Introduction

As a [dental practice name] team member, you need to keep up with training practices as required by law. This helps the American Dental Association verify that our employees keep our working environment for clients and other employees.

After you've completed this subject, you'll be able to:

• Describe what OSHA training is, why it's important, and how often it needs to be completed
• Describe office area safety practices
• Practice psychological safety
• Prevent bloodborne pathogen injuries
• Wear personal protective equipment per policy
• Safely operate our equipment and machinery
• Follow the proper first aid procedure
• Practice proper dental cleaning, sterilization, and hygiene
• Properly dispose of waste
• Practice patient safety

Tip: If you forget anything that you learn in this subject, you can go back and look at it at any time! And check it out on the go with the Trainual mobile app for iOS or Android.

What is OSHA Training?

The Occupational Safety and Health Administration (OSHA) was formed to ensure the health and safety of US medical workers. OSHA requires that all dental workers complete annual training to address potential workplace hazards. This is to increase awareness around proper safety measures and prevent accidents. Enter: OSHA training.

For example, dental offices can put employees at risk for:

• Bloodborne pathogens
• Diseases
• Medications and hazardous chemicals
• Radiation exposure
• Laser exposure
• Wear and tear on the body
• Psychological hazards
• + more
  

So who needs this training?

OSHA training is required for oral surgeons, dentists, dental assistants, hygienists, and office employees (AKA — everyone!).

Dental Office Safety

Ergonomic Hazards

Ergonomic hazards are workplace conditions that cause wear and tear on the body and can lead to bodily (like musculoskeletal/back) injuries. Risk factors include repetition, unnatural posture, forceful motions, stationary positions, direct pressures, vibrations, extreme temperatures, loud noises, and so on.

Ergonomic Best Practices

Here are some tips for preventing bodily injury at our dental practice:

• Adjust the height of your working surfaces to avoid long reaches and awkward postures
• Keep work supplies and equipment within comfortable reach
• Take short rest breaks throughout the day. Use the time to get up and walk, stretch, and relieve physical tension.
• Do not lift anything that causes excessive physical strain. Ask for help or other resources if needed.
• Use hands-free headsets rather than telephone handsets to prevent neck strain
• Use an ergonomic chair
• If using a standing desk, use an anti-fatigue floor mat

General Office Cleanliness

Here's a checklist of the areas of the office to clean twice per day.

• Vacuum carpeted areas
• Wipe down electronics with a disposable wipe
• Spray high-touch surfaces with disinfecting spray. Surfaces include those made of plastic or metal (such as grab bars, plastic seating, countertops, and railings).
• Wash your hands with soap and water for 20 seconds after cleaning
  

Do not mix products or chemicals used for cleaning. Check the product label to see what personal protective equipment (PPE) is required based on potential hazards. Always follow the directions on the product label.

Reading Chemical Labels

It's important that you read, understand, and follow each element of a product or chemical label for the following reasons:

• Safety — for yourself and others
• Protection — of the elements you’re working on and your working environment
• Using the correct amount of product to get the job done — no more, no less
• Proper application of the product you’re using
• In the case of disinfectants and sanitizers, understanding which germs the product kills, and what dwell times are needed for effectiveness
• Understanding first aid procedures in case of an accident
  

See the image below for the main parts of the product label to pay attention to.

For more detailed information about product and chemical safety, read our safety data sheet.

Be sure to read the label and follow safety directions for each product you use. If you have any questions about a product, contact your supervisor before use.

Psychological Hazards

Much of dentistry work is people-facing. Meaning, team members can experience stressors from patients, peers, and/or managers.

These stressors can look like:

• Feelings of being overwhelmed by work-related tasks
• Work-related bullying
• Work-related violence
• Patient aggression
• + more

And unfortunately, they can lead to:

• Distress
• Anxiety
• Panic attacks or disturbed sleep
• Physical illness (like muscle tension, headaches, fatigue, or digestive problems)
• Loss of self-esteem and self-confidence
• Feeling isolated
• Deteriorating relationships with colleagues, family, and friends
• Negative impact on work performance, concentration, and decision-making ability
• Depression
• Suicidal thoughts
  

If you are experiencing suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255.

Next, we'll go over how we can practice psychological safety in the workplace.

Psychological Safety

The goal to combat the negative effects of these stressors is to practice psychological safety, a shared belief that the team is safe for interpersonal risk-taking.

To increase psychological safety in the workplace, be sure to:

• Fill out workplace surveys
• Practice effective communication
• Communicate with managers, peers, and patients to make informed decisions and help others feel heard
• Communicate with your supervisor if you are experiencing any psychological hazards or health issues described in the previous step
• File an injury report for any injury sustained

Angry Patient Safety

Dealing with angry patients is never fun. But it can also make you feel stressed, psychologically unsafe, or physically unsafe. Frequent exposure to angry clients can also lead to long-term stress issues and burnout.

Your goal is to prevent the customer from escalating (getting angrier) while maintaining the integrity of business policies, procedures, safety measures.

Here are some helpful tips for conflict resolution:

• Spot signs of initial anger. Look for changes in body language — like a tightened jaw, tense posture, clenched fists, fidgeting, and any other changes in behavior. If the patient appears angry, spend extra time with them to understand their frustration and make them feel heard. This gives you the opportunity to resolve the issue and provide information/clarity so they don't escalate.
• Show empathy. Calmly and respectfully answer the patient's questions. Repeat what you've heard while listening to the patient's complaints so that they feel as though you have listened to and understand them. Explain any gaps in understanding and let them know our practice is advocating for their health with our actions.
• Stay calm. If a patient is verbally abusing you, do not try to speak over them. This will only escalate the matter at hand. Wait until they are done before you begin to attempt to comfort the patient. Should a patient become irrational, they're likely to try to intimidate you by saying something like, "I'm calling my lawyer" or "I'm going to sue." If this happens, do not defend the actions of our practice. Rather, use short and simple statements as you listen. Never get angry yourself or ask the patient to change their behavior by saying something like, "Calm down" or "Stop yelling."
• Use accepting body language. Let your arms hang loosely at your sides. Sometimes, mirroring the body language of the patient can help them feel more comfortable with you. Refrain from standing with your hands on your hips or with your arms crossed.
• Wait until the patient calms down. When the patient has quieted down, acknowledge their feelings. You can also let them know you think their complaint is valid.
• End the conversation. To do this, ask for the patient's solution to the problem. Try to offer realistic options and reach an acceptable arrangement.
• Document the complaint. Include your attempts to resolve the issue and the effectiveness of those measures. This will help our team understand what patient-facing policies or procedures need review. It will also help us prepare for the patient's return and provide you with the resources you need to strengthen your own psychological safety.

If the patient threatens you physically or you fear for your safety, contact security or the police.

Our Benefits

At [dental practice], we care about your psychological safety and mental wellbeing as much as we care about your physical safety. You are important to us. That's why we offer a robust benefits package that includes the below mental health services.

Please utilize one or more of the following resources and services as needed:

• [Counseling/therapy benefits]
• [Affinity group support]
• [Mental health/sick time off benefits]
• [Support via 1:1 check-ins with leadership]

Bloodborne Pathogens

Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include (but are not limited to) hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). ‍

Bloodborne Pathogen exposure can lead to serious or even fatal infections.‍

So it's important that you take proper precautions to not expose yourself to the health threat of blood contact, needlesticks, or other injuries caused by share objects that may expose you to harmful bloodborne pathogens.

Needlestick Prevention

Here are some best practices for preventing needlesticks on the job:

• Avoid using needles whenever safe and effective alternatives are available
• Avoid recapping or bending needles that might be contaminated
• Use puncture-resistant coverings for sharps containers to clients’ homes
• Plan for the safe handling and disposal of needles before use
• Promptly dispose of used needle devices and sharps, which might be contaminated, in the designated containers in our office
• Secure used sharps containers during transport to prevent spilling

Needlestick Contact

If you sustain a needlestick injury, remain calm and follow the steps below immediately.

You'll want to promptly:

• Wash needlesticks and cuts with soap and water
• Flush splashes to the nose, mouth, or skin with water
• Flush splashes to the eyes with clean water, saline, or sterile irrigants
• Seek immediate medical attention
  

You'll also need to fill out a sharps injury log, noting the type and brand of device used, where the injury occurred, and an explanation of the incident.

Be sure to communicate the occurrence and next steps with your supervisor.

Staff Immunization Requirements

We require proof of the following vaccines to decrease your likelihood of sustaining a bloodborne pathogen-related illness or disease.

Hepatitis B

A three-dose series (on a zero-, one- and six-month schedule) of hepatitis B vaccines.

You only need to get the dose series of the hepatitis B vaccine once and you are expected to be immune for life.

If you choose to decline the hepatitis B vaccine, reach out to your supervisor. You'll have to provide them with a signed copy of a hepatitis B vaccination declination form which we will file in your personnel records.

Personal Protective Equipment

Gloves

Gloves protect you from harmful germs and bacteria that can be found in saliva and blood. It also protects your patients from transmitting any microorganisms to them.

Our office will provide you with disposable nitrile gloves. These gloves are heavy-duty as they're puncture-resistant and offer more hand protection than the thinner latex glove.

Let your supervisor know if you have a latex allergy. Understand where we store latex gloves in the office so you can avoid grabbing them.

Gloves are needed for any patient care procedure or dental tool cleaning.

Of course, switch gloves between every patient and at every instance of contact with contaminated surfaces.

Eyewear

Standard Eyewear

You must wear protective eyewear while carrying out or assisting with any dental procedure or cleaning. Dental work is likely to produce splashing or the spattering of blood or other body fluids, and protective eyewear will protect you from exposure to those fluids.

Other Eyewear

Ensure that you use the specific protective eyewear our office provides during dental procedures that use lasers, light curing units, and bleaching units (more on this later).

Masks

You must wear a tightly-fitted facial mask that covers your nose and mouth completely while carrying out or assisting with any dental procedure or cleaning. Dental work is likely to produce splashing or the spattering of blood or other body fluids, and a mask will protect you from exposure to those fluids.

It will also prevent any bacteria or odor in your mouth from being transferred to your client while in the close proximity of performing dental work.

Clothing

Ensure that you wear scrubs to help identify yourself as team personnel and to protect you from contact with bacteria and fluids while working.  

Have an extra set of scrubs on hand in the office or in your car to change into in the event the scrubs you are wearing are significantly stained during patient treatment.

To limit disease and infection spread, change from your scrubs to personal clothing at the end of your shift and before going home. This will help keep you from carrying collected germs with you into your car and/or home.

Shoes

Ensure you wear close-toed, non-slip shoes to work every day. This will prevent you from slipping and falling while performing work or navigating around the office.

Equipment and Machinery Safety

Laser Safety

You use lasers during bacterial decontamination, applying ablation techniques, and so on. Here are some general best practices for laser use:

• Know where the emergency stop buttons are located
• Know the output limitations of the device
• Make sure the laser is properly labeled with the stickers that come with the product
• Establish a Nominal Safety Zone, (AKA a controlled area where the laser is being fired)
• Update the maintenance log to ensure the beam is working correctly. If there is a problem, check with the laser manufacturer to get it resolved immediately.
• Post the warning signs that come with the laser in the appropriate areas as outlined in the laser safety manual
• Ensure you wear laser safety glasses at all times of operation
• Report any safety incidents to your supervisor
• Ensure no products containing alcohol or other combustibles are present during laser operation

Radiation Safety

When you perform x-rays on patients and do not perform the proper precautions, you're exposed to radiation. Radiation in large amounts can be harmful, even causing long-term health effects such as cancer and cardiovascular disease. Be sure to follow the x-ray practices below to limit your exposure to radiation while performing x-rays.

Best x-ray practices:

• Do not be present in the room during an x-ray unless your presence is necessary for the exam
• Cover up behind a shield when taking the x-ray
• Ensure there is adequate shielding between client chairs
• Wear your personal dosimeter to monitor your exposure levels
• If you perform x-rays and find out you are pregnant, please notify your supervisor immediately. Any necessary precautions will be taken.

First Aid

Our office has multiple first aid kits just in case you or a patient experience a minor injury.

You can find our first aid kids:

• [Location 1]
• [Location 2]
  

Here's what they contain:

• Compress dressings
• Variety of bandaid sizes and shapes
• Adhesive cloth tape
• Antibiotic ointment packets
• Antiseptic wipe packets
• Packets of aspirin (or your choice of pain reliever/fever reducer)
• Tweezers
• Oral thermometer
• Sterile gauze pads
• Hydrocortisone ointment packets
• Breathing barrier
• Vaseline
  

Do not offer aspirin or any other medication found in the first aid kit to a patient unless you are licensed to do so by state law.

First Aid Basics

Remember the 3 Ps of first aid:

1. Preserve life
2. Prevent further injury
3. Promote recovery
   

When someone is injured, it’s easy to let the panic set in and forget what to do. The 3 Ps keep you on track in the event of an emergency.

Minor injuries

If you find yourself in a situation where you are hurt, please do what is required to take care of yourself. If you get a small scrape that has not come into contact with chemicals or blood/bodily fluid, use your standard first aid kit to patch yourself up. You can likely get back to your day without much of a hiccup!

Serious and Emergency Injuries

If you come into contact with a needle/blood/bodily fluid or sustain an injury that can't be patched up with our first aid kit, please remain calm and seek medical attention as needed. Be sure to communicate with your supervisor.

Cleanliness

Cleaning Before Sterilization

You should always clean dental instruments, devices, and equipment prior to sterilizing them. This is because cleaning removes organic and inorganic debris from the tool.  If there is still visible debris on the tool, it cannot be adequately sterilized.

You can use one of the following methods to clean dental instruments:

1. Manual scrubbing. Use warm water and surfactant or detergent. If you're not cleaning the tool immediately after use, soak it in a container filled with warm water and a detergent or enzymatic cleaner. Use long-handled brushes when possible to keep your hand far away from sharp instruments.
2. Automated equipment. We have ultrasonic cleaners, washers, and other machinery in our office that can be used to clean. This does not require pre-soaking or scrubbing. It also decreases your chances of exposure to any blood or bodily fluids that are on the instrument.

After cleaning, rinse instruments with warm water to remove detergent that remains on the surface. While washing and rinsing, minimize splashing to prevent the spread of blood, bodily fluids, or chemicals that were on the tool.

Be sure to wear all personal protective equipment when cleaning instruments, including puncture-resistant nitrile gloves, protective clothing, and eye protection.

Sterilization of Equipment

After you've cleaned your instrument, device, or equipment as outlined in the previous step, you'll need to decontaminate it via the sterilization process before it is ready and safe to use again.

There are 3 kinds of items that you'll be sterilizing:

1. Critical items. These tools penetrate soft tissue or bone and have the highest risk of transmitting infections. They should always be heat sterilized.
2. Semicritical items. These tools touch mucous membranes. While they have a lower risk of transmission than critical items, most should still be heat sterilized. If they are made of material that cannot be heat sterilized, they should be processed using a high-level disinfectant. ‎
3. Noncritical items. These tools only contact the skin. They have the lowest risk of infection transmission. In most cases, they can ‎be cleaned using a low-level disinfectant.

Hand Hygiene

Proper hand hygiene is a basic, but critical way to prevent the spread of infections, diseases, and more. This is because cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics

How

Here's a refresher on how to properly wash your hands and use hand sanitizer:

Soap and Water

1. Wet your hands with warm, clean running water
2. Turn off the tap and apply soap
3. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds.
4. Rise your hands with warm water until all the soap is removed
5. Dry your hands off with a clean paper towel and dispose of the paper towel
   

Alcohol-Based Hand Sanitizer

1. Apply a palmful of sanitizer onto the palm of your hand
2. Using your hands, rub the sanitizer in your palms, on the backs of your hands, between your fingers, and under your nails
3. Let hands air dry for 20 seconds

When

Here's a refresher for when to wash your hands vs. use hand sanitizer:

Soap and Water

• Before eating
• After using the restroom
• When hands are visibly dirty
• After caring for a person with known or suspected infectious diarrhea
• After known or suspected exposure to spores (like B. anthracis and C difficile)
  

Alcohol-Based Hand Sanitizer

• Immediately before touching a patient
• Before performing an aseptic task (e.g., placing an indwelling device) or handling invasive medical devices
• Before moving from work on a soiled body site to a clean body site on the same patient
• After touching a patient or around the patient
• After contact with blood, bodily fluids, or contaminated surfaces
• Immediately after glove removal

Waste Management

Medical Waste Disposal

Use the medical waste disposal method to dispose of the following items that can transmit infections and disease:

• Blood-saturated items
• Blood-saturated gauze/bandages
• Blood and bodily fluids
• Visibly contaminated PPE
• Amalgam fillings
  

To dispose of these items, place them in a red biohazard bag and place them in a red medical waste management mail-back container.

Sharp Waste Disposal

Use the sharp waste disposal method to dispose of the following items that can possibly puncture the skin and possibly contain bloodborne pathogens:

• Blades
• Lancets
• Needles
• Broken carpules/syringes
• Carpules/syringes containing blood
• Used carpules/syringes
• Extracted teeth (except for amalgam fillings)
  

To dispose of these items, place them in a red sharps management mail-back container.

Pharmaceutical Waste Disposal

Use the pharmaceutical disposal method to dispose of medication containers and all forms of medication (capsule, tablet, liquid, etc.).

This includes:

• Unused and partially used medications
• Unused auto-injectors
• Pharmaceutical vials
• Inhalers
• Carpules that are not broken and do not contain blood
  

To dispose of these items, place them in a pharmaceutical recovery mail-back container.

Patient Safety

Patient Protective Equipment

It's important that you provide each patient with the necessary safety equipment during their appointment or procedure.

Eyewear

Provide the patient with protective eyewear to prevent splashing or the spattering of blood or other body fluids into their eyes.

If performing bacterial decontamination, applying ablation techniques, or other activity that requires the use of lasers, ensure the patient wears laser safety glasses at all times of operation.

Patient Bibs

Hook a patient bib around the patient's neck to prevent splashing or the spattering of blood or other body fluids onto their clothing.

X-Ray Apron

When performing an x-ray on the patient, ensure that you cover their torso with an x-ray apron.

Ensure that you ask each patient if they might be pregnant before performing an x-ray on them. If they disclose pregnancy, discuss x-ray options with your supervisor.

Post-Appointment Clean Up

After your patient leaves, you need to make sure you adequately clean the patient area to prepare it for the next patient. Because another one is surely coming!

Complete the following checklist after every appointment and procedure:

• Wipe down the dental chair with [preferred cleaning solution] and a clean towel. When finished, place the towel in the contaminated laundry bin.
• Clean the area around the dental chair with [preferred cleaner]
• Spray any high-touch surfaces the patient may have come into contact with (or placed their belongings on) using a disinfecting spray. Surfaces include those made of plastic or metal (such as door handles, plastic guest seating, and countertops).
• Wash your hands with soap and water for 20 seconds after cleaning
  

Do not mix products or chemicals used for cleaning. Check the product label to see what personal protective equipment (PPE) is required based on potential hazards. Always follow the directions on the product label.

Recap

Congrats — you've finished OSHA Training for Dental Offices! 🎉

You should now be able to:

• Describe what OSHA training is, why it's important, and how often it needs to be completed
• Describe office area safety practices
• Practice psychological safety
• Prevent bloodborne pathogen injuries
• Wear personal protective equipment per policy
• Safely operate our equipment and machinery
• Follow the proper first aid procedure
• Practice proper dental cleaning, sterilization, and hygiene
• Properly dispose of waste
• Practice patient safety

If you are unclear about how to do anything listed above, go back and review the previous topics.

Remember: If you forget anything that you learn in this subject, you can go back and look at it at any time! And be sure to download the Trainual mobile app for iOS or Android for when you're on the go.