Antibiotic Stewardship Continues to be Key Issue (APRIL 5, 2023)
Two new resources are available to encourage the current best practices of antibiotic use in dentistry.
Based on ADA guidelines for prescribing, and part of their Be Antibiotics Aware campaign, the CDC has a new fact sheet titled "DENTISTS: BE ANTIBIOTICS AWARE: Treating Patients with Dental Pain and Swelling" to highlight this important issue for dentists.
Also recently released, the Antiobiotic Stewardship Summit, held by OSAP is available in a recording that reviews challenges to mindful prescribing, guidance, antibiotic adverse events, prophylaxis, antimicrobial resistance issues and more. The recording of the summit is available to all for free.
To register for the recording, click here.To download DENTISTS: BE ANTIBIOTICS AWARE Treating Patients with Dental Pain and Swelling, click here. And, to visit the AAPD's best practice, "Use of Antibiotic Therapy for Pediatric Dental Patients", click here.
National Patient Safety Awareness Week: Are You A Patient Safety Champion? (March 15, 2023)
The Institute for Healthcare Improvement (IHI) has designated this week National Patient Safety Awareness Week to encourage all to learn about patient safety. The American Academy of Pediatric Dentistry not only recognizes safety as an essential component of care delivery, but also as core value of practice. Be safety strong. To champion safety this Patient Safety Awareness Week, visit these resources and readings and find out more on what you can do to incorporate safety practices into your practice. And, don't forget to visit the Safety Toolkit!
- Adverse Events in Pediatric Dentistry: An Exploratory Study
- To Err is Human: Building a Safer Health System
- From Good to Better: Toward a Patient Safety Initiative in Dentistry
- Developing a Reporting Culture: Learning from Close Calls and Hazardous Conditions
- AAPD Policy on Patient Safety
Drug shortage alerts for amoxicillin have been issued by the American Society of Health System Pharmacists (ASHP) and the U.S. Food and Drug Administration. The American Academy of Pediatrics indicates that this shortage is anticipated to last several months. Please refer to AAPD’s resources, Use of Antibiotic Therapy for Pediatric Dental Patients (2022) and Useful Medications for Oral Conditions, to plan for safe and effective alternatives for your patients when necessary.
CDC Updates Core Infection Prevention and Control Practices for Safe Healthcare Delivery
The CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) recently added two new standard practices to the Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings guidelines:
Injection and Medication Safety (5c): Prepare medications in a designated clean medication preparation area that is separated from potential sources of contamination, including sinks or other water sources.
Minimizing Potential Exposure (5e): Develop and implement systems for early detection and management of potentially infectious persons at initial points of patient encounter in outpatient settings and at the time of admission to hospitals and long-term care facilities.
The guidance also indicates, “During periods of higher levels of community respiratory virus transmission*, facilities should consider having everyone mask upon entry to the facility to ensure better adherence to respiratory hygiene and cough etiquette for those who might be infectious. Such an approach could be implemented facility-wide or targeted toward higher risk areas (e.g., emergency departments, urgent care, units experiencing an outbreak) based on a facility risk assessment.” Additional information is available at CDC Infection Control. (Updated 12/6/2022)
Antibiotic Stewardship in Dentistry (Updated November 30, 2022)
The American Academy of Pediatric Dentistry joined many other organizations in recognizing U.S. Antibiotic Awareness Week earlier this month, bringing attention to the increasingly pressing issue of antibiotic resistance. Help protect kids' long-term health with prudent prescribing, using the AAPD's best practice resource, "Use of Antibiotic Therapy for Pediatric Dental Patients." This regularly updated guidance document will equip you with the tools needed to handle contemporary issues with antibiotic prescribing.
To learn more about antibiotic prescribing and stewardship, adverse events related to antibiotics, penicillin allergies, and more, visit OSAP's Antibiotic Stewardship Summit resources and the Antibiotic Stewardship for Oral Health Prescribers Toolkit. Originally published 11/18/2022.
OUTBREAK OF Mycobacteria infections BRINGS ATTENTION TO CONTAMINATED DENTAL UNIT WATERLINES IN PEDIATRIC DENTAL PRACTICEs (November 16, 2022)
A health advisory from CDC's Health Action Network on the importance "maintaining and monitoring dental unit waterlines" was released after a cluster of mycobacteria infections in children was reported. This current outbreak brings attention to several past outbreaks of mycobacteria infections in children stemming from contaminated dental unit waterlines in peditaric dental practices. Described in the health advisory, one outbreak involved 71 children and another affeced a cluster of 24 children. The kids who were infected developed "cervical lymphadenitis and mandibular or maxillary osteomyelitis, [...] tooth loss, hearing loss, facial nerve palsy, and incision fibrosis."
To read more about these cases and for information on treating dental unit waterlines, click here. For more information on dental unit waterline safety, visit the Safety Toolkit.
Updated COVID-19 Booster Available Now (September 2, 2022)
Pfizer BioNTech and Moderna have each released an updated COVID-19 booster shot, known as a bivalent vaccine booster, that offers protection against multiple virus variants. The bivalent vaccine booster will replace the original monovalent booster moving ahead. Children and adults, ages 12 and up, are authorized for the Pfizer bivalent booster, while children and adults, ages 18 and up, have the option to get the Moderna bivalent shot. To learn more about how COVID-19 vaccines and booster shots are changing visit FDA.gov's COVID-19 Vaccines website. Visit the FDA's short Q&A on the bivalent vaccine here.
cdc recommends Novavax COVID-19 Vaccine for 12-17 year olds (August 22, 2022)
The CDC announced today the recommendation for another primary series COVID-19 vaccine for children and adolescents ages 12-17. The Food and Drug Administration (FDA) authorized the adjuvanted vaccine series for adults in mid-July. Further testing showed the vaccine was effective for adolescents as well. For more information on the new vaccine series for adolescents, visit Vaccines for Children and Teens and for a fact sheet on Novavax, visit Novavax COVID-19 Vaccine, Adjuvanted. Click here to read the full announcement.
Children Ages 6 Months and Older Get Vaccine Recommendation from CDC (Updated June 27, 2022)
The CDC has signed off on the recommendation that children over the age of 6 months old receive a COVID-19 vaccine, stressing that children who have already had a COVID-19 infection will have added protection when also getting vaccinated. The recommendation followed the Food and Drug Administration authorization of two long-awaited COVID-19 vaccines for children under the age of 5 years old.
The two vaccines include the Pfizer-BioNTech COVID-19 vaccine for ages 6 months to 4 years old and the Moderna COVID-19 vaccine for ages 6 months to 17 years old. The Pfizer-BioNTech vaccine is given in a three shot primary series while the Moderna vaccine has a two dose primary series (with a third primary dose for children who are immunocompromised).
The new CDC recommendation for children can be found here. More information on the newly authorized vaccines can be found in Coronavirus (COVID-19) Update: FDA Authorizes Moderna and Pfizer-BioNTech COVID-19 Vaccines for Children Down to 6 Months of Age.
SAFETY REALL: Propofol Injectable Emulsion, Usd (containing benzyl alcohol)
In a new announcement, the Food and Drug Administration (FDA) shared that the company Hospira, Inc. is recalling a lot of their Propofol Injectable Emulsion, USD (containing benzyl alcohol) due to visible particulates in one of the vials.
The product is the 100 mL Single Patient Use Glass Fliptop Vial; lot DX9067; Vial: 0409-4699-54; Carton: 0409-4699-24. In the announcement the FDA stressed that there are life-threatening adverse clinical effects for patients who receive the contaminated product. Nothing has been reported so far but any adverse events can be shared with the FDA MedWatch Adverse Event Reporting program:
- Complete and submit the report Online
- Regular Mail or Fax: Download form or call 1- 800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
For more information on the recall, visit Hospira Issues a Voluntary Nationwide Recall for One Lot of Propofol Injectable Emulsion, USP (Containing Benzyl Alcohol), Due to the Potential Presence of Visible Particulate.
CDC Recommends Booster Dose for 5-11 Year Olds (Updated May 20, 2022)
On Thursday, May 19th, the Centers for Disease Control released a statement recommending booster shots for the age group 5-11 years to extend protection by the COVID-19 vaccine against coronavirus. This followed a recent emergency use authorization from the Food and Drug Administration for the Pfizer-BioNTech booster shots. With the official recommendation from the Centers for Disease Control and Prevention (CDC), the booster dose can be sought five months following the 2-shot vaccine series. The media statement, "CDC Strengthens Recommendations and Expands Eligibility for COVID-19 Booster Shots", can be found here. For more details on COVID-19 vaccines for all age groups, visit “COVID-19 Vaccines for Children and Teens" and “Stay Up to Date with Your COVID-19 Vaccines”. Visit AAPD COVID-19 Resources for the latest information on COVID-19 that impacts pediatric dental practice.
Psychosocial Support for Children in Sedation – Safety Plus Security for Patients (May 11, 2022)
This article from the Society for Pediatric Sedation describes how emotional safety for children going through medical procedures is not just integral to patient safety and wellbeing but that clinicians can avoid their own distress caused by the compounding of multiple difficult patient experiences by using some proven tools that give the highest level of emotional support to their patient. Click here to read “Safety in Sedation – Not Just Physical”, and visit the “Sedation and General Anesthesia Safety” and “Developing a Culture of Safety” sections in the AAPD Safety Toolkit for other great tools.
Recall of Lidocaine CHl topical Solution USP, 4%, 50ml from Teligent Pharma (December 10, 2021)
A global recall has been issued for Teligent Pharma Lidocaine HCl Topical Solution USP, 4%, 50ml, sold through retail and wholesale distribution. The lidocaine is being recalled for super-potency (higher than indicated dose) that could result in anesthesia toxicity, severe illness or death. The use of the product (NDC 63739-997-64, Lot #15594 Exp. 05/2023 and Lot #16345 Exp. 01/2024) should be immediately discontinued, according a recent Food and Drug Administration (FDA) announcement. Providers can report any side effects or adverse events because of use of the product to FDA's MedWatch Safety Information and Adverse Event Reporting Program, here. To read the announcement in full, click here.
Comprehensive Infection Control Certification Programs Available Now Through OSAP, the DALE Foundation and DANB
The Organization for Safety, Asepsis and Prevention (OSAP), in collaboration with the Dental Advancement through Learning and Education Foundation (DALE) and the Dental Assisting National Board (DANB), is offering three clinically focused educational programs to dentists and staff interested in becoming certified in infection prevention and control. These trainings set themselves apart because of the quality of content and comprehensiveness of the programs. They are for anyone in dental practice who would like to enhance their infection control knowledge with current research and practices.
OSAP-DALE Foundation Dental Infection Prevention and Control Certificate Program
Certified in Dental Infection Prevention and Control (CDIPC) certification
Dental Industry Specialist in Infection Prevention and Control (DISIPC) certification
FDA Warns Against Two Molecular COVID-19 Lab Tests (Updated 1/6/2021)
The Food and Drug Administration has cautioned against the use of two COVID-19 molecular lab tests (Applied DNA Sciences Linea COVID-19 Assay Kit, and Meridian Biosciences Revogene SARS-CoV-2 RT-PCR Test) to date as the Omicron becomes the dominant variant in the U.S. The concern is that the test will no longer be able to identify the new virus variant's mutation. There are a number of tests that will not be impacted by the mutation. Tide Laboratories have resolved the issue for their DTPM COVID-19 RT-PCR test. Providers are encouraged to seek out tests that use multiple genetic targets to identify SARS-CoV-2, as the virus continues to evolve. To read "SARS-CoV-2 Viral Mutations: Impact on COVID-19 Tests", click here. (Updated 1/6/2021)
MedWatch Highlights Unauthorized COVID-19 Antigen Test, Warns Consumers
In a new MedWatch announcement, the Food and Drug Administration has cautioned against the use of LuSys Laboratories COVID-19 Antigen Test, which may also be sold as Luscient Diagnostics or Vivera Pharmaceuticals, and EagleDx. They warn that despite this test being unauthorized for distribution or use in the U.S. they believe this test is being sold as take-home tests and for use within labs. The test is reportedly "high risk" for false results. To read the announcement in greater detail, click here.
Tylenol Toxicity in Children
Pain management is crucial for the physical and psychological health of children. The pediatric patient who is experiencing pain from dental caries may temporarily be helped with non-opioid pain medications like Tylenol for a short time. If not managed well (intake of acetaminophen through multiple pain medicaments unknowingly or parent unawareness of dose information, for example), Tylenol can produce liver toxicity. The more well-known route of Tylenol toxicity experienced by children is through acute overdose. However, hepatotoxicity also occurs through prolonged regular use of the drug. This is especially significant for the child who is facing a considerable wait time for hospital-based dental treatment
Denial of access to operating room time in hospitals has had significant impacts on the pediatric patient and their families waiting for care.
Careful consideration of pain management in light of OR access denial is warranted because of the potential for toxicity from prolonged use of the Tylenol.
Keeping Safe Around Flood Water
The best way to protect yourself, your practice, and your patients is to plan ahead. The Centers for Disease Control and Prevention Plan Ahead page provides helpful resources on preparing for disasters, breaking recommendations into four categories: stay healthy, stay connected, stay calm, and stay informed.
The National Oceanic and Atmospheric Association’s Severe Storms Laboratory provides basic background information on floods, including distinctions between terminologies, such as the differences between a flood watch and a flood warning, explanations of which areas are at higher risk for flooding, and answers to frequently asked questions.
And what should be done after a flood occurs? Naturally, questions arise about safety, hygiene, and when to re-open business. The Centers for Disease Control and Prevention has numerous resources to help address these challenging topics. The “Clean Up Safely After a Disaster” webpage provides guidance for the general public on protective gear and potential hazards to avoid when cleaning after a disaster. Floodwater after a Disaster promotes hygienic practices to prevent infection and illness. Information on the Re-Opening Healthcare Facilities site includes checklists and considerations for businesses; the “Special Considerations for Designated Activities” paragraph includes helpful information for dentists in particular.
For more information about how to best plan for disasters- ranging from earthquakes to cyberattacks- visit AAPD’s Disaster Preparedness Resource Hub.
New Content in Foundations: Building the Safest Dental Visit Training
These self-paced training modules are based on principles of infection prevention and control. The courses consist of interactive audio and video material on topics including infection prevention, patient and provider protection, and sterilization and disinfection processes. 3 CE credits are available to trainees who complete the course. To visit Foundations: Building the Safest Dental Visit, click here, or find it in the Infection Control section of the AAPD Safety Toolkit training section.
CDC DentalCheck Mobile App Helps Dentists and Team Stay on Top of Infection Prevention Practices
The CDC DentalCheck app offers a smart phone-based template to create personalized checklists to evaluate your infection control practices. The app prompts you or your team members on a range of infection prevention practices. Users can evaluate their policies and practices, taking note from direct observations to ensure you are meeting your safest care standards. With the CDC DentalCheck app you can personalize your checklist for your practice.
If you are interested in doing a primer before getting started on the CDC DentalCheck, visit "Summary of Infection Prevention Practices in Dental Settings". A guidebook in part designed as a checklist, this document highlights the "seven pillars of infection prevention" to keep your patients, team and self free of unintended harm while practicing pediatric dentistry. It offers evidence-based infection prevention and control principles and recommendations for dental settings - as well as an aid for evaluation of your practices. For more information on safety in dental practice, visit the AAPD Safety Toolkit. (February 3, 2023)
Are you cyber-ready?
Cyber attacks continue to devistate those who don't see them coming, often leaving hundreds to thousands of patients vulnerable to identity theft and fraud, not to mention the immense price tag of a data breach for the individual practice, even for small practices. The Cybersecurity & Infrastructure Security Agency (CISA) wants all organizations - including dental practices - to get cyber-smart and start applying cybersecurity actions to protect your patients and your practice from these costly events. Do you know if your practice is vulnerable? Visit CISA's Cyber Essentials Toolkits and learn how you can assess your cyber-readiness and take action. For more information and tools to help you protect your practice, visit the Safety Toolkit's IT Security section. (January 25, 2023)
Workplace Violence Prevention Programs at Ambulatory Care Sites
Workplace violence has been identified as one of the top occupational safety issues in ambulatory settings in healthcare. Many dental practices report experiences of aggression and violence as well. Violence and aggression can arrise because of domestic disputes, upset patients, employee disagreements or other reasons. Start planning now to protect your patients, staff and yourself in the case a verbal scuffle ever becomes something more challenging to resolve. The Crisis Prevention Institute shares that small steps can make a large impact on workplace safety and have created a guide on how to start planning for these uneasy situations, "7 Steps to Establishing Workplace Violence Prevention Programs at Ambulatory Care Sites". For information geared specifically at employee-employee aggression, visit the ADA's resource, "Tip Sheet on Employee-on-Employee Violence".
The U.S. Surgeon General’s Framework for Workplace Mental Health & Well-Being
This resource was created to help keep the conversation on employee health and well-being going, to bring about change in workplaces to support workers health, productivity, and creativity, and to elevate their contentment during their working lives. The framework describes five essential components of workplace mental health and well-being. Each chapter or essential component includes a list of resources like toolkits, guide books, trainings and support links. Practice examples are offered to help inspire your vision. Click here to download and read “The U.S. Surgeon General’s Framework for Workplace Mental Health & Well-Being”.
RDSP Critical Drug Shortage List Keeps You in Informed of Supply Chain Issues Impacting Essential Drug Availability
The Resilient Drug Supply Project (RDSP), a research project out of the Center for Infectious Disease Research and Policy (CIDRP) at the University of Minnesota, has begun tracking critical acute drug supplies to follow issues arrising from global supply chain slowdowns to product use surges and more. The project has mapped the supply chain for each of the 156 critical acute drugs identified as essential for patients, and has created a regularly updated index of the reported drug shortages known to the FDA and ASHP. The project homepage features a dashboard to keep viewers aware about the issues and their resolution. Click here to view the "Critical Drug Shortage List". Click here to view the "RDSP Dashboard".
Health Literacy Universal Precautions Toolkit
According to the AHRQ, very few people (12%) have the health literacy skills needed to understand health information, making it difficult for many to comprehend information from their visit with the dentist or doctor, and to navigate the healthcare system. In fact, people who have health literacy skills have enhanced safety when interacting with health care. At the same time, people with limited-English proficiency (LEP), experience more frequent and severe adverse events than people who don't have LEP. That is why the AHRQ has created a toolkit that will help you be confident in knowing that you are on the same page as your patient and that they are getting the optimal care that you envisioned for them. This toolkit includes practical strategies, trainings and more . Visit https://www.ahrq.gov/health-literacy/improve/precautions/index.html to get started!
COVID-19 Real-Time Learning Network
This resource from Infectious Diseases Society of America (ISDA) is a great website for COVID-19 practice tools, clinical guidance and research for all types of healthcare workers. Find the latest on vaccines, diagnostics and treatments and lots more at https://www.idsociety.org/covid-19-real-time-learning-network/ (July 22, 2022)
TeamSTEPPS Dental Module
TeamSTEPPS is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals. The TeamSTEPS dental module consists of videos (~5 minutes each) showing how dental staff can integrate TeamSTEPPS in their practices. These trainings build skills on teamwork, leadership, mutual support, communication and situational monitoring in dentistry.
To visit the module materials, click here. For more reading on how to reduce errors in your practice visit "System-oriented approaches to medical error reduction" in the Safety Toolkit.
Crisis Prevention Institute’s Top 10 De-Escalation Tips
The Crisis Prevention Institute (CPI) trains health care workers in anticipation that they will face some hostility in their workplace at some time. De-escalation, a first-line response to potential aggression in health care settings, is one tool that pediatric dentists can use to resolve heated interactions. This resource developed by CPI lists practical tips for de-escalation and support for people in crisis who may display disruptive behavior with a focus on support, humanity and compassion.
For more practical information on optimizing personnel safety in your practice, visit the Personnel Security section of the Safety Toolkit and discover practice tools, training tools, scientific documentation and library of great resources.
Making a Commitment to Safe Care: My AAAASF Certification Experience by Dr. Barry Jacobson, D.M.D., May 2020
N95’s and respirators: Are you compliant? by Dr. Joe Castellano, D.D.S., March 2021
Staying Safe and Sedating with a Smile by Dr. Bobby Thikkurissy, D.D.S., M.S., May 2021
Addressing Hidden Dangers for Children by Dr. Paul Casamassimo, D.D.S., M.S., September 2021
Systems and Safety in Dentistry by Dr. Charles Czerepak, D.M.D., November 2021
Are Surface Disinfectants Safe? by Dr. Paul Casamassimo, D.D.S., M.S., May 2022
Checklists in the Dental Office by Dr. Travis Nelson, D.D.S., M.S.D., M.P.H., and Tonya Martino, R.N., B.S.N., N.D., September 2022
Join Dr. Joel Berg as he speaks with AAPD leaders, experts in the field of pediatric dentistry and other professionals for Pedo Teeth Talk & Newly Erupted. In these podcasts, he’ll be discussing the most up-to-date, relevant safety information out there for everyone in the pediatric dental community.
Listen below, or with iTunes, Google Podcasts, Android, Stitcher, Spotify, TuneIn or RSS Feed.
Why you should look into OSAP, ASAP!, With Ms. Michelle Lee August 2022
Managing a start-up practice while championing safety. With Dr. Alexandra Otto, April 26, 2022
Should my practice be accredited? Whether you know what that means or not, learn all about it! With Tom Terranova of AAAASF, August 9, 2021
Are narcotics disappearing from our sedation cases? With Dr. Bryant Cornelius, May 2021
Taking care of yourself, your mental health and wellbeing. With Dr. Sheela Raja, August 2020
All you need to know about infection control. With Dr. John Molinari, March, March 2020