<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.44.36.05" title_num="10" subtitle_num="44" chapter_num="36" heading="Supervising Dentist—Infection Control Activities.">
  <paragraph num="A.">
    <text>The supervising dentist in a private dental office shall be responsible for the following infection control activities:</text>
    <paragraph num="(1)">
      <text>Adherence to the CDC Guidelines in their individual capacity as described in Regulation .06 of this chapter;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The provision and accessibility of sufficient and appropriate:</text>
      <paragraph num="(a)">
        <text>Personal protective equipment including but not limited to:</text>
        <paragraph num="(i)">
          <text>Gloves;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Masks;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Eyewear; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Gowns;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Hand soaps and hand scrubs;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Puncture-resistant sharps containers located in close proximity to where they are to be used;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Products for cleaning and disinfecting environmental surfaces that are approved by the Environmental Protection Agency or its successor;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Periodic water quality testing to ensure that water meets Environmental Protection Agency regulatory standards for drinking water;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Sterilization monitoring of reusable dental equipment and instruments in accordance with the manufacturer’s instructions for use, including:</text>
        <paragraph num="(i)">
          <text>Biological spore testing;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Chemical monitoring; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Mechanical monitoring;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(g)">
        <text>Maintenance of a biohazard waste removal contract for the office; and</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Signage for patient waiting areas for those exhibiting symptoms of respiratory infection.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>In addition to the activities set forth in §A of this regulation, a supervising dentist shall be responsible for the training of clinical staff upon hire and before engaging in clinical duties, and at minimum, annually.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The training of clinical staff shall include training regarding:</text>
    <paragraph num="(1)">
      <text>Standard and transmission based precautions;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Hand hygiene;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Personal protective equipment;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Respiratory hygiene/cough etiquette;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Sharps safety;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Safe injection practices;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Sterilizing and disinfecting clinical contact and housekeeping surfaces;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Spore testing;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Water quality testing; and</text>
    </paragraph>
    <paragraph num="(10)">
      <text>The Occupational Safety and Health Administration Bloodborne Pathogens Standard as set forth in 29 C.F.R. §1910.1030.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A supervising dentist shall ensure that evidence-based written policies and procedures, based upon current CDC Guidelines, regulatory requirements, and other relevant guidance documents, are developed, maintained, and readily available for review by the office’s clinical staff.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The policies and procedures referred to in §D of this regulation shall be updated either annually or more often if appropriate, to reflect new evidence, guidelines, or regulatory requirements.</text>
  </paragraph>
  <paragraph num="F.">
    <text>A supervising dentist shall maintain adequate written records of the activities set forth in §§A—E of this regulation in each office for which the records apply.</text>
  </paragraph>
  <paragraph num="G.">
    <text>A supervising dentist who practices clinical dentistry shall, for their own practice of dentistry, be responsible for all infection control activities in the dental office including those activities that are not considered structural infection control or those that do not impact the entirety of the private dental office.</text>
  </paragraph>
</regulation>