Today's minimal requirements for a practical dental office infection control and exposure control program

The current climate in society regarding infectious diseases in general, and herpes, hepatitis, and HIV infections in particular, dictates that today's dental practices must use effective infection control techniques. The Occupational Safety and Health Administration continues to inspect, cite, and fine health care facilities. More states are implementing regulations concerning the operation of health care facilities. Patients are becoming more sophisticated in their scrutinizing of the dental and medical professions' approach to asepsis. Media coverage of exposure incidents is becoming more intense. All these factors leave dentists no choice; they must implement appropriate infection control techniques. The life-time cost of effective infection control is far less than one malpractice settlement. Implementation of an effective infection control program to promote dental asepsis can be cost-effective. In addition, it can be a practice builder.     

A radiographic quality control system for the dental office

The sensitivity of 18 permanent hemopoietic cell lines to Cyclosporin A (CsA) was tested in a 3H-thymidine incorporation rate assay. Two human T cell lines (Molt4 and CEM) were significantly inhibited by a CsA concentration of 0.5 microgram/ml. Not affected at all or only inhibited by 10 to 20 times higher CsA concentrations were: three human B cell lines (4413a, Daudi, Raji), a monkey B cell line (B95-8), a mouse plasmocytoma line (X63-Ag8/653), a human non-B T cell line (Reh), four human myeloid lines (HL-60, ML-1, ML-2, ML-3), a human myelomonocytic line (Karpas 230), four human monoblastic lines (U 937, SU-DHL-1, THP-1, Karpas 241) and a human erythroid line (K 562). It therefore seems that among permanently growing hemopoietic cells a cell type specificity for T cells also exists.     

Managed care: a call for strategic management in the dental office

Strategic management of any business will enable it to prosper in challenging times of change. Strategic planning is not characteristically found only in large corporations. Indeed, small business, such as solo private practices, can gain much from the process. The successful practice is one that is proactive rather than reactive; it has learned to become the beneficiary of change, rather than its victim.     

Israeli dentists: a survey of infection control office practices and care of medically compromised patients

A familial complex chromosomal rearrangement (CCR) was ascertained through a mentally retarded, dysmorphic individual. Carriers of the CCR have the karyotype 46,XX or XY, t(6;15)(q16;q21), ins(3;6)(q12;q14q16), and malsegregation of the CCR resulted in loss of the segment 6q14 to 6q16 in the proband, and in an additional copy of the same segment in three members of the extended family. The proband has features similar to other reported cases with deletion of 6q1. The individuals with duplication of 6q14 to 6q16 have moderate mental retardation, short stature, obesity, microcephaly, brachycephaly, a short smooth philtrum, central hair whorl, simian creases, 5th finger brachydactyly and skeletal disproportion. In the 4-generation family, CCR carriers have a 20% empiric risk of phenotypically abnormal livebirths.     

General and oral manifestations of human immunodeficiency virus infection: a general overview with guidelines for infection control in the dental practice

The human immunodeficiency virus (HIV-1), responsible for the acquired immunodeficiency syndrome, has in the span of a decade become an epidemic of global proportions. Oral lesions, head and neck diseases are often the first manifestations of HIV-1 infection and AIDS. It is essential for all dentists to familiarize themselves with the oral manifestations of HIV-infection as well as the dental management of such manifestations. In addition to all health care, professionals should become acquainted with the "universal precautions" recommended by the Centers for Disease Control, in order to protect themselves, their staff, and their patients to minimize, if not totally eliminate, any risk of infectious disease transmission in the health care setting. This paper presents a general overview of the human immunodeficiency virus; oral manifestations of HIV-infection; "universal precautions" and guidelines for the control of infection in the dental practice.     

Infection control in dental radiology

Although exposure to blood is rare in oral and maxillofacial radiology, contact with saliva occurs. Thus the spread of infectious diseases is possible through cross-contamination, and specific infection control protocols and unit dosing of items are needed. This article outlines rationale for implementing state-of-the-art infection control procedures; and explains federal standards and guidelines with an impact on infection control and occupational safety in dental radiology procedures.     

Cross-infection control in Malaysian dental practice

STUDY OBJECTIVE: The aim was to study the spectrum of clinical problems and outcomes in infants born at an urban academic hospital. In consequence, as part of the overall study, the incidence of congenital anomalies and the outcomes of affected infants were recorded. DESIGN: This was a prospective, hospital-based study, undertaken on liveborn infants born over a 3-year period, 1 May 1986 to 30 April 1989. SETTING: Kalafong Hospital, Pretoria. MAIN RESULTS: A total of 17,351 liveborn infants was examined and the total congenital anomalies incidence was 11.87 per 1,000 livebirths. The central nervous system was the system most frequently involved (2.30 per 1,000 livebirths), followed by the musculoskeletal system (2.13 per 1,000 livebirths). The commonest individual congenital anomaly was Down syndrome (1.33 per 1,000 livebirths), followed by neural tube defects (0.99 per 1,000 livebirths) and ventricular septal defects (0.69 per 1,000 livebirths). In 11% (2.25 per 1,000 livebirths) of neonatal deaths, infant loss was attributable to congenital anomalies. CONCLUSIONS: The incidence of congenital anomalies in black South African neonates, born in an urban setting, is as high as in other First- and Third-World countries, and the incidence of some individual congenital anomalies is higher. This study indicates the need for further research and the establishment of prenatal, genetics and paediatric facilities to manage these problems.     

HIV, health care workers and patients: how to ensure safety in the dental office

What can be done to preserve the high standards of patient care, give reasonable assurances to patients and acknowledge the rights of health care workers? Conscientious adherence to infection control is the most responsible option available.     

Hepatitis B virus infection in dental surgical practice

Sixty-one dental surgeons at King's College Hospital were interviewed to establish the incidence of attacks of viral hepatitis and to relate this to environmental risk factors. Six (10%) had a history of hepatitis, in one case due to infection with the hepatitis B virus. Screening blood for HBsAg by radioimmunoassay showed no carriers of the antigen, but transient antigenaemia was observed in one dentist. Antibody to HBsAg, tested by radioimmunoassay, was detected in four dentists (7%), only one of whom had had clinical hepatitis. Dental surgeons may be more at risk from infection with the hepatitis B virus than the general population, although this should be minimised in hospital practice, where the most infected patients will already have been identified and appropriate precautions can be taken. The risk of transmission from an antigen-positive dentist to his patients is probably much smaller, and there is no evidence to restrict his clinical activities.     

Infection control in the dental practice with emphasis on the orthodontic practice

Infections present a significant hazard in the orthodontic office because they can be transmitted by blood or saliva through direct or indirect contact, droplets, aerosols, or contaminated instruments and equipment. Because the incidence of certain microbial cross-infections in the dental environment has not been well documented, orthodontic personnel may not take the problem of cross-infection as seriously as they should, and they may transmit or contract more infections than they realize. The use of effective infection-control procedures in the orthodontic office and laboratory will prevent cross-contamination that may extend to the orthodontist, office staff, assistants, and patients. The goal of this article is to present infection control in a simple, yet comprehensive, manner, and to encourage all orthodontic practitioners to implement essential infection-control procedures in their practices.