CROSS INFECTION CONTROL FOR DENTAL CLINICS

Cross infection control for dental clinics



Cross infection control for dental clinics

Literature Review

Infection control refers to a comprehensive and systematic program that, when applied, prevents the transmission of infections agents among persons who are in direct or indirect contact with health care environment.

The increased profile of infections arising from blood-borne viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) since the mid-1980s has resulted in detailed scrutiny of infection control procedures within dentistry. A wide range of organisms pose a threat in the dental setting. However, of the blood-borne viruses, HBV is by far the most infectious and it is fortunate that a vaccine exists to protect dental staff. However most patients are not similarly protected and there also exists the potential for transmission of HCV and HIV to both patients and staff. Since the mid-1980s, recommended measures such as the wearing of gloves, masks, and the autoclaving of handpieces have been reviewed regularly, with additional recommendations continually being issued in the light of new scientific evidence. In particular, the concept of universal infection control, whereby all patients are treated as potential carriers of pathogenic micro-organisms, has become accepted best practice. However, there is little information describing the development of these guidelines or evidence that their publishers have subsequently assessed the uptake of the guidelines. It is also unclear what implementation strategies have been employed, other than direct mailing of questionnaires to members of representative organisations. The present research aimed to identify the dissemination methods which have been employed within this field as well as gaining an understanding of areas in which dental health care workers' (DHCWs') adherence to guidelines are deficient and on which future research should be focused.

The clinical application of "universal precautions," or UP, is most familiar to virtually every health care professional trained within the past 15 to 20 years. This long-standing set of routine infection control precautions was designed to prevent transmission of HBV, HIV, HCV and other bloodborne pathogens during treatment procedures. Key for dental professionals was inclusion of the statement that blood and other body fluids, including saliva, were considered potentially infectious for occupationally transmitted pathogens.14 Interestingly, the perceived primary rationale for UP in many people's minds was prevention of HIV transmission, even though HBV clearly was documented to be far more infectious in occupational health care settings.(Abdullah,2002,21)

Infection prevention

Infection prevention and control are key elements in providing a safe environment for patients and staff within a dental practice.Recent media interest and publications have created heightened concern.6 The discovery of vCJD and the potential for spread of not only this agent, but also bloodborne viruses and other infectious agents, via inadequately decontaminated instruments has also led to increased concerns.

As early as 1976, the American Dental Association published infection control (IC) guidelines, and periodically these have been updated.Shortly after the start of the AIDS epidemic, specific work practice guidelines were also developed to help minimize the risk of bloodborne pathogen exposure within the ...