This document outlines various safety procedures and protocols for a dental clinic, including fire emergency procedures, electrical safety, eye protection, chemical safety, instrument processing, sharps handling, exposure incidents, and more. It emphasizes standard precautions like personal protective equipment and engineering controls to minimize risks of infectious disease transmission or other hazards in patient care activities. The exposure control plan aims to protect dental health care personnel through vaccination, training, and post-exposure follow-up if accidents occur.

1. GENERAL CLINIC
SAFETY
HAZARDOUS WASTE
&
INFECTION CONTROL
Roseman University College of Dental Medicine

2. FIRE EMERGENCY PROCEDURES
 IF YOU DISCOVER FIRE OR SMOKE
 Remove anyone from immediate danger
 Confine the fire by closing doors as you leave the area
 Activate the closest fire alarm to alert building occupants
 Call Security at 801.870.1589
 Give the following information:
• Building Name: CODM College of Dental Medicine
• Floor or Room Number
• Size or type of fire
• Your Location

3. FIRE EMERGENCY PROCEDURES
 Attempt to put the fire out with a extinguisher ONLY
when:
 You have been properly trained
 The fire is small (wastebasket size)
 You are not alone
 A safe escape route is present
 If this is not true, simply close the door and evacuate.

4. FIRE EMERGENCY PROCEDURES
 Evacuate by the nearest exit or exit stairwell. Do not
block/wedge exit doors in an open position and keep
stairwells safe for evacuation and fire personnel
 Go to your pre-determined Evacuation Assembly
Point, located in parking lost adjacent to building
depending on exit used.
 Once assembled, help to account for personnel and
report to the emergency staff if any occupants are
unaccounted for and may be still in the building

5. FIRE EMERGENCY PROCEDURES
 If you hear a fire alarm
 Never assume the fire alarm is a false alarm
 Move to the safest exit or stairwell
 Close doors as you leave the area
 Exit building

6. SAFETY HAZARD
• Fatigue
• Ignorance
• Haste
• Defective Equipment
• Carelessness
• Clutter
• Inadequate Space
• Inadequate Lighting
• Improper Storage
• Stupidity
• Inattentiveness

7. Dental Clinic Electrical Safety
 Ensure floors are kept dry and clean
 Ensure electrical equipment is in good repair
 Report shocks – don’t try to fix them yourself!
 Check cords for worn insulation or defective plugs
 Properly remove plugs from outlets
 If you think equipment is faulty DO NOT USE it;
report to supervisor

8. Dental Clinic Eye Protection
 Eye protection is mandatory for staff and patients
 During operatory procedures
 During laboratory procedures
• Grinding and handpiece procedures
• Dark glasses and goggles during casting
 In Dental Instrument Processing area(s)
 Eyewash areas identified to all personnel and tested
weekly

9. Dental Chemical Safety
 Don’t take any dental chemicals or materials for
granted
 Keep exterior of containers clean and labeled
 Avoid direct contact with skin
 Use appropriate PPE
 Latex gloves provide minimal protection
 Material Safety Data Sheets (MSDS)
 Must be located for accessibility by everyone

10. Dental Instrument Processing
 Use eye protection, protective clothing & rubber
utility gloves when handling contaminated
instruments
 Do not open sterilizers until pressure drops to zero;
allow steam to dissipate after opening
 Use care when handling hot instruments/ packs

11. Dental Sharps
 Visible sharps container in every operatory,
laboratory and the instrument processing area
 Wall mount preferable
 Must be above level accessible to children
 Replace when ‘Fill line’ is reached (e.g. ¾ full) to avoid
sharps protruding from the top

12. Dental Sharps
 Use care with loading, passing, breaking down and
cleaning sharp instruments including:
 Scalpels
 Needles
 Endo Files
 Burs
 Instruments
 After sterilizing, take broken instruments to dental
logistics

13. Recapping Guidelines
 Know and use local needle recapping guidelines
 Do not pass unsheathed needles
 Us a mechanical recapping device
 Do not use two hands to recap
 Use a one handed scoop technique

14. Reporting Occupational Exposure Incidents
 Occupational Exposure Incident
 Needlestick, Cut or mucous membrane (eyes, mouth, or
nasal) splash resulting in exposure of a health care worker to
blood or body fluids from a patient.
 Each CPT Coordinator has a packet to be completed by the
Exposed and the Exposure.

15. Fire/Flammables
 Common sense is most important fire preventive
measure
 Never leave burning Bunsen burners or portable
torches unattended
 Flammables must be kept in manufacturer’s original
container or an approved and properly labeled safety
container

16. Fire Safety
 R Rescue –
 Immediately stop what you are doing and remove anyone in immediate
danger from the fire to a safe area
 A Alarm –
 Activate the nearest fire alarm pull stations (if applicable)
 Call 911 and/or the front desk (if applicable) to report the location and current
extent of the fire
 C Contain –
 Close all doors and windows that you can safely reach to contain the fire
 During evacuation close the doors behind you)
 E Evacuate –
 to an area of refuge
 Extinguish – Only attempt to extinguish the fire if it is safe for you to do so.
 Retrieve the nearest fire extinguisher and follow the ‘P.A.S.S’ procedure

17. Fire Safety
 P Pull the pin breaking the plastic seal
 A Aim the hose at the base of the fire
 S Squeeze the handles together
 S Slowly sweep side to side at the base of the fire

18. General Clinic Safety
 Be aware of general hazards
 Sharp corners from drawers and cabinets
 Cords or hoses on the floor
 Spilled liquids
 Jewelry and loose clothing around machinery
 Ask for help
 Lift properly
 Use proper lifting techniques
 Store heavier items on lower shelves
 ASK FOR HELP

19. General Clinic Safety
 Mercury Hygiene
 Risk is low but sill exists; is cumulative
 Keep amalgamator lid closed during mixing
 Avoid direct skin contact
 Store dry amalgam scrap in airtight container
 Never heat amalgam
• Turn clogged/obstructed carriers in to supply
 In case of mercury spill
 Contact supervisor
 Use spill kit or contact Bioenvironmental Engineer (BEE)
Back to Quiz

20. General Clinic Safety
 Nitrous Oxide (N2O)
 Pregnant (or attempting to become) technicians should not
assist if N2O is being used.
 Ensure proper room ventilation and scavenger system.

21. Exposure Control Plan
 Key Elements
 Determination of employee exposure to blood/OPIM
 Implementation of various methods of exposure control
• Standard precautions
• Engineering work practice controls
• Personal Protective Equipment
• Housekeeping
• Hepatitis B vaccination
• Post-Exposure evaluation & follow-up
 Communication of hazards to employees and training
 Recordkeeping
 Procedures for evaluating circumstances surrounding exposure
incidents

22. Occupational Exposure Determination
 Reasonably anticipated:
 Skin
 Eye
 Mucous membrane
 Puncture wound (parenteral) contact with blood
 OPIM that may result from the performance of employee
duties

23. Standard Precautions
 The same IC procedures are used for all patients
 Assume all patients are potentially infectious
 Infection control policy are determined by the procedure,
not the patient

24. Engineering & Work Practice Controls
 Primary methods used to control transmission of
HBV/HCV/HIV
 Primary strategy for protection of DHCP & Patients
 Eliminates or isolates the hazard
 Commonly used in combination with work practice
control & PPE to prevent exposure
 Must be examined, maintained or replaced on
scheduled basis

25. Engineering Controls Examples
 Puncture resistant sharps container
 Safer medical devices
 Sharps with engineered sharps injury protection Y
needleless systems
• Non-needle devices
• Devices with built-in safety features

26. Engineering Controls
 2001 OSHA revised the BBP Standard
 Employers should identify, evaluate, & select safer medical
devices as they become available
 Annually
 Involve employees directly responsible for patient care in
identifying and choosing such devices
• Dentists
• Hygienists
• Dental Assistants
 Follow local MTF policy regarding device selection, Use,
Documentation

27. Work Practice Controls
 Reduce likelihood of exposure by altering the manner
in which task is performed
 Placing used disposable syringes & needles, scalpel blades &
other sharp items in puncture resistant containers located as
close as practical to the point of use
 Using a one-handed ‘scoop’ technique or a mechanical
device to facilitate needle recapping
 Not passing unsheathed needles
 Using engineered sharps injury protection devices during
use or disposal

28. Work Practice Requirements
 Wash hands immediately after
 skin contact with blood/OPIM
 After removing gloves or other PPE
 Flush mucous membranes immediately if splashed
with blood/OPIM
 Do not bend or break needles before disposal
 Do not pass needles unsheathed
 Recap needles with a one-handed technique before
removal from non-disposable aspirating syringes

29. Work Practice Requirements
 Discard disposable sharps
 Endo Files
 Orthodontic wires
 Anesthetic/suture needles
 Designated sharps container
 Closable
 Puncture resistant
 Leak-proof
 Colored red or labeled with biohazard symbol

30. Work Practice Requirements
 Place contaminated, reusable sharp instruments in
containers that are
 Puncture-resistant
 Leak-proof
 Colored Red or labeled with biohazard symbol
 Until reprocessed
 Do not store or process instruments in a way that
would require DHCP to reach by hand into the
container to retrieve instruments

31. Work Practice Requirements
 Do not do the following in areas where there is risk for
occupational exposure
 Eat
 Drink
 Smoke
 Apply cosmetics
 Handle contact lens
 Do not do store food/drinks where blood/OPIM are
present
 Refrigerators
 Cabinets
 Shelves
 countertops

32. Personal Protective Equipment (PPE)
 Specialized clothing or equipment to protect
 Skin, Mucous membranes, Eyes, Nose, Mouth
 Protect DHCP from exposure of infectious or
potentially infectious materials
 PPE must not allow blood/OPIM to pass through
clothing, skin or mucous membrane
 Based on degree of anticipated exposure & procedure
performed
 Remove PPE before leaving the work area and
immediately if penetrated by blood/OPIM

33. PPE
 Gloves
 Surgical Mask
 Long-sleeved protective clothing
 Long-sleeved lab coat
 Long-sleeved gown
 Protective eyewear with solid side
shields
 Chin-length face shield worn with a
surgical mask

34. PPE - Gloves
 Gloves
 Wear gloves when contact with blood or OPIM is possible
 Remove gloves after caring for a patient
 Do not wear the same pair of gloves for the care of more than
one patient
 Do not wash or disinfect patient-care gloves
 Do not use petroleum-based hand lotions with latex gloves
(causes deterioration of the glove material.
 Removal: grasp at wrist and strip off ‘inside-out’
Sequence for Donning & Removing PPE, CDC 2004

35. PPE – Utility Gloves
 Used for cleaning instruments, surfaces, handling
laundry, or housekeeping
 May be washed, autoclaved, or disinfected and reused
as long as integrity is not compromised
 After washing with soap, pull off by finger tips

36. PPE - Eyewear
 Wear when splash, spray, or spatter is anticipated
 Eyewear must have solid side shields
 A chin-length face shield may be worn withy a mask if
additional protection is desired
 Remove by headband or side arms
 Do not touch shield or lens area
 If reusable, may be decontaminated and reused
Sequence for Donning &
Removing PPE, CDC 2004

37. PPE - Clothing
 Long sleeves required by OSHA if worn as
PPE
 Wear when splash, spray, or spatter is
anticipated
 Remove immediately if penetrated by
blood/OPIM
 Use tie strings to remove and peel off
 Minimize contact during removal
 If reusable, place in marked laundry
container
Sequence for Donning &
Removing PPE, CDC 2004

38. PPE – Employer Responsibility
 Provide, maintain and replace
 Ensure accessibility in appropriate sizes
 Provide alternative products
 Latex-free gloves
 Powderless gloves
 Ensure employee use
 Launder or discard if appropriate

39. Contaminated Laundry
 Place in bags or containers that are red or marked
with biohazard symbol
 If clinic uses Standard Precautions for handling
soiled laundry
 Alternative labeling is permitted
 Ensure all employees are trained and recognize bags
containing contaminated laundry

40. Housekeeping
 Employer must ensure clean/sanitary workplace
 Work surfaces, equipment, and other reusable items
must be decontaminated upon completion of
procedure when contaminated with blood/OPIM
 Barriers protecting surfaces/equipment must be
replaced between patients

41. Housekeeping
 Reusable receptacles (bins pails, cans)
 Must be inspected/decontaminated on a regular basis and
when visibly soiled
 Broken glass that may be contaminated
 Cleaned up with brush/tongs
 Never picked up with hands, even if gloves are worn
 Contaminated equipment must be decontaminated
before servicing or labeled as biohazard

42. Regulated Waste
 Liquid or semi-liquid blood or OPIM
 Items contaminated with blood/OPIM that would
release these substances in a liquid or semi-liquid stat
if squeezed
 Items caked with dried blood/OPIM and capable of
releasing these materials during handling
 Contaminated sharps
 Pathological/microbiological waste containing
blood/OPIM
 Extracted teeth

43. Regulated Waste Disposal
 Sharps
 Place in container that is closable, puncture-resistant, leak-
proof, and colored red or labeled with biohazard symbol
 Other regulated waste
 Must be contained in closable bags or containers that
prevent leakage and colored red or labeled with the
biohazard symbol
 If contaminated on outside, use secondary container with
same features

44. Biohazard Label
 Symbol accompanied by the word BIOHAZARD
 Must be fluorescent orange or orange/red with
lettering and symbols in contrasting colors
 Red or orange/red bags or containers may substitute
for labels
 Decontaminated regulated waste does not need to be
labeled or placed in red bags

45. Biohazard Label
 Sharps container
 Regulated waste container
 Contaminated laundry bags
 Refrigerators/freezers containing blood/OPIM
 Containers used to ship blood/OPIM
 Contaminated equipment
NOTE: Red or Orange/Red bags or containers may
substitute for labels

46. Hepatitis B Vaccination
 Effective in preventing Hepatitis B
 Three Dose vaccination series
 Titer Test for antibodies to HBsAG 1 to 2 months
after 3-dose vaccination series completed
 Revaccinate DHCP who do not develop adequate
antibody response
 Safe, effective and long-lasting
 Booster doses not necessary for vaccine responders

47. Occupational Exposure Incident
 Specific eye, mouth, other mucous membrane non-intact
skin or parenteral contact with blood/OPIM resulting
from performance duties
 Percutaneous Injury
• Needlestick, puncture wound, or cut
 Splash of blood or body fluid on
• Mucous membranes (eye, nose or mouth)
• Non-intact skin (chapped, abraded, dermatitis)
 Employer
 Responsible for establishing procedure for evaluating exposure
incident
 Through assessment and confidentiality are critical

48. Post Exposure Management
 Goal: prevent infection after an occupational
exposure incident to blood
 A qualified health-care professional should evaluate any
occupational exposure to blood or OPIM including saliva,
regardless of whether blood is visible in dental settings
• A qualified health-care professional is any health-care provider
who can provide counseling and perform all medical
evaluations and procedures in accordance with the most
current recommendations of the US Public Health Service,
including post exposure chemotherapeutic prophylaxis when
indicated

49. Post Exposure Management
 Wound Care
 Clean wounds with soap and water
 Flush mucous membranes with water
 No evidence of benefit for
• Application of antiseptics or disinfectants
• Squeezing (‘milking’) puncture sites
 Avoid use of bleach and other agents caustic to skin

50. Post Exposure Management
 Overview
 Immediately report exposure incident to initiate timely
follow-up process by health care professional
 Exposed individual must be directed to a qualified health
care professional
 Initiate prompt request for evaluation of source individual’s
HBV/HCV/HIV status

51. Post Exposure Management
 Exposure Report
 Date and time of exposure
 Procedure details – what, where, how, with what device
 Exposure details – route, body substance involved,
volume/duration of contact
 Information about source person
 Information about the exposed person
 Exposure management details

52. Post Exposure Management
 Unknown or Untestable Source
 Consider information about exposure
• Where and under what circumstances
• Prevalence of HBV/HCV/HIV in the population group
 Testing of needles and other sharp instruments not
recommended
• Unknown reliability and interpretation of findings
• Hazard of handling sharp

53. Post Exposure Management
 Evaluating the Source
 If the HBV/HCV/HIV status of the source is unknown,
testing should be done
 Testing should be preformed as soon as possible
 Consult your laboratory regarding most appropriate test to
expedite obtaining results
 Informed consent should be obtained in accordance with
state and local laws

54. Recordkeeping
 Medical Records
 Requirement for each employee with potential occupational
exposure
 Confidential and separate from other personnel records
 Kept on-site or retained by HCP providing services to clinic
 Occupational exposure reports included
 Maintained for 30 years past last date of employment
 Confidentiality is critical

55.  CDC. Updated US Public Health Service guidelines for the
management of occupational exposures to HBV, HCV, and HIV
and recommendations for post exposure prophylaxis. MMWR
2001;50(No. RR-11).
 CDC. Updated U.S. Public Health Service guidelines for the
management of occupational exposures to HIV and
recommendations for post exposure prophylaxis. MMWR
2005;54(No. RR-9):1–17.
 US Department of Labor, Occupational Safety and Health
Administration. 29 CFR Part 1910.1030. Occupational exposure
to bloodborne pathogens; needle sticks and other sharps
injuries; final rule. Federal Register 2001;66:5317–25. As
amended from and includes 29 CFR Part 1910.1030.
Occupational exposure to bloodborne pathogens; final rule.
Federal Register 1991;56:64174–82. Available at
ww.osha.gov/SLTC/dentistry/index.html.
References

56.  Occupational injury and illness recording and reporting
requirements; Final Rule. Title 29 CFR Parts 1904 and 1952,
Federal Register 66 (13): 5916-6135, January 19, 2001.
 OSHA Directive CPL 2-2.44D-Enforcement Procedures for the
Occupational Exposure to Bloodborne Pathogens, November 5,
1999.
 OSHA Brochure, Medical and Dental Offices: A Guide to
Compliance with OSHA Standards, 2003.
References