Infection Control and Clinical Safety Requirements
What you must know
California dental infection control rests on the Cal/OSHA Bloodborne Pathogens Standard plus CDC-style clinical practice. The employer's written Exposure Control Plan must be reviewed and updated and must describe exposure determination, methods of compliance, hepatitis B vaccination (offered free within 10 working days of assignment, with declination documented), hazard communication, and recordkeeping.
Every patient is treated as potentially infectious: gloves, mask, eye protection, and gowns as indicated; hand hygiene before and after; engineered sharps devices and rigid sharps containers; no recapping by hand. Instruments are cleaned (ultrasonic or washer-disinfector) before sterilization - cleaning is not sterilization. Sterilizers are monitored mechanically each load and biologically (spore testing) at least weekly, with results logged; a positive result triggers recall of the load and retesting.
Apply Spaulding logic: critical items (surgical, periodontal, and endodontic instruments that penetrate tissue) require sterilization; semi-critical items (contacting mucosa without penetrating, such as mouth mirrors and impression trays) require sterilization or high-level disinfection; non-critical surfaces require an EPA-registered hospital disinfectant used per label. Use barriers on surfaces and handpieces, maintain dental unit waterlines, and manage regulated waste and amalgam under the applicable rules.
Traps
- Calling ultrasonic cleaning sterilization.
- Monthly spore testing when the standard is at least weekly.
- Using a surface disinfectant on instruments or reusing single-use items.
- Skipping post-exposure evaluation and prophylaxis after a needlestick.
Rule of thumb
Ask whether the item penetrates tissue or touches mucosa. If yes, sterilize when feasible; if it touches only intact skin, clean and disinfect. When in doubt, sterilize.