The Risk of Cross-Infection Between Dental Auxiliaries and Patients
Dental personnel, including auxiliaries, are always at risk from cross-infection. The mouth is a permanent source of microorganisms that can be transmitted and infect others. The dental profession has traditional standards for cross-infection control, but with more recent concerns by the public and the profession, a more formalized and extended teaching of cross-infection control has been introduced into the curriculum.
The importance of infection control in dental settings cannot be understated, and failure to abide by these standards will endanger both patients and dental workers. Herpes, hepatitis, HIV, tuberculosis, Pseudomonas aeruginosa, MRSA, and Candida albicans are some of the most common cross-infections between patients and dental workers.
From Patient to Dental Workers
A patient’s oral microorganisms can be spread either through direct or indirect contact, depending on the infection, as well as through injection, or droplet inhalation. When it comes to hepatitis C, the risk of transmission is not fully evaluated, but many dental workers were shown to have a high frequency of antibodies to the virus, meaning that exposure has occurred. Occupational hazards such as needle sticks or contaminated sharp object accidents are the primary means of contamination with HCV.
Cross-infection from herpes type 1 is possible through saliva contamination and contact. The most common type of infection was via contaminated dental record cards with herpetic whitlow on the fingers being a typical lesion amongst dental personnel before the routine use of gloves.
From Dental Workers to Patients
Even though the transmission of pathogens from dental personnel to patients is rare, it can still happen if the proper protective protocols are not followed. One case in a dental office in Florida where six patients were infected with HIV from a dentist at the dental practice. The HIV strain was identical in both the dentist and the six patients.
From Patient to Patient
Like before, patient to patient cross-infection is possible when the proper procedures and protocols are enforced and applied. There was one case reported in New South Wales, Australia where five of nine patients seen at that practice on the same day got infected with HIV. While the surgeon remained HIV-negative and four of the five not exposed to any other risk factors, the fifth admitted to having sex with partners of unknown HIV status.
With Methicillin-resistant Staphylococcus aureus (MRSA), it’s important to remember that it can be a severe health risk for older populations. It’s possible for the infection to be discharged from surgical wards and can reach the dental worker’s hands. Dental auxiliaries and dentists can be passive vectors. Dental treatment of patients with MRSA infections needs to follow strict infection control practices.
From Patient to Dental Technicians
Cross-infection control is the responsibility of all members of staff. Its effectiveness influences by the standards by which each member operates as well as how effectively they cooperate. It’s recommended to disinfect any dental work in the form of impressions, gypsum casts, dentures, or wax registration records before being sent to the lab. It’s also advisable that the dental technician performs the disinfection provided they use safe packaging. The entire lab can be contaminated if cross-infection control is neglected.
Dental Specialties Institute, Inc. provides a Dental Board of California program on Infection Control Certification as well as Infection Control, California Dental Practice Act, and Law and Ethics Review. For more information, please feel free to contact us directly.