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Transmission of blood-borne pathogens in US dental health care settings: 2016 Update.

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Cleveland JL, Gray SK, Harte JA, Robison VA, Moorman AC, Gooch BF,


Cleveland JL, Gray SK, Harte JA, Robison VA, Moorman AC, Gooch BF, (click to view)

Cleveland JL, Gray SK, Harte JA, Robison VA, Moorman AC, Gooch BF,

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Journal of the American Dental Association (1939) 2016 5 24() pii 10.1016/j.adaj.2016.03.020

Abstract
BACKGROUND
During the past decade, investigators have reported transmissions of blood-borne pathogens (BBPs) in dental settings. In this article, the authors describe these transmissions and examine the lapses in infection prevention on the basis of available information.

METHODS
The authors reviewed the literature from 2003 through 2015 to identify reports of the transmission of BBPs in dental settings and related lapses in infection prevention efforts, as well as to identify reports of known or suspected health care-associated BBP infections submitted by state health departments to the Centers for Disease Control and Prevention.

RESULTS
The authors identified 3 published reports whose investigators described the transmission of hepatitis B virus and hepatitis C virus. In 2 of these reports, the investigators described single-transmission events (from 1 patient to another) in outpatient oral surgery practices. The authors of the third report described the possible transmission of hepatitis B virus to 3 patients and 2 dental health care personnel in a large temporary dental clinic. The authors identified lapses in infection prevention practices that occurred during 2 of the investigations; however, the investigators were not always able to link a specific lapse to a transmission event. Examples of lapses included the failure to heat-sterilize handpieces between patients, a lack of training for volunteers on BBPs, and the use of a combination of unsafe injection practices.

CONCLUSIONS
The authors found that reports describing the transmission of BBPs in dental settings since 2003 were rare. Failure to adhere to Centers for Disease Control and Prevention recommendations for infection control in dental settings likely led to disease transmission in these cases.

PRACTICAL IMPLICATIONS
The existence of these reports emphasizes the need to improve dental health care personnel’s understanding of the basic principles and implementation of standard precautions through the use of checklists, policies, and practices.

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