Infection control and sterilization standards
What this domain tests
Infection-control questions test the standard of care, not microbiology trivia. Montana expects compliance with CDC dental infection-control guidance and OSHA’s Bloodborne Pathogens Standard; Board rules make violations a disciplinary matter.
Core rules
- Maintain a written exposure-control plan, offer hepatitis B vaccination, train staff, and provide PPE. Use standard precautions for all patients; treat blood and saliva as potentially infectious.
- Perform hand hygiene before and after patient contact and after glove removal. Wear gloves, mask, eye protection, and gowns when splatter is expected.
- Clean and then sterilize critical and semicritical instruments. Autoclaves require biological monitoring with spore tests at least weekly and a log; positive results trigger retesting, repair, and assessment of items processed since the last negative test.
- Use heat-sensitive high-level disinfectants for items that cannot be autoclaved. Use barriers or disinfect surfaces between patients.
- Dental unit waterlines must meet the CDC limit of no more than 500 CFU/mL of heterotrophic bacteria. Flush lines and maintain treatment according to the manufacturer.
- Sharps go in puncture-resistant containers; never recap by hand.
Worked example
A spore test is positive. The office should stop using that autoclave until it passes retesting, notify the person responsible for infection control, and determine whether instruments processed since the last negative test need reprocessing or patient notification. Simply running one more cycle without investigation is wrong.
Traps
“Cold sterile” is not a substitute for autoclaving. Gloves do not replace hand hygiene. A surface wipe is not sterilization. Do not confuse OSHA worker-protection duties with CDC patient-care duties; both apply.