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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

CDC issues new Infection Control Guidelines for Dental Settings

By Gary Evans, Senior Staff Writer

The Centers for Disease Control and Prevention has issued comprehensive new infection control guidelines for dental settings, citing the rare but real risk of transmission to patients and personnel.

There have been some high publicized outbreaks in dentistry, including the first documented case of hepatitis C virus infection via cross-transmission between patients in a dental office in 2013. Public health investigators found the Tulsa, OK dental practice was riddled with infection control problems, including injection practices that could contaminate multidose vials and multiple sterilization issues. Then there was the infamous Florida Dental Case in 1990, when the late Kimberly Bergalis and five other patients contracted HIV after receiving care from an HIV-positive dentist. The case was never definitively solved — partly due to the absence of dental records — though the initial molecular epidemiology seemed to suggest the patients were infected by the HIV-positive dentist.

“In most cases, investigators failed to link a specific lapse of infection prevention and control with a particular transmission,” the CDC states in the guidelines. “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.”

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, the CDC underscores. The guidelines summarize current infection prevention recommendations and includes a checklist that can be used to evaluate compliance. Key sections include:

  • Infection prevention program administrative measures.
  • Infection prevention education and training.
  • Respiratory hygiene and cough etiquette.
  • Updated safe injection practices.
  • Administrative measures for instrument processing