Infection control is the cornerstone of any successful dental practice.
All Virginia Family Dentistry dental settings maintain an active and ongoing infection prevention program. We follow applicable federal and/or state law, as well as the standard precautions and other infection prevention recommendations contained in the Centers for Disease Prevention’s (CDC) Guidelines for Infection Prevention in Dental Healthcare Settings and the Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.
Federal Law: This applies to all states under OSHA’s Bloodborne Pathogens Standard.
State Law: Virginia has adopted the CDC Guidelines for Infection Control in Dental Settings.
VA STATE RESOURCES:
Virginia State Dental Board
Virginia Board of Dentistry Laws and Regulations
Standards for Professional Conduct in The Practice of Dentistry
Virginia Department of Environmental Quality: Solid & Hazardous Waste
Virginia Department of Environmental Quality: Dental Rule
Virginia Occupational Safety and Health (VOSH)
2022 VA Rules for Dentistry and Dental Hygiene
Infection Prevention and Control collaboration with the CDC
VIRGINIA FAMILY DENTISTRY – complies with the OSHA Bloodborne Pathogen Standard requirements for hand washing that include (29 CFR 1910.1030(d)(2)(iii)):
PURPOSE: To establish proper hand hygiene practices and education to decrease the risk of cross contamination from patients, patient care equipment and the health care environment and decrease healthcare associated infections.
Dental Unit Waterlines
Water filtration system OSO PURE ADG-3600 installed in-line to our incoming water supply. This allows for multi-stage filtration as well as ultraviolet disinfection for 99.9% viable bacterial reduction, with addition to the OSO PURE Aquious Disinfectant Generator.
PROTOCOL: All DUWL will be treated and tested (monitored) in order to maintain an acceptable water quality of ≤500CFU/ml.
Water quality will be tested quarterly using in office product Quick Pass.
Delivery of Sterile Surgical Irrigation. The following are used to deliver sterile solutions during surgical procedures: Sterile single-use devices Sterile Surgical Solution – The following is used as the sterile surgical solution: 0.9 % sodium chloride Irrigation
Personal Protective Equipment
VIRGINIA FAMILY DENTISTRY – follow the Centers for Disease Control guidelines and OSHA’s Bloodborne Pathogens Standard for wearing PPE. (29 CFR 1910.1030(d)(3)) Also, refer to the Office’s Exposure Control Plan found in the OSHA manual.
PURPOSE: To explain the use and availability of personal protective equipment (PPE) which is designed to protect the skin and the mucous membranes of the eyes, nose, and mouth of dental healthcare personnel (DHCP) from exposure to blood or other potentially infectious material (OPIM).
Respiratory Hygiene/Cough Etiquette
PURPOSE: Respiratory hygiene/cough etiquette infection prevention measures are designed to limit the transmission of respiratory pathogens spread by droplet or airborne routes. The strategies target primarily patients and individuals accompanying patients to the dental setting who might have undiagnosed transmissible respiratory infections, but also apply to anyone (including DHCP) with signs of illness including cough, congestion, runny nose, or increased production of respiratory secretions.
iWave Air Filtration Systems have been installed in the HVAC systems of all locations. This system uses ions to reduce pathogens, allergens, particles, smoke and odors in the air. The ions remove hydrogen molecules from viruses, bacteria or mold, eliminating the pathogens energy source.
In 2007, CDC published updated guidelines for preventing the transmission of infectious agents in health care settings. As a result, two areas of practice relevant to dentistry were added to the set of standard precautions: respiratory hygiene/cough etiquette and safe injection practices.
Safe Injection Practices
PURPOSE: To ensure safe injection practices when administering medications via injection to patients, and to prevent occupational exposure involving patient blood or OPIM to DHCP that may occur when handling contaminated sharp instruments and devices.
Aseptic injection technique: Method to prevent contamination from microorganisms by using a new sterile syringe and sterile needle to draw up medications while preventing contact between the injection materials and the non-sterile environment.
Sterilization of Handpieces and other devices attached to air and waterlines
VIRGINIA FAMILY DENTISTRY – will follow the manufacturer’s instructions for use (IFU) and CDC recommendations for cleaning/maintenance and sterilizing of handpieces and other items including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high level or surface disinfected.
PURPOSE: To establish the appropriate procedure for proper cleaning/maintenance and sterilizing of dental handpieces and other items that can be removed from the air or waterlines of dental units in order to destroy all microorganisms.
Sterilization Monitoring Protocol
To create a quality control system to validate the effectiveness of the instrument sterilization process in order to reduce the risk of infection, promote patient safety and maintain high standards for infection control.
VFD use mechanical, chemical, and biological monitors according to manufacturer instructions to ensure the effectiveness of the sterilization process. Maintain sterilization records for 3 years in accordance with state and local regulations.
Mechanical monitoring: M11 autoclaveproper working time, temperature, and pressure.
Biological indicator (BI): A device used weekly to monitor the sterilization process that consists of a known number of microorganisms (bacterial spores) known to be resistant to the mode of sterilization being monitored. Indicate whether all the parameters necessary for sterilization were present.
Chemical indicator (internal and external): Device used to monitor the presence or attainment of one or more parameters of the sterilization process. Integrators Type 5 used inside each instrument pack. They are intended to detect potential sterilization failures.
Patient-care items (dental instruments, devices, and equipment) are categorized as critical, semicritical, or noncritical, depending on the potential risk for infection associated with their intended use. Critical items used to penetrate soft tissue or bone have the greatest risk of transmitting infection and should be sterilized by heat. Semicritical items touch mucous membranes or nonintact skin and have a lower risk of transmission; because the majority of semicritical items in dentistry are heat-tolerant, they also should be sterilized by using heat and steam. Item non-heat tolerant are disposable only. FDA-cleared sterilant and EPA registered disinfectants must have clear label claims for intended use, and manufacturer instructions for use must be followed.
VFD is following established policies and procedures for routine cleaning and disinfection of environmental surfaces in dental health care settings recommended by CDC. Clean and disinfect clinical contact surfaces that are not barrier-protected with an EPA-registered hospital disinfectant after each patient. Use an intermediate-level disinfectant (i.e., tuberculocidal claim) if visibly contaminated with blood. We follow manufacturer instructions for use of cleaners and EPA-registered disinfectants (e.g., amount, dilution, contact time, safe use, disposal).
VIRGINIA FAMILY DENTISTRY – has FDA-cleared sharps containers that are closable, labeled, and color-coded in accordance with OSHA Standard 1910.1010 (g)(1)(i). Refer to Transportation Protocol.
PURPOSE: To establish procedures for proper handling, storage and disposal of all types of hazardous waste from dental practices.
VFD has established an effective, ongoing training and education program that will ensure new and current dental health care personnel (DHCP) understand and follow infection prevention and safety principles to protect patients and themselves from exposure to blood and other potentially infectious materials (OPIM)