Protects the Employee. Mandates annual training for all employees.
Recommendations to protect the patient.
State Dental Boards
Nearly all the State Dental Boards require in statute or rules that dental offices follow CDC Guidelines as a minimum standard of care. There may be some State by state variance in record keeping or monitoring standards, if OSHA does not specify how monitoring should be done (i.e. nitrous oxide, and radiation exposure).
Best Online Resources
The Organization for Safety, Asepsis and Prevention (OSAP) www.OSAP.org is a growing community of clinicians, educators, researchers, and industry representatives who advocate for safe and infection-free delivery of oral healthcare. OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. OSAP offers an extensive online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the safest dental visit possible for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team.
Infection Control Certification Program
The Dental Infection Control Education and Certification, www.dentalinfectioncontrol.org “The OSAP-DANB-DALE Foundation Infection Control Certificate and Certification Steering Commission (ICCCSC) was established to promote the health and safety of the public and dental healthcare personnel. The commission provides guidance in the development and implementation of certificate and certification programs, in accordance with accreditation standards.”
Sanitation, Disinfection and Sterilization
Sanitation // kill SOME of the bugs
Disinfection // kill MOST of the bugs
Sterilization // kill ALL of the bugs
Yes, the CDC guidelines (since 1993) have said we need to spore test at least weekly by using a biological indicator with a matching control. As for how long offices need to retain those records depends on State Board rules and regulations.
The CDC guidelines state ‘results of biological monitoring should be recorded and sterilization monitoring records retained long enough to comply with state and local regulations.’ Please check with your State health department to confirm their requirements for records retention. Depending on the spore test you use, most mail-in companies archive that information for you.
Slow speed hand pieces, just like high speed hand pieces, must be heat sterilized between each patient. These are semi-critical items, which the CDC says must be heat sterilized. See Kim Laudenslager’s Article for more information.
You need to follow the manufacturer’s Instructions For Use (IFU). I created a document for showing the Dentsply IFU … and they say it is acceptable to use an ultrasonic for up to 15 minutes. And below is what Hu-Friedy states for their IFU. In short, I think that YES … most ultrasonic inserts on the market now are safe in the ultrasonic BUT … be careful, I always suggest folks READ the IFU for their product to make sure!
A separate “designated” ultrasonic for appliances should be used. The appliance is put into a baggie filled with ‘appliance cleaning solution’, sealed and then inserted into the ultrasonic unit filled with water for proper amount of time to clean appliance. When done, the baggie is carefully removed from unit, opened over a sink and the solution is discarded. The WATER in the unit must also be discarded and the inside of the ultrasonic is disinfected. Of course the employee must wear proper PPE (ie: gloves) throughout the process.
The Americans with Disabilities Act (ADA) specifies regulations with regards to service animals. They specify that a service animal is a “dog that is individually trained to do work or perform tasks for a person with a disability.” See full text here.
According to the ADA, if it is not readily obvious what service the animal provides, there are ONLY two questions that staff may ask of the person with disabilities. “1) Is the dog a service animal required because of a disability, and 2) what work or task has the dog been trained to perform.”
Service dogs may only be asked to leave the premise if it is uncontrollable, or is not housebroken; The ADA specifies that allergies or fear of animals are NOT acceptable reasons. The dog may be excluded from a medical area where it may compromise sterility (i.e. OR or burn unit).
Some states do have laws regarding misrepresenting a comfort/therapy dog as a service dog; however, the ADA does not allow a staff member to ask about the dog’s training or documentation of training. If there are serious concerns that the individual may be misrepresenting his/her animal as a service animal, call animal welfare.
For more common questions regarding service animals, see the ADA’s FAQ page here.
If your office is considering having an office animal, make sure you do it correctly. SHEA (The Society for Healthcare Epidemiology of America) has written a document to help. It is a MUST READ for any office considering animals. “Animals in Healthcare Facilities: Recommendations to Minimize Potential Risks”