Infection Control, Sterilization, and Safety Standards
What this domain tests
This domain checks whether you can map a real office practice onto the Board's infection control rule, the CDC infection control guidelines for dental settings, and OSHA's bloodborne pathogens standard at 29 CFR 1910.1030.
Program-level requirements
- A written exposure control plan, reviewed and updated, with the hepatitis B vaccination offered at no cost and post-exposure evaluation available.
- Annual bloodborne pathogens training with a training record.
- Engineering and work practice controls: sharps containers, safe needle recapping, hand hygiene, and PPE matched to anticipated exposure.
- Labeled waste, regulated medical waste handling, and laundry procedures.
Sterilization and disinfection
- Critical and semicritical items are cleaned, packaged, and sterilized, generally by steam autoclave.
- Monitor every load with chemical indicators and monitor the sterilizer at least weekly with biological spore tests, keeping a log.
- A positive spore test means stopping use of that sterilizer and recalling or reprocessing items processed since the last negative test.
- Environmental surfaces get an EPA-registered hospital disinfectant with a label claim, or barriers that are changed between patients.
- Single-use items are not reused; dental unit waterlines are flushed and treated per the office's written program.
Enforcement
The Board can discipline a licensee for failing to follow required infection control practices, and infection control is a standard continuing education content area.
Worked example
A spore test comes back positive on Tuesday morning; the office ran three loads on Monday. The wrong response is to autoclave the test vial again and keep working. The right sequence is: take the sterilizer out of service, identify and reprocess every instrument from loads since the last negative test, arrange service, and then verify with consecutive negative biological tests before returning to patient care.
Traps
- Substituting cold chemical soak for sterilization of critical items.
- Wiping a handpiece with disinfectant and calling it sterile.
- No written log, so the office cannot prove monitoring occurred.
- Confusing OSHA (worker protection) with the Board rule (patient protection); both apply.