In December 2003, the Centers for Disease Control and Prevention (CDC) revised and repackaged its infection control guidelines to the dental profession for the first time since 1993. More than 200,000 copies were shipped across the nation to dentists, hygienists, assistants and educators. The revised guidelines will help dentists improve infection control protocols within the dental office and anticipate new areas of concerns, according to an article in the May 2004 issue of AGD Impact, the newsmagazine of the Academy of General Dentistry (AGD).
The document is more than 100 pages long, but less than a quarter of it is dedicated to the actual recommendations. The bulk of the guidelines comprise research, background material and supporting supplements from more than 450 articles. It features contributions from hundreds of experts from dozens of health-care fields to provide evidence-based recommendations for everything from staff education and management to the efficacy of alcohol-based hand rubs.
It's hoped that the overhauled guidelines will provide dentists a clearer understanding of why certain recommendation were made. Though the CDC lacks regulatory and enforcement powers, the guidelines are de facto regulations; they are the template from which most states legislators and local dental boards draw their various laws and rules.
"Proper infection control procedures can prevent transmission of diseases to patients and dental health care personnel, " said William G. Kohn, DDS, associate director for science in the CDC's Division of Oral Health. "This new document provides the latest information to assist the dental profession in maintaining its already strong record of safe dental care."
Broadly, the guidelines are divided into two parts. The first half is dedicated to the evidence-the clinical studies, background information, and evidence-based rationales behind the recommendations. The second half of the document comprises the actual guidelines. According to the CDC, some recommendations are new, but most carryover from 1993 and others were integrated from the infection-control reports, such as the CDC's hand hygiene and needle-stick guidelines and the Occupational Safety & Health Administration's 1991 blood-borne pathogen standard. New guidelines cover issues such as work restrictions for health-care personnel occupationally exposed to or infected with infectious diseases, and latex hypersensitivity.
Each recommendation is supported by evidence then ranked according to the level of evidence. From an infection-control consultant's perspective, the guidelines should make it easier for dentists to discover what's needed to achieve good infection control, using specific policies and procedures, and backing it up with research and cited studies.
Admittedly, it's a huge amount of information for a busy GP to sift through, much less implement. Several resources from the CDC and dental organizations are available to help dentists understand and implement the recommendations.
The AGD is a non-profit organization of more than 37,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.