Infection Control Law

Chapter 1. General Provisions Applicable to All Licensees

Article 1. General Provisions

1000. Definitions
1001. Delegation to Board's Executive Officer
1002. Rules of Order
1003. Posting of Notice--Experimental Dental Health Programs
1004. Abandonment of Applications
1005. Minimum Standards for Infection Control
1000. Definitions.

For purposes of this chapter:

(a) "Act" means the Dental Practice Act.

(b) "Board" means the Board of Dental Examiners.

(c) "Code" means the Business and Professions Code.

(d) "Committee," unless otherwise indicated, means the Committee on Dental Auxiliaries.

(e) "Examining Committee" means the Examining Committee appointed by the board.

(f) "Licentiate" means any individual or corporation licensed or registered by the board.

(g) "Academic year" means a period of education consisting of 45 quarter units, 30 semester units, or a duration deemed equivalent thereto by the board.

(h) "Board office" means the board office located in Sacramento, California.

(i) "Board's Executive officer" means the executive officer appointed by the board.

(j) The masculine gender includes the feminine, and the feminine, the masculine.

Note Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1611 and 1614, Business and Professions Code.

1001. Delegation to Board's Executive Officer.

(a) It shall be the duty of the Board's executive officer to plan, direct and organize the work of the staff; attend Board meetings and hearings; consult with and make recommendations to the Board; dictate correspondence; attend committee meetings of various organizations and associations; assist in compiling examination material; attend examinations and assist in conducting the examinations; notify applicants of their success or failure on examinations; and prepare reports and direct and supervise the field investigators concerning enforcement of the Act.

(b) The power and discretion conferred by law upon the board to initiate, review and prosecute accusations and statements of issues pursuant to Sections 11500 through 11528 of the Government Code are hereby delegated to and conferred upon the board's executive officer or in the absence thereof, the assistant executive officer.

Note Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1614 and 1670, Business and Professions Code; and Sections 11500-11528, Government Code.

1002. Rules of Order.

The most recent edition of Robert's Rules of Order shall be used for all meetings to the extent such rules are not in conflict with law.

Note Authority cited: Section 1614, Business and Professions Code. Reference: Section 1614, Business and Professions Code.

1003. Posting of Notice -- Experimental Dental Health Programs.

Prior to the undertaking of any dental health experimental program utilizing members of the public as patients, a notice approved by the board that is written in English, as well as a second language if warranted by the needs of the local community, shall be posted in a conspicuous and publicly accessible area within the treatment facility and shall be maintained in such area for the life of the program. Such a notice shall clearly state the nature and intent of said experimental dental health program.

Note Authority cited: Section 1614, Business and Professions Code. Reference: Section 1614, Business and Professions Code; and Section 429.77, Health and Safety Code.

1004. Abandonment of Applications.

(a) An application shall be deemed to have been abandoned in any of the following circumstances:

(1) The applicant fails to submit the application, examination, or reexamination fee within 180 days after notification by the board that such fee is due and unpaid.

(2) The applicant fails to take the licensing examination within two years after the date his application was received by the board.

(3) The applicant, after failing the examination, fails to take a reexamination within two years after the date applicant was notified of such failure.

(b) An application submitted subsequent to the abandonment of a former application shall be treated as a new application.

Note Authority cited: Section 1614, Business and Professions Code. Reference: Section 1614, Business and Professions Code.

1005. Minimum Standards for Infection Control.

(a) As used in this section:

(1) "Universal precautions" is an approach to infection control according to which all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV and other blood-borne pathogens.

(2) "Critical instruments" are surgical and other instruments used to penetrate soft tissue or bone.

(3) "Semi-critical instruments" are surgical and other instruments that are not used to penetrate soft tissue or bone, but contact oral tissue.

(4) "Non-critical instruments and devices" are instruments and devices that contact intact skin.

(5) "Low-level disinfection" is the least effective disinfection process. It does not kill bacterial spores or mycobacterium tuberculosis var bovis, a laboratory test organism used to classify the strength of disinfectant chemicals.

(6) "Intermediate-level disinfection" kills mycobacterium tuberculosis var bovis that indicates less resistant organisms such as hepatitis B and HIV are also killed.

(7) "High-level disinfection" kills some, but not necessarily all bacterial spores.This process kills mycobacterium tuberculosis var bovis, and other bacteria, fungi and viruses.

(b) Licensees with one or more employees shall comply with infection control precautions mandated by the California Occupational Safety and Health Administration. All licensees shall comply with the following minimum precautions to minimize the transmission of pathogens in health care settings:

(1) Universal precautions shall be practiced in the care of all patients.

(2) Medical exam gloves shall be worn whenever there is potential for contact with blood, blood-contaminated saliva, or mucous membranes. Sterile gloves shall be worn in connection with surgical procedures involving soft tissue or bone. Sterile coolants/irrigants shall be used for surgical procedures involving soft tissue or bone. Sterile coolant/irrigants are deemed to be sterile when delivered using a device or process that has a Food and Drug Administration (FDA) marketing clearance for delivery of sterile coolant/ irrigants to the patient. Delivery of sterile coolant/ irrigants shall be in accordance with the manufacturer's directions.

(3) Health care workers shall wash hands and put on new gloves before treating each patient. Antimicrobial soap shall be used to wash hands for surgical procedures. Health care workers shall wash hands after removing and discarding gloves after treatment of each patient or before leaving the operatory. Gloves shall not be washed before or after use.

(4) Health care workers shall wear surgical face masks and either chin length plastic face shields or surgical masks and protective eyewear when treating patients. After each patient, and during patient treatment if applicable, masks shall be changed if moist or contaminated. After each patient, face shields and protective eyeware shall be cleaned and disinfected, if contaminated.

(5) Health care workers shall wear reusable or disposable gowns when their clothing is likely to be soiled with blood or other bodily fluids.

(6) Protective attire must be removed when leaving the laboratories and work areas.

(7) Items or surfaces such as, but not limited to, light handles which are impossible to clean and disinfect, shall be protected with impervious barriers. Between patients, the covering must be removed, discarded and replaced with clean covering.

(8) Splash shields shall be used in dental laboratories.

(9) Health care workers who have exudative lesions or weeping dermatitis shall refrain from all direct patient care and from handling patient care equipment until the condition resolves.

(10) Needles shall be recapped only by using the scoop technique or a mechanical device designed for holding the needle sheath, or a mechanical device which eliminates the need for two handed capping. Needles shall not be bent or broken prior to disposal. Disposable needles, syringes, scalpel blades and/or other sharp items and instruments shall be placed into puncture resistant containers for disposal.

(11) Heat stable critical and semi-critical instruments shall be cleaned and sterilized before use by using steam under pressure (autoclaving), dry heat, or chemical vapor. Cal/EPA1-registered sterilants/disinfectants shall be used for sterilization of heat-sensitive critical items and for high-level disinfection of heat-sensitive semi-critical items.

(12) Heavy-duty utility gloves shall be worn to process instruments before sterilization or high-level disinfection.

(13) Critical and semi-critical instruments shall be packaged before sterilization if they are not to be used immediately and remain sealed until used.

(14) Proper functioning of the sterilization cycle shall be verified at least weekly through use of a biological indicator (such as spore test).

(15) Counter tops and dental unit surfaces shall be cleaned with disposable towels followed by an Cal/EPA intermediate-level disinfectant between patients. Cal/EPA low-level disinfectants shall be used for visibly soiled areas such as floors, walls and other housekeeping surfaces.

(16) Intraoral items such as impressions, bite registrations, prosthetic and orthodontic appliances shall be cleaned and disinfected with an intermediate-level disinfectant before manipulation in the laboratory and before placement in the patient's mouth.

(17) All high-speed dental handpieces, low-speed handpiece components used intraorally, and other dental unit attachments such as reusable air/water syringe tips and ultrasonic scaler tips shall be heat-sterilized between uses.

(18) Anti-retraction devices in dental unit water lines shall be installed and maintained.

(19) The dental unit line shall be flushed between each patient.

(20) Single-use disposable instruments (e.g. prophylaxis, angles, prophylaxis cups and brushes, tips for high-speed evacuators, saliva ejectors, air/water syringe tips) shall be used for one patient only and discarded appropriately.

(21) At the beginning of each workday, dental unit lines shall be purged with air or flushed with water for at least two (2) minutes prior to attaching handpieces, scalers and other devices.

(22) Contaminated solid waste shall be disposed of according to applicable local, state and federal environmental standards.

(23) A written protocol shall be developed for proper instrument processing, operatory cleanliness, and management of injuries. A copy of this regulation shall be conspicuously posted in each dental office.

(c) The Board shall review this regulation annually.

NOTE: Authority cited: Section 1614, Business and Professions Code. Reference: Section 1680, Business and Professions Code.

1Cal/EPA contacts: WEBSITE www.cdpr.ca.gov or Main Information Center (916) 324-0419.