The Venturi Fluoride Saturator project.

This study was conducted to determine whether Venturi Fluoride Saturator (VFS) systems could be used to fluoridate small community and school water supply systems with an acceptable level of maintenance. VFS systems were installed and operated at four school and six community well sites according to state and federal regulations and recommendations. School VFS systems were unable to maintain optimum fluoride residuals even with substantial maintenance. All six community well site VFS systems performed acceptably, with only a few short lapses. VFS system maintenance was labor intensive. Recurring problems were caused by lengthy equipment delivery delays, the unavailability of timely technical assistance to support the VFS system, and the inadequate quality of VFS equipment and design. Based upon these findings, further expansion of the use of VFS systems either for community or school fluoridation cannot be recommended. Additional study of and improvements in the VFS system are indicated. Three major recommendations appear appropriate: (1) extensive laboratory testing of the VFS system concept under controlled conditions should be performed to determine the functioning parameters of this equipment under different hydrodynamic conditions; (2) additional research and development of the VFS unit to improve the quality of operations and the quality control of manufacturing and assembly should be undertaken; and (3) a VFS equipment distribution network should be developed, with sufficient logistical and technical support to supply equipment parts and expertise for installation, monitoring, and maintenance in a timely and efficient manner.

Use of tobacco prevention and cessation strategies and techniques in the dental office.

To establish a uniform method of determining dental team members' involvement in tobacco prevention and cessation, the National Cancer Institute developed assessment guidelines. The Minnesota Department of Health, Dental Health Program, was named to design and implement the first major study using these guidelines. Study results show most Minnesota dentists and staffs have not received formal training, but want to learn how to help their patients.

Effectiveness of dental office instrument sterilization procedures.

To evaluate instrument sterilization procedures in Minnesota, biological indicators were used to monitor 406 sterilizers in 381 dental offices. Findings suggest a general improvement in instrument performance over that of a decade ago, but sterilization failure rates are still too high. Sterilizer operator errors are a major cause of sterilization failures. BIs are useful in monitoring sterilization performance only when sterilization procedures are performed consistently and competently by well-trained staff using adequately maintained equipment.

Dental health care workers' response to the HIV epidemic.

Random samples of Minnesota DHCWs were surveyed in late 1989 regarding HIV-related and infection control KAPs. Response rates were: dentists 69% (438/631); hygienists 73% (439/603); and assistants 56% (384/691). More than 50% of DHCWs said they did not have sufficient information to safely and effectively provide care for HIV-infected patients. Use of infection control techniques varied considerably. Parenteral injuries were relatively high, but only 5% of DHCWs believed they could have been exposed to HIV from these occurrences, and few DHCWs sought medical evaluation. Less than 45% of offices had a blood/body fluid exposure staff protocol, and few offices had a policy for HIV-infected staff. Nearly twice as many DHCWs said offices have an ethical versus a legal duty to treat HIV-infected persons. Low percentages of DHCWs believed the private practice dental office is the best place to treat HIV-infected patients, but approximately 50% said they would provide care. Twenty percent indicated that a diagnosed HIV-infected person had been seen at their office. Seventy-six percent said staff had been uncomfortable treating HIV-infected patients, 14% said staff had refused to treat, and 10% said referrals were difficult. DHCWs exhibited substantial improvements in their HIV-related KAPs compared to previous surveys. Nevertheless, additional cognitive and behavioral changes are necessary to ensure that all DHCWs provide care with the highest technical, legal, and ethical standards for all patients.

Infection control practices and beliefs of Minnesota dental hygienists and dental assistants.

To obtain comprehensive information about the knowledge, attitudes, and practices of Minnesota dental hygienists and registered dental assistants, a questionnaire was mailed to random samples of both groups in the fall of 1988. Most assistants and hygienists claimed to always wear gloves, but substantially fewer indicated always wearing a mask. Use of eye protection showed even lower compliance, with less than half of either group routinely using protective eyewear or a face shield. Assistants and hygienists reported incurring numerous needlesticks and instrument injuries. A contributing factor may be that many staff were still recapping needles with an unprotected hand. Most people who had not been vaccinated against hepatitis B said that they would be immunized if their employer or health insurance paid for it. Less than one-half of either group felt knowledgeable about infection control. Only one-third of assistants and less than one-half of hygienists claimed to be familiar with the Centers for Disease Control's "Recommended Infection Control Practices for Dentistry." This is consistent with assistants' and hygienists' reported infection control related behaviors. Other than gloving, many recommended infection control measures--masking, wearing protective eyewear and uniforms, hepatitis B immunization, and proper handling of sharps--were not employed by a substantial number of respondents. Many respondents indicated insufficient knowledge to safely and effectively care for patients with hepatitis B, hepatitis B carriers, or individuals infected with the human immunodeficiency virus (HIV). This is reflected in the relatively small percentages of respondents who indicated willingness to treat these patients.(ABSTRACT TRUNCATED AT 250 WORDS)