Disposing of Sharps

Sharps Injury

Any puncture or injury to the skin involving a sharp instrument such as a dental bur, syringe needle, or suture needle; clinically significant because it can transmit blood-borne viruses (HBV, HCV, HIV).

Why Sharps Prevention Is Important

Sharps injuries or splashes to eyes or broken skin can transmit blood-borne virus (BBV) infections; prevention protects both clinicians and patients.

Common Routes of BBV Transmission

In dentistry, most BBV transmission occurs from infected patients to clinicians; asymptomatic carriers may not be detected from medical history.

Risk Factors to Consider

Nearly 50 % of dental-team sharps incidents are preventable; 39 % occur after the procedure but before disposal; all blood and saliva are considered potentially infectious—apply Standard Infection Control Precautions (SICPs).

Half of Sharps Injuries Are Preventable

Emphasizes that many injuries can be avoided through training, behavioral change, and engineering controls.

Common Causes of Intraoral Sharps Injuries

1 Accidental patient movement, mouth closing, poor visibility 2 Use of excessive force 3 Bending needles 4 Passing sharps between dentist and nurse.

Reducing Intraoral Sharps Injuries

Can be minimized by training, behavioral changes, and engineering innovations, though never eliminated completely.

Extraoral Injury Statistics

Forty percent of extraoral injuries involve dental burs and probe tips; they usually carry less blood contamination than hollow-bore needles.

Good Practice – Protecting Employees

Use instruments (mirror or cheek retractor) rather than fingers to retract cheeks/tongue when using sharps; improves safety and visibility.

Prevention of Clinical Sharp Injuries

Do not bend or recap needles with unprotected hands; use safety needles; place sharps in a neutral zone; avoid hand-to-hand passing of instruments.

Safe Disposal of Sharps

Discard single-use sharps immediately after use; never leave on trays; remove burs from handpieces; place directly into rigid puncture-proof yellow-lidded sharps bins; discard syringe + needle as one unit.

Assembly and Placement of Sharps Bins

Ensure lids are secured before use; place bins near point of use; never on floor or above shoulder height; keep aperture closed when not in use; seal and dispose when ¾ full; never retrieve items.

Employer Responsibilities

Employers must ensure staff know procedures for immediate first aid, reporting, and management after sharps or splash incidents.

Goals of Dental Office Sharps Management

1 Reduce sharps injuries in all healthcare personnel and students 2 Develop practical solutions to reduce preventable injuries.

What to Do During an Accident

Perform occupational health risk assessment for BBV exposure: check source patient history, ensure cooperation and confidentiality, and modify management based on recipient immunity and exposure significance.

Occupational Health Risk Assessment – Basis

Assessment considers patient history, injury type, blood presence on instrument, and local infection rates.

Management of Hepatitis C Exposures

Baseline anti-HCV test; genome 1 detection at 6 & 12 weeks; anti-HCV at 12 & 24 weeks; confirm by HCV RNA if positive; retest at 6 months if source unknown; treatment guided by results.

Post-Exposure Prophylaxis for HIV and HBV

Start HIV PEP as soon as possible (within 1–2 h, max 72 h); typical regimen = Raltegravir + Truvada for 28 days; HBV prophylaxis via vaccine or anti-HBV immunoglobulin; follow-up testing at 12 weeks.

Recording of Sharps Injuries

All sharps/splash incidents must be logged with incident details and kept confidential for ≥3 years; BBV-contaminated sharps = “dangerous occurrence.”

Clinical Governance and Accident Risk Assessment

Use accidents and near misses for staff training; analyze causes and take steps to prevent recurrence; create a culture where staff can report incidents confidently.