As used in this subpart:

1. (1) “Critical instruments”:

   1. (A) Penetrate soft tissue, contact bone, or enter into or contact the bloodstream or other normally sterile tissue; and
   2. (B) Include surgical instruments, periodontal scalers, scalpel blades, and surgical dental burs;

2. (2)

   1. (A) “Dental healthcare personnel (DHCP)” means all paid and unpaid personnel in the dental healthcare setting who might be occupationally exposed to infectious materials, including body substances and contaminated:

      1. (i) Supplies;
      2. (ii) Equipment;
      3. (iii) Environmental surfaces;
      4. (iv) Water; or
      5. (v) Air.

   2. (B) “DHCP” includes:

      1. (i) Dentists;
      2. (ii) Dental hygienists;
      3. (iii) Dental assistants;
      4. (iv) Dental laboratory technicians (in-office and commercial);
      5. (v) Students and trainees;
      6. (vi) Contractual personnel; and
      7. (vii) Other persons not directly involved in patient care but potentially exposed to infectious agents (e.g., administrative, clerical, housekeeping, maintenance, or volunteer personnel);

3. (3)

   1. (A) “Disinfection” means destruction of pathogenic and other kinds of microorganisms by physical or chemical means.
   2. (B) “Disinfection” is less lethal than sterilization because it destroys the majority of recognized pathogenic microorganisms but not necessarily all microbial forms (e.g., bacterial spores).
   3. (C) “Disinfection” does not ensure the degree of safety associated with sterilization processes;
4. (4) “Exposure-prone invasive procedure” means any surgical, diagnostic, or therapeutic procedure involving manual or instrumental contact with or entry into any blood, body fluids, cavity, internal organ, subcutaneous tissue, mucous membrane, or percutaneous wound of the human body in which there is a risk of contact between the blood or OPIM of the DHCP and the blood or OPIM of the patient;
5. (5) “HBV” means the Hepatitis B virus;
6. (6) “HCV” means the Hepatitis C virus;
7. (7) “HIV” means the human immunodeficiency virus, whether HIV-1 or HIV-2;

8. (8) “Noncritical instruments”:

   1. (A) Contact intact skin; and
   2. (B) Include radiograph head/cone, blood pressure cuff, facebow, and pulse oximeter;
9. (9) “Occupational exposure” means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that can result from the performance of an employee’s duties;

10. (10)

    1. (A) “OPIM” means other potentially infectious materials.

    2. (B) “OPIM” is a term that refers to:

       1. (i) Bodily fluids including:

          1. (a) (a) Semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, fluids including semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, and saliva in dental procedures;
          2. (b) (b) Any body fluid visibly contaminated with blood; and
       2. (c) (c) All body fluids in situations where differentiating between body fluids is difficult or impossible; and
       3. (ii) Any unfixed tissue or organ (other than intact skin) from a human (living or dead);

11. (11) “Semi-critical instruments”:

    1. (A) Contact mucous membranes or nonintact skin;
    2. (B) Will not penetrate soft tissue, contact bone, or enter into or contact the bloodstream or other normally sterile tissue; and
    3. (C) Include dental mouth mirror, amalgam condenser, and reusable dental impression trays;

12. (12)

    1. (A) “Standard precautions” means the concept that all blood and OPIM should be treated as infectious because patients with bloodborne infections can be asymptomatic or unaware they are infected.

    2. (B) Preventive practices used to reduce blood exposures, particularly percutaneous exposures, include:

       1. (i) Careful handling of sharp instruments;
       2. (ii) Use of rubber dams to minimize blood spattering;
       3. (iii) Hand washing; and
       4. (iv) Use of personal protective barriers (e.g., gloves, masks, protective eyewear, and gowns).
    3. (C) “Standard precautions” integrate and expand the elements of “universal precautions” (the term used by the Centers for Disease Control and Prevention prior to 1996) into a standard of care designed to protect DHCP and patients from pathogens that can be spread by blood or any other body fluid, excretion, or secretion.

    4. (D) “Standard precautions” apply to contact with:

       1. (i) Blood;
       2. (ii) All body fluids, secretions, and excretions (except sweat), regardless of whether they contain blood;
       3. (iii) Nonintact skin; and
       4. (iv) Mucous membranes.

    5. (E)

       1. (i) Saliva has always been considered a potentially infectious material in dental infection control.
       2. (ii) Thus, no operational difference exists in clinical dental practice between universal precautions and standard precautions; and
13. (13) “Sterilization” means use of a physical or chemical procedure to destroy all microorganisms, including substantial numbers of resistant bacterial spores.