Case Studies in Infection
Training in Infection Control
The Bug Blog
Page updated 1 October 2006
In 1985 in response to the identification of the HIV virus the Centre for Disease Control and Prevention in Atlanta , USA introduced the concept of "universal precautions" which has since been adopted by health care providers across the world. Universal precautions were designed to limit the spread of BBV in the health care setting. The precautions are based on the assumption that all blood and other body fluids, such as saliva that might contain blood should be treated as infectious, because patients with blood borne infections can be asymptomatic or unaware they are infected. Hence the same infection control precautions are applied to all dental patients.
Universal infection control precautions if implemented correctly should protect you and your patients from occupational transmission of all known BBV. Immunisation should not be viewed as a substitute for good infection control practice, especially as there are no vaccines for BBV other than against Hepatitis B.
The relevance of universal precautions to other aspects of disease transmission was recognised by the CDC Atlanta, so in 1996 the concept was expanded to include the precautions required to prevent the spread of airborne infections and those infections transmitted by excretions and secretions. The name was changed from universal precautions to "Standard Precautions".
Standard precautions apply to contact with:
Standard infection control precautions that reduce the exposure of patients, the dental team, laboratory staff, maintenance engineers and the general public to blood and other bodily fluid include:
A comprehensive medical history should be obtained from all patients at the initial visit. Previously completed medical history form should be up-dated regularly i.e. at the start of a new course of treatment. An example is the BDA medical history proforma.
As defined under Standard infection control precautions it is essential to undertake the same infection control procedures for all patients, as many carriers of latent infection are unaware of their condition. Strict confidentiality must be maintained on all information disclosed by patients.
Centre for Disease Control and Prevention. -Guidelines for infection control in the dental health-care setting -2003. MMWR 2003; 52: 1-76.
Clinical Guidelines 2. Infection control. Prevention of healthcare -associated infections in primary and community care. National Institute for Clinical Excellence (NICE). NHS 2003.
BDA Advice sheet A12 - Infection control in dentistry. 2003. http://www.bda.org.uk or for non-BDA members via http://www.decontamination.nhsestates.gov.uk/guidance_information/index.asp