Minimizing the risk of exposure to bloodborne pathogens is a critical priority in dental settings. Dental professionals are at increased risk of exposure to bloodborne viruses—including hepatitis B (HBV), hepatitis C (HCV), and HIV—through needlesticks or contact with mucous membranes. The risk of transmission increases with the depth and severity of exposure.
Regulatory Guidance
The Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard (29 CFR 1910.1030) mandates that dental practices implement a written Exposure Control Plan and follow universal precautions. Employers must provide engineering and work practice controls, personal protective equipment (PPE), training, and post-exposure evaluation and follow-up. The Centers for Disease Control and Prevention (CDC) also outlines basic expectations for safe care in dental settings.
Key Strategies to Prevent Sharps Injuries and Pathogen Exposure
- Stay Focused and Avoid Distractions
- Take your time and stay present during procedures to prevent accidental injuries.
- Organize Instruments Carefully
- Arrange instruments in a single layer on trays.
- Avoid stacking used instruments.
- Use Covered, Puncture-Resistant Containers
- Transport contaminated instruments in containers specifically designed to prevent injury.
- Implement Safe Needle Handling Techniques
- Use the one-handed scoop method or a needle recapping device.
- Recap before cartridge or needle changes.
- Never pass uncapped needles.
- Dispose of Sharps Immediately
- Use sharps containers that are visible, easily accessible, and not hidden behind doors or drawers.
- Remove Burs Promptly
- Detach burs from handpieces immediately after use.
- Alternatively, cover with an inverted plastic cup until removal is possible.
- Use Safety-Engineered Devices
- Adopt safety syringes and self-sheathing needles when available (e.g., SecurInject, 1SHOT Safety Syringe, Ultra Safety Plus XL).
- Wear Utility Gloves
- Use heavy-duty gloves when cleaning instruments or handling sharps.
- Provide Ongoing Training and Protocols
- Educate staff on injury prevention.
- Maintain clear, written exposure and needlestick response protocols.
- Sharps Disposal Protocol
- Place all sharps in designated containers immediately, using caution and avoiding unnecessary handling.
Post-Exposure Management
All dental facilities must establish a clear protocol for post-exposure evaluation and care. When an injury occurs:
- Immediate Action: Wash wounds with soap and water. Flush mucous membranes with water.
- Report the Incident: Notify the designated safety officer or supervisor.
- Seek Medical Evaluation: Follow CDC and U.S. Public Health Service guidelines for testing and prophylaxis.
- Source Patient Testing: Encourage testing for HBV, HCV, and HIV. Testing may be declined by either party.
- Document Thoroughly: Include details of the exposure and the instruments involved.
Maintaining a culture of safety is essential to protecting dental teams and their patients. Consistent adherence to safe practices, use of protective equipment, and proactive incident response protocols can significantly reduce the likelihood of bloodborne pathogen exposure.
Injury prevention is not only a regulatory requirement—it’s a daily commitment to the health and safety of your entire dental team.
Resources
- OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)
- CDC Summary of Infection Prevention Practices in Dental Settings
- ADA Guidance on Sharps Safety and Disposal
- CDC Checklist for Infection Prevention in Dental Settings