1. Regulatory and Advisory Agencies
Chapter 22

2. Introduction
Several government agencies and professional organizations have direct influence on dentistry, infection control, and other healthcare safety issues
In addition to issuing recommendations and regulations, some have regulatory roles and others are advisory
These agencies can serve as an excellent resource for information and educational materials
Ask students to name the agencies and organizations they believe are involved with dentistry. (Answers will vary.)

3. Introduction
Recommendations are made by individuals, groups, or agencies that are advisory and have no authority with regard to enforcement
Regulations are made by groups or agencies that do have the authority to enforce compliance with the regulations
Enforcement penalties may include fines, imprisonment, or suspension or revocation of licenses
Recommendations may be made by anyone, but regulations are made by governmental groups or licensing boards in towns, cities, counties, and states
Of the agencies and organizations named by the students, ask which provide regulations versus recommendations.

4. Associations and Organizations
Professional organizations are a valuable resource for current infection control and other professional information
Many dental professionals choose to become members of their professional organizations
What do you think may be some of the benefits to joining the American Dental Association? (The ADA publishes both a journal and a newsletter, sponsors seminars and meetings, and provides group rates for insurance. It has a Web site with a wealth of information for both professionals and the public.)
Refer to Table 22.1: Professional Organizations.

5. American Dental Association (ADA)
The ADA is the professional organization for dentists
The ADA periodically updates its infection control recommendations as new scientific information becomes available
Today, more than 157,000 dentists are members.
Not only does the ADA provide information for dental professionals, it also provides information for the public on oral health.

6. American Dental Assistants Association (ADAA)
The oldest, largest group that represents professional dental assistants
Its members include clinical personnel who work chairside with the dentist, as well as the receptionist, the office manager, and those working behind the scenes in dental product sales, insurance, and education
The ADAA states its mission as follows:
To advance the careers of dental assistants and to promote the dental assisting profession in matters of education, legislation, credentialing and professional activities which enhance the delivery of quality dental health care to the public.
There are no requirements to becoming a member, and certification is not mandatory. Members must simply complete an application form and stay current on any association dues.

7. American Dental Hygienists Association (ADHA)
The national professional organization for dental hygienists
Provides its members with professional support, educational programs, and opportunities to participate in the organization
ADHA is the largest professional organization representing the interests of dental hygienists. Members enjoy professional support, educational programs, and numerous opportunities for participation in association decision making. ADHA seeks to carry out its mission to advance the art and science of dental hygiene and to promote the highest standards of education and practice in the profession.
To qualify to become an active member of ADHA, an applicant must provide proof of licensure.

8. Organization for Safety, Asepsis and Prevention (OSAP)
A not-for-profit organization composed of dentists, hygienists, dental assistants, government representatives, dental manufacturers, university professors, researchers, and dental consultants
This organization is an excellent resource for information on infection control, injury prevention, and occupational health issues
The OSAP Web site is

9. State and Local Dental Societies
State and local dental societies can help you comply with regulatory issues in your specific area
National, state, and local dental-assisting societies can often answer questions and provide opportunities for continuing dental education
In the state of Washington, the dental association is composed of 17 local component societies that play an important role in implementing projects and programs at the state and local levels.
Why is it important to be involved with the local dental society? (It can answer questions and work with the dental professional or act as a liaison with regulatory agencies.)

10. Government Agencies Centers for Disease Control and Prevention
Food and Drug Administration
Environmental Protection Agency
Occupational Safety and Health Administration
National Institutes of Health
National Institute of Dental and Craniofacial Research
National Institute for Occupational Safety and Health
Ask each student to name a dental product that is regulated by the FDA. (Answers will vary.)
Refer students to Table 22.2: Government Agencies.

11. Centers for Disease Control and Prevention (CDC)
Recognized as the lead federal agency for protecting the health and safety of people at home and abroad
Bases its public health recommendations on the highest- quality scientific data
Infection control procedures practiced in dentistry today are based on the Guidelines for Infection Control in Dental Healthcare Settings, issued by the CDC
Guidelines contain an Oral Health Services section that concerns oral diseases, fluoride application, and infection control in dentistry
The CDC does not have the authority to make laws, but many local, state, and federal agencies use CDC recommendations to formulate laws
Recently the CDC published statistics on how many people in the United States visited the dentist within a 1-year timeframe. What do you believe the statistics were? (67.9% yes, 32.1% no)

12. Food and Drug Administration (FDA)
Regulatory agency that is part of the U.S. Department of Health and Human Services
The FDA regulates the manufacture and labeling of medical devices as well as antimicrobial hand-washing products and mouth rinses
Inform the students what should occur if a medical device regulated by the FDA malfunctions.
What are some examples of medical devices regulated by the FDA? (Examples include sterilizers, biologic and chemical indicators, ultrasonic cleaners and cleaning solutions, liquid sterilants, gloves, masks, protective eyewear, dental handpieces and instruments, dental chairs, and dental-unit lights.)

13. Dental Operatory
Figure An overview of a dental operatory showing items (arrows) regulated by the U.S. Food and Drug Administration (FDA).

14. Environmental Protection Agency (EPA)
Regulatory agency that ensures the safety and effectiveness of disinfectants
Manufacturers of disinfectants must submit information about the safety and effectiveness of the product
If the claims meet the EPA criteria, the product receives an EPA registration number that must appear on the product label
The EPA regulates discharge and final treatment of waste materials (e.g., chemicals), as well as medical waste after it leaves the dental office
Discuss different disinfectants and the information provided on the labeling.

15. Occupational Safety and Health Administration (OSHA)
Regulatory agency that protects workers against physical, chemical, and infectious hazards in the workplace
It establishes protective standards, enforces those standards, and offers technical assistance and consultation programs
OSHA is a federal agency, but 22 states administer their own state-operated OSHA programs
In states that administer their own OSHA programs, the state standards must be equivalent to or more stringent than those of the federal agency
What OSHA standards apply to dentistry? (Bloodborne pathogens, hazard communication, occupational exposure to hazardous chemicals in laboratories, medical services and first aid, respiratory protection, personal protective equipment, formaldehyde, portable fire extinguishers, nitrous oxide, ethylene oxide)

16. National Institutes of Health (NIH)
Part of the U.S. Department of Health and Human Services
The primary federal agency for conducting and supporting medical research
Many important health and medical discoveries of the last century resulted from research supported by the NIH
Translates research results into practice and communicates research findings to patients and their families, healthcare providers, and the general public
The National Institutes of Health is located in Bethesda, Maryland, just outside of Washington, D.C.

17. National Institute of Dental and Craniofacial Research
The dental research institute of the NIH
Its mission is to promote the general health of the American people by improving their oral, dental, and craniofacial health
Through research and the training of researchers, the NIDCR promotes health, prevents diseases and pathologic conditions, and develops new diagnostic and therapeutic techniques
The Web site for NIDCR is

18. National Institute for Occupational Safety and Health (NIOSH)
NIOSH does not have regulatory authority
It is responsible for conducting research and making recommendations for the prevention of work-related disease and injury
NIOSH makes recommendations and disseminates information on preventing workplace disease, injury, and disability
It provides training to professionals in the field of occupational safety and health
The research branch is known as the National Occupational Research Agency, or NORA.
What projects or areas might NORA research benefit dental professionals? (Allergic and irritant dermatitis, infectious diseases, lower-back disorders, emerging technologies, mixed exposures, control technology and personal protective equipment, exposure-assessment methods, and risk-assessment methods)