CDC issues H1N1 recommendations for dental healthcare providers
Dental care providers, like their medical counterparts, need to take precautions to prevent the transmission of the 2009 H1N1 influenza. The Centers for Disease Control and Prevention recently issued recommendations specifically for dental care providers, which augment existing recommendations for all healthcare settings.
The CDC recommendations flow from what is known about the H1N1 virus, namely that it is most likely transmitted in one of three ways: 1) through droplet exposure of mucosal surfaces, 2) through indirect contact, usually via the hands, with respiratory secretions from an infectious patient or contaminated surface, and 3) through inhalation of small particle aerosols in the vicinity of the infectious individual.
Specific recommendations for dental healthcare
The CDC recommends that dental healthcare settings should do the following:
- Encourage all dental healthcare personnel to receive seasonal influenza and 2009 H1N1 influenza vaccinations.
- Use patient-reminder calls to identify patients reporting influenza-like illness and reschedule non-urgent visits until 24 hours after the patient is free of fever, without the use of fever-reducing medicine.
- Identify patients with influenza-like illness at check-in. Offer a facemask or tissues to symptomatic patients; follow protocols for respiratory hygiene and cough etiquette; and reschedule non-urgent care. Ill patients should be separated from others whenever possible if evaluating for urgent care.
- Use a treatment room with a closed door, if available. If not, use one that is farthest from other patients and personnel. That said, urgent dental treatment may be performed without the use of an airborne infection isolation room, because transmission of 2009 H1N1 influenza is thought to occur over shorter distances through the air; it is unlikely that the virus is transmitted from one patient room to another.
- Wear recommended personal protective equipment before entering the treatment room. Dental healthcare personnel should wear a NIOSH fit-tested, disposable N95 respirator when entering the patient room and when performing dental procedures on patients with suspected or confirmed 2009 H1N1 influenza. If N95 respirators and/or fit-testing are not available despite reasonable attempts to obtain, the dental office should switch to a prioritized use mode. (Until fit-tested N95 respirators are available, dental healthcare providers at lower risk of exposure or lower risk of complication from influenza can use non-fit-tested, disposable N95 respirators or surgical facemasks.)
- As customary, minimize spray and spatter (i.e., use a dental dam and high-volume evacuator).
Personnel duties
The CDC recommends the following for dental healthcare personnel:
- Self-assess daily for symptoms of febrile respiratory illness, that is, fever plus one or more of the following – nasal congestion or runny nose, sore throat, or cough.
- Personnel who develop fever and respiratory symptoms should promptly notify their supervisor and stay away from work.
- Personnel should remain at home until at least 24 hours after they are free of fever (100 degrees F) or signs of a fever, without the use of fever-reducing medications.
- Personnel having a family member who is diagnosed with 2009 H1N1 influenza can still go to work, but they should monitor themselves for symptoms so that any illness is recognized promptly.
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