YOUR ADAA is carefully monitoring the communications issued by the Centers for Disease Control and Prevention concerning the recent outbreak of Ebola Virus Disease (EVD,) We strongly encourage dental assistants to immediately seek information from reliable sources with regards to Ebola Virus Disease and to regularly refresh their knowledge of current recommended infection control practices for dentistry.
All members of the dental team must be responsible for staying current in regard to the rapidly changing knowledge of EVD and strive to provide the most recent and accurate information to concerned patients. In light of this national concern, the ADAA continues to advocate that all dental assistants strictly adhere to current Center for Disease Control recommendations and Occupational Safety and Health Administration and state regulations with regards to occupational exposure to all infectious agents. Dental assistants should be mindful of all protocols established by the CDC and their individual state's Department of Health to ensure safety of the public and healthcare workers related to this outbreak. This week, the CDC published new Personal Protective Equipment guidelines for health care workers who are treating patients with EVD. (http://www.cdc.gov/vhf/ebola/)
According to information from the American Dental Association, those infected with Ebola are not considered contagious until symptoms appear. They state that due to the virulent nature of the disease, it is highly unlikely that someone with Ebola symptoms will seek dental care when severely ill.
However, according to the Centers for Disease Control and Prevention and the ADA Division of Science, dental professionals are advised to take a medical history, including a travel history from their patients exhibiting symptoms in which a viral infection is suspected.
As recommended by the ADA Division of Science, any person within 21 days of returning from the West African countries Liberia, Sierra Leone and Guinea, may be at risk of having contacted persons infected with Ebola and may not exhibit symptoms. In cases such as these, dental professionals are advised to delay routine dental care of the patient until 21 days have elapsed from their trip. Palliative care for serious oral health conditions, dental infections and pain can be provided if necessary after consulting with the patient's physician and conforming to standard precautions and physical barriers and the new CDC PPE guidelines.
According to the CDC, an elevated temperature is often a consequence of infection. But Ebola is not the only infection that may have similar signs and symptoms. The most common signs and symptoms of Ebola infection are:
- fever (greater than 38.6°C or 101.5°F) and severe headache
- muscle pain
- stomach pain or unexplained bleeding or bruising
The ADA advises that you not treat dental patients if they have these signs and symptoms for Ebola. If a patient is feeling feverish and their travel history indicates they may be at risk of Ebola, dental professionals and staff in contact with the patient should:
- immediately protect themselves by using standard precautions with physical barriers (gowns, masks, face protection, and gloves)
- immediately call 911 on behalf of the patient
- notify the appropriate state or local health department authorities
- ask the health department to provide up-to-date guidance on removing and disposing of potentially contaminated materials and equipment, including the physical barriers.
The Ebola virus is spread through direct contact (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit and semen) of a person who is sick with Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food. Again, there is no reported risk of transmission of Ebola from asymptomatic infected patients.