title: Methicillin-resistant Staphylococcus aureus and infection control for restorative dental treatment in nursing homes.
abstract: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in nursing home residents now averages 20-35%. This includes both numerous asymptomatic mostly unidentified carriers, and the occasional patient with an active infection. Among the most common sites for positive MRSA colonization are the nares and mouth (saliva). Ohio State University (OSU) dental students perform routine restorative dental care onsite in local nursing homes using portable equipment including handpieces that can generate aerosols. Using a series of cultured test swabs and plates, this pilot study suggests that protection for both dental health care personnel and patients are provided by the following: 1. universal barrier precautions (for example, gloves, gowns, masks, hats, facial shields, glasses), 2. surface disinfectants, 3. pre-op 0.12% chlorhexidene mouth rinses, 4. high volume evacuation, 5. perioral skin scrubs. Additional infection control methods, techniques and equipment were evaluated and compared including rubber dam isolation, hand excavation and bond technique, high-speed air turbine and electric "high" speed handpiece. There was no indication of a special tendency or heightened ability of MRSA to aerosolize.
authors.affiliation: The Ohio State University College of Dentistry, Section of Primary Care, 305 W. 12th Ave. # 186, Columbus, OH 43218, USA. hall.611@osu.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Hall
mesh_terms: D000336:Aerosols; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003755:Dental High-Speed Technique; D003793:Dental Restoration, Permanent / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use; D006801:Humans; D019552:Infection Control, Dental / Q000379:methods*; D016106:Methicillin Resistance; D009067:Mouthwashes / Q000627:therapeutic use; D009735:Nursing Homes; D010865:Pilot Projects; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects*; D016635:Universal Precautions
chemical_list: D000336:Aerosols; D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D000431:Ethanol; D002710:Chlorhexidine