Ebola, infection control guidance

The ADA is working with the Centers for Disease Control and Prevention (CDC) to provide resources, including an upcoming webinar, for dentists regarding infection control and the Ebola virus.

The ADA, along with the Organization for Safety, Asepsis and Prevention (OSAP), is developing a webinar focusing on infection control procedures in the dental office. The ADA and CDA will provide members with information on the webinar as soon as it is posted.

Below is information CDC has provided as guidance to dental professionals:

CDC works with partners at ports of entry into the United States to help prevent infectious diseases, like Ebola, from being introduced and spread in the United States.

A person infected with Ebola is not contagious until symptoms appear. Signs and symptoms of Ebola include fever (greater than 38.6°C or 101.5°F) and severe headache, muscle pain, vomiting, diarrhea, stomach pain or unexplained bleeding or bruising.

The virus is spread through direct contact [CDC emphasis] (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit and semen) of a person who is sick with Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food.

You are advised not to treat dental patients if they have these signs and symptoms for Ebola. If a patient is feeling feverish and their travel history indicates they may be at risk of Ebola, dental professionals and staff in contact with the patient should:

  • immediately protect themselves by using standard precautions with physical barriers (gowns, masks, face protection, and gloves);
  • immediately call 911 on behalf of the patient and notify the appropriate county health department authorities; and
  • ask the health department to provide you and your staff with the most up-to-date guidance on removing and disposing of potentially contaminated materials and equipment, including the physical barriers.

Any person within 21 days of returning from the West African countries Liberia, Sierra Leone and Guinea may be at risk of having contacted persons infected with Ebola and may not exhibit symptoms. If this is the case, dental professionals are advised to delay routine dental care of the patient until 21 days have elapsed from their trip. Palliative care for serious oral health conditions, dental infections and pain can be provided, if necessary, after consulting with the patient’s physician and conforming to standard precautions and physical barriers.

Dental providers should continue to follow standard infection control procedures.”

Dentists can follow the CDC Guidelines for Infection Control in Dental Health Care-Settings for precautionary actions.

In addition, Cal/OSHA has issued interim guidance for employers of health care workers caring for a sick individual and others in critical sectors who may come into contact with sick individuals or their body fluids. The guidance refers to both the Bloodborne Pathogens and the Aerosol Transmissible Diseases regulation. Dental practices that want to be exempt from the ATD regulation are required to comply with specific conditions, including the screening of patients for ATDs. The state Department of Public Health has Ebola information and resources available on its website.

Information and resources on Ebola are posted on the CDC's website at cdc.gov and there also is an Ebola-specific checklist for health care providers. Visit ADA.org/ebola for continued updates on this important public health issue.

CDA will keep members updated on any further information in the Update and on cda.org.  

Updated on 10/2014