California Infection Control Regulations for Dental Professionals.

Infection control regulations that affect dental professionals come from several regulatory agencies and are increasingly complex. Staying up to date on changes and the overlapping requirements can challenge a busy dental practice. This article reviews the current regulations in California and suggests methods for ensuring every dental office is in compliance.

Health considerations for oral piercing and the policies that influence them.

With the increase in popularity of piercings, the health care professional needs to be aware of the complications that can occur due to lack of regulations of the piercing establishments. Due to lack of training of piercing professionals and lack of enforcement of sterilization procedures, infection and life threatening complications can arise. Complications include, but are not limited to, hemorrhage, nerve damage, gingival recession, HIV, tongue swelling, tooth fracture, Bactermia, Ludwigs angina, increase salivary flow, jewelry aspiration, and localized infection. Texas requires an individual to be 18 years of age to receive a piercing. However, Texas does not regulate the piercing establishment or the artist providing the services. Oral health care providers should be aware of the lacking regulations of piercing studios so they can be more vigilant of oral complications that may occur.

Is your office prepared for an accidental needlestick or other unexpected exposure incident?

Recommendations and mandatory guidelines for preventing and managing needlestick incidents and other accidental exposures to bloodborne pathogens in healthcare facilities have been published by the Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) for more than 2 decades. Over the years, the incidence of official enforcement actions has declined and a complacency about the standards may have evolved in some dental offices. Some practitioners may not have written an occupational exposure incident protocol or made appropriate arrangements for medical laboratory testing and postexposure medical evaluation following an unexpected needlestick or other exposure incident in the office. When an unexpected event occurs, practitioners may become confused regarding the steps to be taken, and may turn to their local dental society or fellow practitioners for guidance. The provided information may or may not be complete, accurate and/or current. Implementation of periodic personnel training to prevent exposure incidents is extremely important and could ultimately save a dental practice thousands of dollars in expenses related to the occurrence of even one exposure incident, as well as save the life and/or career of a dental healthcare provider. This article does not comprehensively detail all infection control and bloodborne pathogen transmission prevention requirements for dental offices. Rather, the article provides suggestions for dental practitioners regarding the step by step management of exposure incidents, and provides resource information for additional steps that can be taken towards prevention, improved office compliance, and improved litigation protection.

The business of dentistry.

There are many reasons why someone chooses to become a dentist: a family member was in the profession, they have a proclivity for the sciences of health care, or they like the autonomy of having their own practice. Mark Gonthier, assistant dean for admissions of Tufts University School of Dental Medicine, offered this description of the ideal dental school applicant, "We are looking for mature, well-rounded students capable of handling the rigor of the basic sciences curriculum and are equally adept and committed to providing quality comprehensive patient oral health care" Few dentists will report that they chose their profession because they wanted to run a small retail business.

Dentistry and the ethics of infection.

Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but are obliged not to treat any patients if they themselves are HIV-positive. Furthermore, prospective dental students are now screened for hepatitis B and C and HIV, and are not allowed to enrol on Bachelor of Dental Surgery degrees if they are infectious carriers of these diseases. This paper will argue that: (i) the current restriction on HIV-positive dentists is unethical, and unfair; (ii) dentists are more likely to contract HIV from patients than vice versa, and this is not reflected by the current system; (iii) the screening of dental students for HIV is also unethical; (iv) the fact that dentists can continue to practise despite hepatitis B infection, but infected prospective students are denied matriculation, is unethical; and (v) that the current Department of Health protocols, as well as being intrinsically unfair, have further unethical effects, such as the waste of valuable resources on 'lookback' exercises and the even more damaging loss of present and future dentists. Regulation in this area seems to have been driven by institutional fear of public fear of infection, rather than any scientific evidence or ethical reasoning.