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The Infection Control Practices of General Dental Practitioners

Published online by Cambridge University Press:  02 January 2015

Gillian M. McCarthy  and
John K. MacDonald
Gillian M. McCarthy*
Affiliation:
School of Dentistry and Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
John K. MacDonald
Affiliation:
School of Dentistry and Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
*
Division of Oral Biology, Faculty of Medicine and Dentistry, the University of Western Ontario, London, Ontario N6A 5C1, Canada
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Abstract

Objectives:

To investigate the infection control practices of general dentists in Ontario in 1994.

Design:

Confidential coded questionnaires were mailed to all general dental practitioners in Ontario (n=5,176), with three follow-up attempts. Data were analyzed using Pearson's chi-squared test and multiple logistic regression.

Setting:

Offices of general dental practitioners in Ontario.

Participants:

General dental practitioners actively involved in treating patients.

Results:

The response rate adjusted for nondelivery was 70%. A high proportion of respondents reported using gloves (always, 91.8%; sometimes, 7.8%), masks (always, 74.8%; sometimes, 21.1%), or protective eyewear (always, 83.6%; sometimes, 13%); heat sterilization of hand-pieces (83.9%); and hepatitis B (HBV) vaccination of dentists (92.3%). However, only 61.4% of respondents reported HBV vaccination of all clinical staff, and 87.7% used additional precautions for patients with human immunodeficiency virus (HIV). Significant predictors of the use of recommended infection control procedures (ie, always using gloves, masks, and eye protection; heat sterilization of handpieces; HBV vaccination for dentist and staff; and no extra precautions for patients with HIV) were age ?40 years (odds ratio [OR], 2.6), lack of concern regarding increased personal risk (OR, 2.0) or costs of infection control procedures (OR, 1.5), and knowledge of the low infectivity of HIV after a needlestick injury (OR, 2.0) and that infection control procedures for HBV are adequate for HIV (OR, 2.7).

Conclusion:

Additional education is required to promote a more realistic perception of risk of HIV transmission in the dental office and the use of all recommended infection control practices, including Universal Precautions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 10 , October 1997 , pp. 699 - 703
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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References

1. Centers for Disease Control. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR 1991;40(RR-8):1–9.Google Scholar
2. American Dental Association. Infection control recommendations for the dental office and the dental laboratory. JADA 1996;127:672–680.Google Scholar
3. Canadian Dental Association. Recommendations for infection control procedures. Communiqué. 05 1992:10.Google Scholar
4. Osterman, JW. Beyond Universal Precautions. Can Med Assoc J 1995;152:1051–1055.Google ScholarPubMed
5. Gershon, RRM, Vlahov, D, Felknor, SA, et al. Compliance with Universal Precautions among health care workers at three regional hospitals. Am J Infect Control 1995;23:225–236.CrossRefGoogle ScholarPubMed
6. Hersey, JC, Martin, LS. Use of infection control guidelines by workers in healthcare facilities to prevent occupational transmission of HBV and HIV: results from a national survey. Infect Control Hosp Epidemiol 1994;15:243–252.Google Scholar
7. Soto, JC, Levi, MD, Allard, R, Franko, EL. Determinants of AIDS preventive behaviour among dental professionals. Can J Public Health 1993;84:128–131.Google ScholarPubMed
8. Dillman, DA. Implementing mail surveys. In: Dillman, DA, ed. Mail and Telephone Surveys. The Total Design Method. Toronto, Ontario, Canada: John Wiley & Sons; 1978:160–200.Google Scholar
9. McCarthy, GM, Koval, JJ, MacDonald, JK. Non-response bias in a survey of Ontario dentists' infection control and attitudes concerning HIV. J Pub Health Dent 1997;57:59–62.Google Scholar
10. Nash, KD. How infection control procedures are affecting dental practice today. J Am Dent Assoc 1992;123:67–73.CrossRefGoogle ScholarPubMed
11. Manz, MC, Weyant, RJ, Adelson, R, Sverha, SK, Durnan, JR, Geboy, MJ. Impact of HIV on VA dental services: report of a survey. J Public Health Dent 1994;54:197–204.Google Scholar
12. McCarthy, GM, MacDonald, JK. Gender differences in characteristics, infection control practices, knowledge and attitudes related to HIV among Ontario dentists. Community Dent Oral Epidemiol 1996;24:412–415.Google Scholar
13. Hudson-Davies, SCM, Jones, JM, Sarll, DW. Cross infection control in general dental practice: dentists' behaviour compared with their knowledge and opinions. British Dental Journal 1995;178:365–369.Google Scholar
14. McCarthy, GM, Koval, JJ. Changes in dentist's infection control practices, knowledge and attitudes concerning HIV over a two year period. Oral Surg Oral Med Oral Pathol 1996;81:297–302.Google Scholar
15. Lewis, DL, Boe, RK. Infection risks associated with current procedures for using high speed dental hand pieces. J Clin Microbiol 1992;30:401–406.CrossRefGoogle Scholar
16. Epstein, JB, Rea, G, Sibau, L, Sherlock, CH. Assessing viral retention and elimination in rotary dental instruments. J Am Dent Assoc 1995;126:87–92.Google Scholar
17. Bentley, EM, Sarll, DW. Improvements in cross-infection control in general dental practice. Br Dent J 1995;179:19–21.Google Scholar
18. Treasure, P, Treasure, ET. Survey of infection control procedures in New Zealand dental practices. Int Dent J 1994;44:342–348.Google Scholar
19. American Dental Association. Infection control for the '90s: data reveals stringent infection control techniques practiced. ADA News Releases. 10 7, 1995.Google Scholar
20. Lloyd, L, Burke, FJ, Cheung, SW. Handpiece asepsis: a survey of the attitudes of dental practitioners. Br Dent J 1995;178:23–27.Google Scholar
21. Williams, CO, Campbell, S, Henry, K, Collier, P. Variables influencing worker compliance with Universal Precautions in the emergency department. Am J Infect Control 1994;22:138–148.Google Scholar
22. Cockroft, A, Elford, J. Clinical practice and the perceived importance of identifying high risk patients. J Hosp Infect 1994;28:127–136.Google Scholar
23. Bauer, BJ, Kenney, JW. Adverse exposures and use of Universal Precautions among perinatal nurses. J Obstet Gynecol Neonatal Nurs 1993;22:429–435.CrossRefGoogle ScholarPubMed
24. Beekmann, SE, Vlahov, D, Koziol, DE, McShalley, ED, Schmitt, JM, Henderson, DK. Temporal association between implementation of Universal Precautions and a sustained, progressive decrease in percutaneous exposures to blood. Clin Infect Dis 1994;18:562–569.Google Scholar
25. Canadian Dental Association. Ottawa dentist faces charges of discrimination. Communiqué; 07 1995:7.Google Scholar
26. Royal College of Dental Surgeons of Ontario. CDA, ODA and RCDSO clarify guidelines on Universal Precautions and the application of the human rights code. RCDSO Dispatch 1996;10(3):5.Google Scholar
27. McCarthy, GM, MacDonald, JK. A national study of infection control procedures of Canadian dentists. J Dent Res 1997;76. Abstract 2170.Google Scholar
28. Tokars, JI, Marcus, R, Culver, DH, et al. Surveillance of HIV-infection and zidovudine use among healthcare workers after occupational exposure to HIV-infected blood. Ann Intern Med 1993;118:913–919.Google Scholar