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    The dangers of STDs in the dental practice

    What every dental professional needs to know about contracting STDs in the dental practice.

     

    In the dental lab, the risk for exposure continues, particularly in those diseases that can live outside the body, such as HBV and HCV. Impressions and implant components could have saliva and blood present. If the lab worker isn’t in compliance with the universal precautions, it can lead to an infection. Borg-Bartlett cites the universal precautions as the best defense against these types of exposures, starting at the dental practice. “Prior to packaging items that have saliva and blood on them, the dental staff should remove the blood and disinfect the items,” she says, then explains that the lab should also rinse and disinfect the items before proceeding with any manufacturing, per OSHA’s requirements in the Bloodborne Pathogen Standard and the recommendations by the CDC. 

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    In states where dental technicians can perform chairside services in the operatory, the technicians should also use personal protective equipment (PPE). PPE includes gloves, mask, safety eyewear or face shield, and gown. If the PPE isn’t provided by the lab, then the practice must provide them. “Dental technicians must abide by all state and federal regulations regarding participation in procedures such as All-on-4’s,” Borg-Bartlett says. The State Dental Board for each state will have guidelines on the legality of these types of relationships in the dental operatory. 

    One additional consideration pertaining to HIV exposure Dr. Reznik would add is for dental professionals to be aware of post-exposure prophylaxis, a short-term antiretroviral treatment to reduce the likelihood of HIV infection, and know how to get the treatment within two hours of the potential exposure. “You want to get that as soon as possible, preferably within two hours. We have no data for effectiveness after that, but the sooner, the better,” Dr. Reznik says. “They should have protocols in place. Whether it's corporate offices or private offices, you should have a protocol if there is a needle stick.”

    In 2016, the CDC released a summary that reviewed the practices in place and made recommendations to improve infection control practices. Borg-Bartlett explains that one of the new recommendations pertained to safety when administering anesthesia through a needle. The CDC recommended reducing the risk of a needle stick by looking for safer devices.

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    The CDC also recommended that each facility, dental practice or dental laboratory, needs to appoint an Infection Prevention Coordinator. “The CDC gives a good checklist in that summary. So appoint someone who is responsible for infection prevention,” Borg-Bartlett says.

    Both experts contend that when the dental practice or the lab follows the universal or standard precautions, there is no risk of contracting STDs and other serious diseases in the dental practice—at least not from dental work.

    “Both dental practices and dental laboratories must practice universal precautions as required by OSHA. This is for the protection of the employees in those organizations. To the best of my knowledge using universal precautions will protect these employees from STDs,” Borg-Bartlett says.

    “Be familiar with the CDC recommendations for standard precautions, truly be familiar with the OSAP's CDC checklist on how to follow them and what steps should be taken,” Dr. Reznik says. “And then there's nothing to worry about.”

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