pathogens (29 CFR 1910.1030), which was published in the Federal Register on December 6, 1991 (4).

A set of infection-control strategies common to all health-care delivery settings should reduce the risk of transmission of infectious diseases. "universal precautions," must be observed routinely in the care of all dental patients.

Emphasis should be placed on consistent adherence to recommended infection-control strategies, including the use of protective barriers and appropriate methods of sterilizing or disinfecting instruments and environmental surfaces. Each dental facility should develop a written protocol for instrument reprocessing, operatory cleanup, and management of injuries (3). Training of all DHCWs in proper infection-control practices should begin in professional and vocational schools and be updated with continuing education.

Allan Melnick, D.D.S. Serving the Encino, Tarzana , Sherman Oaks, Nothridge and Woodland Hills areas of the San Fernando Valley.