Infection control standards updated in new law

Legislation to improve infection control safety in dentistry passed the Legislature and was signed into law Oct. 2 by Gov. Jerry Brown.

An outbreak of mycobacterial infection in Southern California that led to the hospitalization of more than 60 children prompted the legislation. The infections, some producing severe complications, were traced back to a children’s dental clinic in Anaheim. Investigation into what occurred suggests that the bacterium that infected the children was likely introduced by water used during the performance of pulpotomies.

Assembly Bill 1277, authored by Tom Daly (D-Anaheim), sets a new standard for infection control that requires dentists to use sterile water or a disinfecting or antibacterial agent when irrigating exposed dental pulp and directs the Dental Board of California to codify these requirements in its infection control regulations. CDA supported the legislation.

The dental board must adopt final regulations by Dec. 31, 2018, and has emergency authority to expedite the process to ensure compliance with the deadline.

“CDA appreciates the ability to work proactively to ensure that all Californians have access to safe and effective dental care and worked closely with Assemblymember Daly’s office to find a solution that appropriately addresses the vulnerability that led to the infection outbreak,” states a letter from CDA to Gov. Brown urging him to sign the bill.

Mycobacterial infections can be severe and difficult to treat. The children hospitalized last fall experienced complications ranging from long hospital stays for administration of intravenous antibiotics to surgery, including for jaw reconstruction.

Purging, flushing dental water lines

Dental Board regulations require that dental water lines be purged at the beginning of each workday and flushed between patients. And as water line maintenance is essential to water quality, the CDC also recommends following manufacturer’s instructions to properly maintain water line equipment. This new regulation provides an added requirement for water quality to enhance patient protection.

For more background on the Anaheim clinic case, read “Cleaning and maintaining dental water lines for infection control” in the February issue of the CDA Update (page 3).

CDA will update members about the status of the pending regulations on cda.org and in the CDA Update.

Related Items

Dentists who share a building with other dental practices are contacting CDA Practice Support to inquire about their obligations under the Environmental Protection Agency’s amalgam separator requirement, which took effect July 14, 2017. The amalgam separator is designed to remove mercury and other metals entering the waste stream from dental practices.

A new mobile app released in mid-January by the Centers for Disease Control and Prevention can assist dental facilities in monitoring their compliance with recommended infection control practices. The CDC DentalCheck app can be used to ensure adequate supplies and appropriate infection prevention policies are in place, such as proper training and education of staff.

The ordered closure in mid-December of a children’s dental clinic in Southern California reminds dental practices of the importance of cleaning and maintaining dental unit water lines for the safety of patients. CDA urges dentists to ensure they are following the Dental Board of California’s current requirements along with CDC recommendations.