Protect your patients, protect
your team, protect yourself.
The ADA Practical Guide to Effective Infection Prevention and Control,
Fifth Edition, outlines the importance of implementing comprehensive
infection prevention and control practices in the dental office. This
edition features a chapter on dental water quality and synthesizes
the most current science-based recommendations for infection
prevention and control in dental settings from the CDC and federal
agency rules and regulations, including OSHA, the FDA and the EPA.
This guide is divided into five chapters:
Chapter 1: Fundamentals of Infection Prevention and Control
Chapter 2: Disinfection and Sterilization
Chapter 3: Dental Water Quality
Chapter 4: Infection Control During Clinical Procedures
Chapter 5: Special Considerations and Pandemic Preparedness
This book also includes a self-assessment checklist of current
infection control practices and continuing education (CE) review
questions to reinforce important concepts.
The ADA Practical Guide to Effective Infection Prevention and
Control covers important aspects of infection prevention and
control, including:
• How infections spread and preventing transmission
• Tools to prevent transmission including PPE, cleaning,
decontamination, disinfection and sterilization
• Managing dental unit water quality
• Infection control during pretreatment, chairside and
post-treatment
• Sterilization of dental handpieces and other tools
The ADA Practical Guide to Effective Infection Prevention and Control, Fifth Edition
Earn 3 hours CE credit.*
P69222BT Paperback book +e-book, 158 pages
Members $119.95 Retail $179.95
Paperback book ISBN: 978-1-68447-167-6
*CE tests are subject to a $20 grading fee per test.
B E S T S E L L E R HIPAA and OSHA Compliance Kit
This complete HIPAA and OSHA kit gives you all the tools you need to train your staff and stay
on top of HIPAA and OSHA regulations. Kit includes:
• The ADA Practical Guide to HIPAA Compliance: Privacy and
Security Manual with e-book and customizable forms
• The ADA Practical Guide to HIPAA Training videos +booklet
• ADA Guide to OSHA Compliance for Dental Offices
with e-book and customizable forms
• ADA OSHA Training: Guidance for Dental Teams with e-book Includes editable forms!
34 l © 2022 American Dental Association
Chapter 1
The OSHA Bloodborne Pathogens Standard requires that employers offer dental healthcare professionals
(DHCP) hepatitis vaccine at no cost within ten days of an assignment where exposure to blood or OPIM
is reasonably anticipated or obtain documentation of prior immunity. Employees who decline to accept
HBV vaccination must sign a declination statement but must be advised they can accept the vaccine later
at no cost. Employees declining vaccination should be educated as to their exposure risks and infection
prevention policies and procedures, including management of work-related illness and possible work
restrictions if they are exposed or become infected.15, 16, 54, 57
Following completion of the vaccine series, DHCP should be tested for antibody response (HBsAb) to
the HBV surface antigen. Persons in whom a protective antibody response (greater than 10 mIU/ml) are
considered immune. Persons who do not demonstrate sufficient antibody titers should complete a second
vaccine series. If there is no antibody response after the second series, testing for hepatitis B surface
antigen should be performed. Although antibody titers tend to decline over time, it appears that immunity
continues to prevent clinical disease. Booster vaccines and periodic serological testing to monitor antibody
levels after completion of the vaccine series are not recommended for vaccine responders.160
Figure 1.4. Personal Protective
Equipment (PPE) Figure 1.5. Sharps Disposal
Properly used PPE greatly reduces risk of
contact with blood and other potentially
infectious material.
When disposing of contaminated sharps, place them
in puncture-resistant containers that are color-
coded or marked with the biohazard symbol.
© 2022 American Dental Association l 19
Fundamentals of Infection Prevention and Control
Each link in the chain is necessary for an infection to spread. Effective infection prevention and control
and prevention strategies are intended to break one or more links to avoid disease transmission.
Let’s now look at each link and learn how we can thwart the spread of infectious disease.
Causative Agent (Pathogen)
Causative agents include pathogenic bacteria, fungi, protozoa, and parasitic worms that infect a
susceptible host and cause disease.64, 65 Each of these microscopic organisms uses their own DNA and
cellular machinery to grow and reproduce, either in a living host or in the environment. Viruses, however,
can only reproduce by hijacking the cellular machinery of bacterial, plant, or animal cells to make copies
of themselves (virions), which can cause disease and then can be transmitted to a new host.65 Prions
are another type of causative agent that consists of infectious, non-living proteins which, on contact
with normal proteins in brain tissue, slowly but irreversibly change their shape and alter brain function,
ultimately resulting in death. Examples of prion-spread diseases include Creutzfeldt-Jakob disease and
so-called “mad-cow” disease, which are known as spongiform encephalopathies.66, 67
To break this link: Be educated about the nature and prevalence of pathogens likely to be present in your
clinical environment and community. Develop policies and procedures using recommended infection
prevention strategies spelled out in this guide to prevent disease transmission between DHCP and patients,
from one patient to another, and among DHCP and nonclinical staff, their families, and the community.
Human, Animal, or Environmental Reservoirs
Pathogens require a source reservoir in which to survive prior to transmission to a host. These may be
living organisms such as humans or animals or environmental reservoirs like water or soil. Examples of
infectious agents from the human reservoir include bloodborne pathogens such as HBV,68, 69 HCV,68, 69 and
HIV.70 Bacterial respiratory pathogens such a Mycobacterium tuberculosis (TB)61 and Bordatella pertussis
(the bacteria that causes “whooping cough”)73 may be present in saliva, nasal secretions, and respiratory
droplets encountered in dental procedures. The viruses that cause other respiratory diseases like
measles,34 varicella (chickenpox),71 influenza,58, 72 or COVID-1925 may also be present in the oral cavity
and in nasal secretions and may be spread via an airborne route. Pathogens such as MRSA,74 HSV,28
Chain of
Infection
Human,
Animal, or Environmental
Reservoir
Mode of Transmission
(including portal of entry and
exit)
Susceptible Host
Causative
Agent
Figure 1.1. Chain of Infection
Don’t risk your practice–get the kit and
protect your business.
COMPLIANCE
Earn 4-5 hours CE credit.*
*CE tests are subject to a $20 grading fee per test.
K017BT Kit |Members $529.95 Retail $899.95
ORDER BY PHONE: 800.947.4746 10 11 ORDER ONLINE: ADASTORE.ORG
c
o
m
p
l
i
a
n
c e
EFFECTIVE
INFECTION
PREVENTION
AND CONTROL
|HIPAA
AND
OSHA
KIT
your team, protect yourself.
The ADA Practical Guide to Effective Infection Prevention and Control,
Fifth Edition, outlines the importance of implementing comprehensive
infection prevention and control practices in the dental office. This
edition features a chapter on dental water quality and synthesizes
the most current science-based recommendations for infection
prevention and control in dental settings from the CDC and federal
agency rules and regulations, including OSHA, the FDA and the EPA.
This guide is divided into five chapters:
Chapter 1: Fundamentals of Infection Prevention and Control
Chapter 2: Disinfection and Sterilization
Chapter 3: Dental Water Quality
Chapter 4: Infection Control During Clinical Procedures
Chapter 5: Special Considerations and Pandemic Preparedness
This book also includes a self-assessment checklist of current
infection control practices and continuing education (CE) review
questions to reinforce important concepts.
The ADA Practical Guide to Effective Infection Prevention and
Control covers important aspects of infection prevention and
control, including:
• How infections spread and preventing transmission
• Tools to prevent transmission including PPE, cleaning,
decontamination, disinfection and sterilization
• Managing dental unit water quality
• Infection control during pretreatment, chairside and
post-treatment
• Sterilization of dental handpieces and other tools
The ADA Practical Guide to Effective Infection Prevention and Control, Fifth Edition
Earn 3 hours CE credit.*
P69222BT Paperback book +e-book, 158 pages
Members $119.95 Retail $179.95
Paperback book ISBN: 978-1-68447-167-6
*CE tests are subject to a $20 grading fee per test.
B E S T S E L L E R HIPAA and OSHA Compliance Kit
This complete HIPAA and OSHA kit gives you all the tools you need to train your staff and stay
on top of HIPAA and OSHA regulations. Kit includes:
• The ADA Practical Guide to HIPAA Compliance: Privacy and
Security Manual with e-book and customizable forms
• The ADA Practical Guide to HIPAA Training videos +booklet
• ADA Guide to OSHA Compliance for Dental Offices
with e-book and customizable forms
• ADA OSHA Training: Guidance for Dental Teams with e-book Includes editable forms!
34 l © 2022 American Dental Association
Chapter 1
The OSHA Bloodborne Pathogens Standard requires that employers offer dental healthcare professionals
(DHCP) hepatitis vaccine at no cost within ten days of an assignment where exposure to blood or OPIM
is reasonably anticipated or obtain documentation of prior immunity. Employees who decline to accept
HBV vaccination must sign a declination statement but must be advised they can accept the vaccine later
at no cost. Employees declining vaccination should be educated as to their exposure risks and infection
prevention policies and procedures, including management of work-related illness and possible work
restrictions if they are exposed or become infected.15, 16, 54, 57
Following completion of the vaccine series, DHCP should be tested for antibody response (HBsAb) to
the HBV surface antigen. Persons in whom a protective antibody response (greater than 10 mIU/ml) are
considered immune. Persons who do not demonstrate sufficient antibody titers should complete a second
vaccine series. If there is no antibody response after the second series, testing for hepatitis B surface
antigen should be performed. Although antibody titers tend to decline over time, it appears that immunity
continues to prevent clinical disease. Booster vaccines and periodic serological testing to monitor antibody
levels after completion of the vaccine series are not recommended for vaccine responders.160
Figure 1.4. Personal Protective
Equipment (PPE) Figure 1.5. Sharps Disposal
Properly used PPE greatly reduces risk of
contact with blood and other potentially
infectious material.
When disposing of contaminated sharps, place them
in puncture-resistant containers that are color-
coded or marked with the biohazard symbol.
© 2022 American Dental Association l 19
Fundamentals of Infection Prevention and Control
Each link in the chain is necessary for an infection to spread. Effective infection prevention and control
and prevention strategies are intended to break one or more links to avoid disease transmission.
Let’s now look at each link and learn how we can thwart the spread of infectious disease.
Causative Agent (Pathogen)
Causative agents include pathogenic bacteria, fungi, protozoa, and parasitic worms that infect a
susceptible host and cause disease.64, 65 Each of these microscopic organisms uses their own DNA and
cellular machinery to grow and reproduce, either in a living host or in the environment. Viruses, however,
can only reproduce by hijacking the cellular machinery of bacterial, plant, or animal cells to make copies
of themselves (virions), which can cause disease and then can be transmitted to a new host.65 Prions
are another type of causative agent that consists of infectious, non-living proteins which, on contact
with normal proteins in brain tissue, slowly but irreversibly change their shape and alter brain function,
ultimately resulting in death. Examples of prion-spread diseases include Creutzfeldt-Jakob disease and
so-called “mad-cow” disease, which are known as spongiform encephalopathies.66, 67
To break this link: Be educated about the nature and prevalence of pathogens likely to be present in your
clinical environment and community. Develop policies and procedures using recommended infection
prevention strategies spelled out in this guide to prevent disease transmission between DHCP and patients,
from one patient to another, and among DHCP and nonclinical staff, their families, and the community.
Human, Animal, or Environmental Reservoirs
Pathogens require a source reservoir in which to survive prior to transmission to a host. These may be
living organisms such as humans or animals or environmental reservoirs like water or soil. Examples of
infectious agents from the human reservoir include bloodborne pathogens such as HBV,68, 69 HCV,68, 69 and
HIV.70 Bacterial respiratory pathogens such a Mycobacterium tuberculosis (TB)61 and Bordatella pertussis
(the bacteria that causes “whooping cough”)73 may be present in saliva, nasal secretions, and respiratory
droplets encountered in dental procedures. The viruses that cause other respiratory diseases like
measles,34 varicella (chickenpox),71 influenza,58, 72 or COVID-1925 may also be present in the oral cavity
and in nasal secretions and may be spread via an airborne route. Pathogens such as MRSA,74 HSV,28
Chain of
Infection
Human,
Animal, or Environmental
Reservoir
Mode of Transmission
(including portal of entry and
exit)
Susceptible Host
Causative
Agent
Figure 1.1. Chain of Infection
Don’t risk your practice–get the kit and
protect your business.
COMPLIANCE
Earn 4-5 hours CE credit.*
*CE tests are subject to a $20 grading fee per test.
K017BT Kit |Members $529.95 Retail $899.95
ORDER BY PHONE: 800.947.4746 10 11 ORDER ONLINE: ADASTORE.ORG
c
o
m
p
l
i
a
n
c e
EFFECTIVE
INFECTION
PREVENTION
AND CONTROL
|HIPAA
AND
OSHA
KIT
