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American Dental Association Persuades CDC To Revise Handpiece Infection Control Recommendations

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ATLANTA, Gerogia — Responding to an urgent request from the American Dental Association (ADA), the Centers for Disease Control and Prevention (CDC) has revised its guidelines regarding infection control for newer types of handpieces, agreeing that dentists can follow manufacturers' recommendations for reprocessing handpieces that cannot be autoclaved.

The original guidelines required heat sterilization for all components of handpieces. Those recommendations contradicted many manufacturers' instructions for reprocessing newer types of devices, since the use of heat could damage the handpieces. CDC reviewed the 2003 guidelines and issued an update in 2016, but did not change the advice for newer handpieces at that time.

"This is a huge victory for the ADA in something that meaningfully affects dentists and their patients," said Dr. Craig Ratner, chair of the ADA Council on Dental Practice. "It is another example of the ADA successfully advocating for its members and all patients. Infection prevention and control is an essential part of providing safe treatment."

On January 16, Dr. Lorena Espinoza, associate director in the division of oral health at the CDC, responded to an August letter from Dr. Dave Preble, senior vice president of the ADA Practice Institute. Dr. Espinoza wrote, "Manufacturers of handpieces, such as newly released cordless hand hygiene handpieces, may not recommend reprocessing using heat sterilizations. In these instances, CDC recommends that dental health care personnel use FDA-cleared devices and follow the validated manufacturer's reprocessing instructions (cleaning, lubrication and/or sterilization) for these devices."

In August, Dr. Preble wrote to the CDC saying that there was uncertainty expressed by dentists about dueling processes for disinfecting handpieces — the CDC's recommendations or the manufacturer's instructions. "The fact that some handpieces, by virtue of the manufacturing design and the manufacturer's instructions, cannot be heat sterilized has led to a great deal of confusion in the profession as well as some state regulatory agencies charged with oversight regarding best practices for infection control of these devices."

Dr. Preble continued: "On behalf of the 161,000 members of the American Dental Association, I urge the Centers for Disease Control to promptly provide revision of the guidelines in agreement with the ADA position, and that of the FDA, that dental handpiece reprocessing should follow the manufacturer's recommendation. I cannot stress enough that our members urgently need this information so they can continue to provide safe, effective and efficient oral health care for millions of patient visits every year."

In the January correspondence, Dr. Espinoza said that if dentists are concerned about the validity of the manufacturer's reprocessing instructions or believe that the instructions are not consistent with basic infection prevention and control principles, they should contact the manufacturer to request documentation of FDA clearance of the device. If the manufacturer is not able to provide that information, dentists can contact the U.S. Food and Drug Administration's Office of Compliance for assistance by calling (240) 402-7675 or emailing OCMedicalDeviceCo@fda.hhs.gov.

ADA policy, passed by the House of Delegates at the 2012 annual meeting, is to support the implementation of standard precautions and infection control recommendations appropriate to the clinical setting, per the 2003 Guidelines for Infection Control in Dental Health Care Settings from the CDC. This policy includes implementation of CDC recommendations for the prevention and management of exposures involving nonintact skin, mucous membranes and percutaneous injuries.

To help dentists implement solid infection control procedures, the ADA offers The ADA Practical Guide to Effective Infection Control. Readers can save 15 percent on this and all ADA Catalog products with promo code 18108 until April 27. To order, visit ADAcatalog.org or call (800) 947-4746.

Webdentistry readers may read and/or download the CDC's 2016 publication Summary of Infection Control Practices in the Dental Setting: Basic Expectations for Safe Care here.

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