Dental care is an essential part of healthcare, and it is important to ensure that the necessary safety protocols are followed when using certain types of dental supplies and tools. The Occupational Safety and Health Administration (OSHA) recommends a combination of standard precautions, contact precautions, and precautions against drops, including eye protection, to ensure the safety of dental workers. In addition, the General Duties Clause of the Act requires employers to provide their employees with a workplace free from recognized hazards that could cause death or serious physical injury. The OSHA Guide on Returning to Work provides general recommendations for dental offices to safely reopen and resume operations.
It is important to keep abreast of the changing conditions of the outbreak, including the spread of the virus and the availability of tests in your community, and update hazard assessments and implement infection prevention measures accordingly. OSHA recommends that dental procedures be performed on patients with suspicion or confirmation of COVID-19 only in cases of emergency. When carrying out such procedures, appropriate controls must be implemented. The Centers for Disease Control and Prevention (CDC) offers infection prevention and control recommendations for dental procedures during the COVID-19 pandemic.
The OSHA blood-borne pathogen standard applies to occupational exposure to human blood and other potentially infectious materials, including saliva in dental procedures. Even when the standard does not apply, its provisions provide a framework that can help control some sources of the virus, including exposure to body fluids. In areas with ongoing community transmission of SARS-CoV-2, consider only emergency dental procedures and evaluate whether elective procedures, surgeries, and non-urgent outpatient visits should be postponed. If possible, use directional airflow, such as that from exhaust fans, to ensure that air does not move from patient treatment areas to staff work areas.
Perform a health evaluation at or immediately before patient registration to determine if a patient should be considered a suspected or confirmed case of COVID-19. Advise patients, and anyone who accompanies them, to cover their faces with cloth when they enter the clinic and at all times, except during treatment. Consider extending business hours or reducing the number of appointments to minimize the number of patients in the clinic at the same time. When performing aerosol-generating procedures, take standard precautions, contact precautions, air transport precautions, and eye protection. Minimize aerosol-generating procedures and take all appropriate precautions to protect workers.
Avoid aerosol-generating procedures completely if proper precautions are not in place. Minimize the number of personnel present when performing aerosol-generating procedures. When performing the necessary aerosol-generating procedures, it is particularly important to exclude any staff members who are not needed for the procedure itself. Increase the frequency of cleaning and disinfecting rooms and equipment; at a minimum, ensure that rooms and equipment are cleaned between patients. When performing dental care, workers must follow all appropriate precautions for dental and health workers, as well as ensure that appropriate regulations on blood-borne pathogens are met when they encounter saliva and blood.
Use high-evacuation dental and suction systems to minimize droplet splashes and aerosols. Employers should consider risks in their hazard and risk assessments when providing PPE for workers exposed to potential sources of SARS-CoV-2 in the workplace. Care for patients with suspected or confirmed COVID-19 must be taken regardless of community transmission of COVID-19 in the local area. It is important for employers to ensure that their employees are aware of all safety protocols that must be followed when using certain types of dental supplies and tools. By following these protocols, employers can help protect their employees from potential hazards associated with working in a dental office.