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This information is a service of the Organization for Safety, Asepsis and Prevention (OSAP), dentistry’s resource for infection control and safety. The FAQs are reprinted from the December 2009 issue of OSAP’s "Infection Control in Practice." OSAP assumes no liability for actions taken based on the information provided. OSAP is not in a position to provide legal or medical advice nor does it test, evaluate, endorse, promote, or recommend products. To contact OSAP, go to www.OSAP.org or call (800) 298-OSAP (6727).
General infection control
Should uniforms be long sleeved?
Answer: If the uniform is the outer layer of clothing worn at chairside, then the uniform is considered as personal protective equipment (PPE). The doctor has the responsibility to determine what is appropriate PPE, based on the types of exposure that may occur during the various tasks performed in the office.
According to OSHA, PPE will be considered "appropriate" only if it does not permit blood or other potentially infectious material to pass through to – or reach – the skin, employees’ underlying garments, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time that the PPE will be used. Thus, if the tasks being performed could contaminate forearms with the patient’s blood or saliva droplets, then long-sleeved protective clothing should be worn when performing these tasks.
The doctor won’t let me take my uniform home to clean, but when we launder it in the office it looks terrible. Can you please tell him that it’s OK for me to launder it at home?
Answer: The doctor is correct. It is his or her responsibility to provide and clean staff’s protective clothing. But if you take the uniform home, it is out of his or her control. The other option besides laundering in the office is to contract with a medical laundry service. But since you already have in-house laundering, it seems like the best approach would be to work on improving your laundering and ironing procedures.
If the uniform is worn in place of street clothes and a protective garment is used over the uniform during procedures likely to generate splash, spray, or spatter, then it is not necessary for the employer to launder the uniform. If the uniform is worn as the protective attire, it must be removed prior to leaving the work environment and the employee may not take the uniform home for laundering.
Dried composites are difficult to clean off of instruments. Is it permissible to wipe off these instruments at chairside?
Answer: Only if done carefully. If you do this, make it a safe work practice. For example, hold a 2x2 gauze pad on a flat surface with cotton pliers or other instrument. While holding the dirty instrument in the other hand, wipe the tip off on the pad. Never hold the pad with your fingers. Another option for instrument debridement is to tape two to three cotton rolls to a covered tray surface and wipe instruments without touching the cotton rolls with your fingers. If desired, moisten the cotton rolls to help remove debris.
Rules and recommendations
How do engineering controls and work practices differ?
Answer: Engineering controls are items that physically address (isolate or remove) bloodborne pathogen hazards in the office. Examples include safety syringes/needles, rubber dams, sharps containers, and high-volume evacuators. Work practice controls are procedures that reduce the likelihood of exposure by changing the manner in which a task is performed.
Examples would be safely recapping a used needle with the one-handed scoop technique rather than using two hands, positioning a patient’s head properly during ultrasonic scaling, not touching blood- or saliva-contaminated surfaces with bare hands, and not reaching blindly into a tray containing contaminated sharps instruments.
What are my infection-control responsibilities for temporary employees?
Answer: If the employee comes from an employment agency, the agency is responsible for bloodborne pathogens training, vaccinations, and providing proper follow-up evaluations following an exposure. You would be required by OSHA to provide training specific to your office, personal protective equipment, and a safe and healthy work environment. It is best if the contract between you and the agency describes who will be responsible for what.
Where do I go to find specific infection-control laws in my state?
Answer: Contact the state’s dental association. Also go to www.osha.gov/html/RAmap.html to contact the local or regional OSHA office for your state. You also may wish to contact a dental school in your area and ask for the infection control officer.
References available upon request.
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