Virginia Board of Dentistry

Perimeter Center
9960 Mayland Drive, Suite 300
Henrico, VA 23233-1463

Dear Honorable Members of the Board,

Thank you for continuing the conversation to promote the safest environment for patients to receive quality dental care and advance the education for dental assistants. As this public testimony is open, I have just spent 3 weeks of instruction on infection control principles with newly admitted dental assisting students.  This is such a strong foundation for the practice of dental assistants. An unclear understanding of the aseptic technique could result in cross-contamination and the spread of disease to patients, providers, and our communities.  

As you consider all the comments that have been coming in over this topic, I would like for you to have insight into the different areas that are covered when we formally educate dental assistants about infection control.  The topics include:

1. Microbiology
   1. capsules
   2. spores
   3. types of microorganisms
2. Disease transmission and infection prevention
   1. types of infection
   2. modes of disease transmission
   3. immunity
   4. disease transmission in the dental office
3. CDC Guidelines
4. OSHA's Blood-Borne Pathogen Standard
5. Standard Precautions
6. Postexposure Management
7. Infection Control Practices
   1. Handwashing
   2. Personal Protective Equipment
8. Waste Management
9. Environmental Infection Control
10. Sterilization
11. Disinfection
12. Waterlines
13. Quality Assurance
14. Hazard Communication Program 

The typical on-the-job training for infection control is having a more senior employee show the new person how to disinfect a room or sterilize instruments when they are hired.  There is no background understanding or critical thinking about what is actually being done and why.  Unfortunately, this is not enough.  

I have read the comments that have been put forth in opposition to this petition.  I want to clarify just a few points.  First, the Centers for Disease Control has no oversight authority.  They only make recommendations for safe practice.  If a dental assistant has no other training than what an office may share with him or her, how would they even know to use the CDC as a resource and for guiding principals? 

Another point from others that is worth repeating is that the Occupational Safety and Health Act is an administration designed to protect employees, not patients.  The Board of Dentistry is called to uphold the mission of the Department of Health Professions and that includes "ensure safe and competent patient care by licensing health professionals, enforcing standards of practice, and providing information to health care practitioners and the public ."  This petition requiring minimal infection control training for dental assistants helps to advance the mission of ensuring safe and competent care and enforces standards of practice.  

I leave you with this question, if everyone is already complying with infection control principles and practices why is there opposition to this?  Wouldn't it be relatively easy for everyone to demonstrate compliance?  

Respectfully submitted,

Misty L. Mesimer, MSCH, RDH, CDA