Article Abstract:
Tuberculosis (TB) infection control guidelines updated by the Centers for Disease Control in 1994 can be flexibly adapted to dental offices. A dentist or designated staff person should conduct a baseline assessment to determine the risk of TB transmission in the facility. The level of risk guides the development, implementation, and maintenance of a written infection control program. Administrative and engineering controls and personal respiratory protection devices are components of the control program. Dental personnel must identify patients with symptoms of infectious TB and postpone elective dental care for these patients. Dental offices classified as minimal or low-risk should establish referral agreements with facilities that are equipped to provide urgent dental care to infectious TB patients. All dental personnel should receive regular TB education, counseling, training, and a baseline tuberculin skin test.
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Article Abstract:
Dental residents may be most likely to sustain puncture wounds from sharp instruments while they are working outside the patient's mouth and while preparing dentures. Researchers recorded the frequency and circumstances of injuries sustained by residents in general dentistry and oral surgery during routine dental procedures. Between March and October 1993, dental residents sustained 14 puncture injuries from sharp instruments during 16,340 procedures. One injury occurred while the dentist's fingers were inserted in the patient's mouth, 12 occurred while the dentist was working outside the patient's mouth, and the circumstances of one injury were undetermined. The instruments that inflicted 11 injuries could have been contaminated with the patients' body fluid. Almost half of all injuries occurred while the dentist was making, placing, or repairing dentures.
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Article Abstract:
The risk of HIV transmission from infected health care workers to patients appears to be very small. Researchers surveyed health officials who had investigated 61 HIV-infected clinicians and had notified the patients of these clinicians. Approximately 22,171 patients of 51 HIV-infected health care workers had HIV tests. There were no cases of HIV infection among 13,059 patients of 37 infected health care workers. A total of 113 cases of HIV infection were identified in 9,108 patients of 14 health care workers. Twenty-eight patients were HIV-positive before they received care from the infected clinician, 62 had risk factors for HIV, 15 had potential exposure to HIV, and five had no identifiable HIV risks. Laboratory tests revealed that HIV strains from infected providers and patients were unrelated.
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