May 10, 2019
There have been some positive changes made to the latest edition (2018) of the Communicable Diseases Network Australia’s Australian National Guidelines for the management of healthcare workers living with blood borne viruses and healthcare workers who perform exposure prone procedures at risk of exposure to blood borne viruses (The Guidelines).
Do The Guidelines Apply to Dental Practitioners?
Yes, The Guidelines apply to dental practitioners as we perform exposure prone procedures (EPPs).
The Guidelines also provide information and recommendations for dental practitioners living with blood borne viruses (BBV) such as HIV, Hep B & Hep C.
Did you also realise that you confirm you are complying with these guidelines when applying for your Dental Board of Australia renewal of registration? Want to know more? Then read on!
The 2018 Edition
There have been three major changes in this new edition.
In the previous 2012 edition, some health care workers (HCWs) living with a BBV were excluded from performing exposure prone procedures (EPPs).
But, in the 2018 edition, thanks to new definitions of EPPs and the effectiveness of antiviral treatments, HCWs living with a BBV can now return to practice, as long as they follow The Guidelines. This is great news!
In the 2018 edition, the definition of EPPs has changed for the better and is much simpler. Instead of three categories of EPPs, there is now only one definition.
Exposure Prone Procedures
are procedures where there is a risk of injury to the HCW resulting in exposure of the patient’s open tissues to the blood of the HCW. These procedures include those where the HCW’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
Non-Exposure Prone Procedures
are procedures where the hands and fingers of the healthcare worker (HCW) are visible and outside of the body at all times and procedures or internal examinations that do not involve possible injury to the HCW’s hands by sharp instruments and/or tissues, provided routine infection prevention and control procedures are adhered to at all times
Here are some examples :
Exposure Prone Procedures Non-Exposure Prone Procedures
- All maxillofacial surgery
- Extraction of highly mobile or exfoliating teeth
- All oral surgical procedures
- Assessment and management of removable dentures and mouthguards
- The extraction of teeth (with some exceptions)
- Taking impressions of teeth
- Periodontal surgical procedures
- Apply decay preventive agents
- Endodontic surgical procedures
- Removing dental plaque, calculus and stains
- Implant surgical procedures
In the 2018 edition, the recommendation for dental practitioners to know their BBV status has not changed, but instead of yearly testing, testing is now only required once every three years.
It is also worth knowing that you are also expected to:
- have appropriate and timely testing and follow up care after a potential occupational exposure associated with a risk of BBV acquisition;
- have appropriate testing and follow up care after potential nonoccupational exposure, with testing frequency related to risk factors for virus acquisition;
- cease performing all EPPs if diagnosed with a BBV until the criteria in the Guidelines are met.
- Infection Control