Safety and Infection Prevention Guidance for
Oral Healthcare Environments

OSAP supports infection prevention and safety regulations and guidance from governmental agencies and other recognized evidence-based sources.

When situations occur for which recognized guidance has not yet been developed, the leadership of OSAP may convene a representational taskforce of key stakeholders to research the issue.  If the scientific evidence supports it, the taskforce may work to develop appropriate guidance to help the dental community.

Such is the case for a recent project that OSAP has undertaken.

Infection Control Considerations for Dental Services in Sites Using Portable Equipment or Mobile Vans - DRAFT GUIDANCE

Introduction

Dental infection control recommendations from the Centers for Disease Control and Prevention (CDC) apply to all settings where dental services are provided, including those that use portable dental equipment or mobile van systems. Such settings often present challenges in implementing these guidelines. The Organization for Safety and Asepsis Procedures (OSAP) formed a national advisory group to develop a practical community site assessment and corresponding infection control and safety checklists. These checklists offer infection control guidance for oral health surveys, screenings, preventive care and treatment regardless of setting. This guidance is based on general principles of infection control and is determined by the provider's level of anticipated contact with the patient's oral mucous membranes (MM), blood or saliva contaminated with blood.

Reviewing the DRAFT guidance tools

With the understanding that the tools are still in draft form, OSAP encourages dental healthcare personnel and others involved in delivering dental care outside the traditional dental setting to review and comment. 

These guidance tools are designed to help dental programs determine what factors present challenges to providing safe, quality care and to make decisions about possible adaptations or the need to select another site to provide services. Forms are formatted to answer specific questions about the site, personnel and procedures. Answers to the questions on the forms should be analyzed in terms of the level of services to be provided and any special circumstances related to the site or the patient population. Space is provided on the forms to summarize findings and decisions and create an action plan to overcome any identified challenges.

The Site Assessment tool is best used when considering a new site to deliver services, although existing sites also should be assessed to determine possible problems that may have been overlooked or have not yet been addressed. For mobile vans, questions would relate to both the van and the site where it is parked. The Infection Control Checklist for Dental Settings Using Mobile Vans or Portable Dental Equipment is organized around the level of anticipated contact with mucous membranes, blood or saliva contaminated with blood and the 4 Basic Principles of Minimizing Transmission of Bloodborne and Infectious Diseases:

1. Take Action to Stay Healthy
2. Avoid Contact with Blood and Other Potentially Infectious Body Substances
3. Make Patient Care Items (instruments, devices, equipment) Safe for Use
4. Limit the Spread of Blood and Other Infectious Body Substances

Prior to using the Checklist, programs should determine the level of risk for transmission of infections and bloodborne diseases both to providers and to those receiving services.  This will be different for programs only doing dental screenings versus those providing clinical services.

Once the level of risk has been ascertained, match the 4 Basic Principles to the Levels of Risk to determine which of the three Checklist columns to use and next steps.  Finally, print the draft Checklist and use the appropriate column to help inform your provision of safe dental care to your particular program.