Papers by Helene Bednarsh
Journal of Dental Hygiene, Mar 22, 2005
Compendium of Continuing Education in Dentistry, Feb 1, 2004
Attention to infection control and concerns over transmission of disease is not a new phenomenon ... more Attention to infection control and concerns over transmission of disease is not a new phenomenon relative to the human immunodeficiency virus epidemic. There is evidence dating back to the early part of the 19th century of theories and practices designed to minimize infection risks associated with health care delivery. These strategies were not necessarily based in research, or what is referred to as evidence-based, but more on observation. Nonetheless, the practices were successful and evolved over time into principles of infection control. Over the past decade, guidelines for infection control have become evidence-based, where possible. In the absence of evidence, assumptions based on past experience and knowledge have driven recommendations. The newly released Centers for Disease Control and Prevention Guideline for Infection Control in Dental Health-Care Settings, 2003, reflect a format different from the 1993 guidelines, and the recommendations are ranked according to categories of existing scientific data, theoretical rationale, and the opinions of experts.
Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 2004
Attention to infection control and concerns over transmission of disease is not a new phenomenon ... more Attention to infection control and concerns over transmission of disease is not a new phenomenon relative to the human immunodeficiency virus epidemic. There is evidence dating back to the early part of the 19th century of theories and practices designed to minimize infection risks associated with health care delivery. These strategies were not necessarily based in research, or what is referred to as evidence-based, but more on observation. Nonetheless, the practices were successful and evolved over time into principles of infection control. Over the past decade, guidelines for infection control have become evidence-based, where possible. In the absence of evidence, assumptions based on past experience and knowledge have driven recommendations. The newly released Centers for Disease Control and Prevention Guideline for Infection Control in Dental Health-Care Settings, 2003, reflect a format different from the 1993 guidelines, and the recommendations are ranked according to categorie...
Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 1998
Dental professionals currently entering the dental workforce are witness to a signifi - cantly di... more Dental professionals currently entering the dental workforce are witness to a signifi - cantly different set of oral health issues with HIV than those encountered when the epidemic began. Populations at risk for infection have changed over time and, in Canada, the United States, and the rest of the world, higher proportions of minorities and women have become infected. Medication
Healthcare workers (HCWs) frequently face the risk of occupational infection from bloodborne path... more Healthcare workers (HCWs) frequently face the risk of occupational infection from bloodborne pathogens following exposure to blood and body fluids. This study describes the results of a surveillance system of occupational exposure to bloodborne pathogens among HCWs in Rio de Janeiro, Brazil, during an eight-year period. A total of 15 035 exposures reported from 537 health units were reviewed. Six circumstances comprised nearly 70% of the reported exposures: recapping needles (14%), performing surgical procedures or handling surgical equipment (14%), handling trash (13%), during disposal into sharps containers (13%), performing percutaneous venepuncture (10%) and during blood drawing (5%). Easily preventable exposures, such as incidents related to recapping needles, handling trash, and sharps left in an inappropriate place, represented 30% of the exposures reported. Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) was initiated for 46% of exposed HCWs. Although Brazilian guidelines indicate that PEP is usually not recommended for exposures with insignificant or very low risk of HIV infection, PEP was prescribed to a large proportion of exposed HCWs under these circumstances. The prevention of occupational exposure to bloodborne pathogens among HCWs and their safety must be considered as a public health issue. Although infection-preventative measures such as antiretroviral drugs and rapid tests are available, this study shows that there are still a high number of easily preventable exposures. The implementation of more effective prevention strategies is urgently required in this country.
Oral health care is an essential yet often unmet need for underserved and underinsured population... more Oral health care is an essential yet often unmet need for underserved and underinsured populations in the US. This is a social justice issue that requires national attention from not only policy makers, but oral health providers, public health workers and the general public. This unmet need is extensive in the HIV population and has been widely documented. This session will provide information about how social justice can be promoted by increasing access to oral health care for persons living with HIV and share the results from the multisite evaluation identifying the structural and personal barriers to oral health care that lead to poor dental care utilization, lower literacy about oral hygiene and health, and higher unmet needs. Strategies will be presented for promoting greater access that can reduce the disparity within this population. The 3 panelists will present the following topics: 1. A lack of access to oral health care leading to dissatisfaction with a patients' appea...
Journal (Canadian Dental Association), 2007
Dental professionals currently entering the dental workforce are witness to a significantly diffe... more Dental professionals currently entering the dental workforce are witness to a significantly different set of oral health issues with HIV than those encountered when the epidemic began. Populations at risk for infection have changed over time and, in Canada, the United States, and the rest of the world, higher proportions of minorities and women have become infected. Medication regimens that help manage HIV as a more chronic disease have affected its presentation, its frequency and, perhaps, the significance of its oral manifestations. These medications may provoke comorbidities that challenge medical and dental disease management and health promotion. The dental office may become a site for rapid testing for HIV. The complexity of HIV infection and treatment behooves all health care professionals to be aware of developments in the prevention and epidemiology of HIV infection, and in oral health care for patients who are HIV-positive.
Journal of Public Health Dentistry, 2011
This article describes a typology of program models for expanding access to dental services for p... more This article describes a typology of program models for expanding access to dental services for people living with HIV/AIDS (PLWHA). These programs serve communities with limited access and high unmet need for oral health care, such as rural areas, low-income and racial/ethnic minorities. Interviews and site visits with dental and program directors were conducted at participating sites, including AIDS service organizations, community health centers, and university-affiliated medical centers or hospitals. Despite the differences across organizational structure, similar models and approaches were developed to engage and retain PLWHA in dental care. These approaches included: using mobile dental units; expanding the type and availability of previous dental services provided; providing training opportunities for dental residents and hygienists; establishing linkages with medical providers; providing transportation and other ancillary services; using dental case managers and peer navigators to coordinate care; and patient education. This typology can assist program planners, medical and dental care providers with service delivery strategies for addressing the unmet need for oral health care in their area.
Dental Clinics of North America, 2016
Interprofessional collaboration in health has become essential to providing high-quality care, de... more Interprofessional collaboration in health has become essential to providing high-quality care, decreased costs, and improved outcomes. Patient-centered care requires synthesis of all the components of primary and specialty medicine to address patient needs. For individuals living with chronic diseases, this model is even more critical to obtain better health outcomes. Studies have shown shown that oral health and systemic disease are correlated as it relates to disease development and progression. Thus, inclusion of oral health in many of the existing and new collaborative models could result in better management of chronic illnesses and improve overall health outcomes.
Compendium of Continuing Education in Dentistry, Mar 1, 2005
The mission of the Occupational Safety and Health Administration (OSHA) is to ensure the safety a... more The mission of the Occupational Safety and Health Administration (OSHA) is to ensure the safety and health of America's workers. Although OSHA's focus is on safety, there is a natural overlap into the infection control arena. The work practice control, engineering control, and personal protective equipment regulations are examples of OSHA safety topics that have a direct impact on dental infection control. In a similar fashion, the regulations designed to protect the dental health care worker often translate into increased safety for the dental patient. To ensure their safety, OSHA requires workers to be appropriately trained. This article reviews the regulatory significance of OSHA, compares OSHA with other regulatory and advisory agencies, and discusses OSHA's training requirements. Principles for conducting training in the dental health care setting along with suggestions for assessing training also are presented.
Public Health Reports, May 1, 2012
Objectives. We analyzed the characteristics of people living with HIV/AIDS (PLWHA) who reported u... more Objectives. We analyzed the characteristics of people living with HIV/AIDS (PLWHA) who reported unmet oral health needs since testing positive and compared those characteristics with people reporting no unmet health needs. We also identified barriers to accessing oral health care for PLWHA.
Compendium of Continuing Education in Dentistry, Jul 1, 2002
The primary focus in occupational injury management is the prevention of injuries before they tak... more The primary focus in occupational injury management is the prevention of injuries before they take place through standard precautions, personal protective equipment, and administrative, work practice, and engineering controls. However, should an exposure occur, prompt and appropriate response may reduce the risk of bloodborne pathogen transmission. The Centers for Disease Control and Prevention (CDC) recently released an updated guideline for postexposure management after occupational exposure to hepatitis B, hepatitis C, or human immunodeficiency virus. This article reviews the steps that should be taken to prevent exposure to bloodborne pathogens as well as the appropriate response in the event of an exposure. In addition, the CDC's updated guidelines for postexposure management will be reviewed.
Public Health Reports, May 1, 2012
Objective: In previous work we found that dentists, patients, and physicians have a favorable att... more Objective: In previous work we found that dentists, patients, and physicians have a favorable attitude towards point-of-care screening for medical conditions in a dental setting. Dental hygienists are likely to be involved in or actually conduct the screening tests. Therefore, understanding attitudes and perceived barriers among practicing dental hygienists is important for successful implementation. Method: A 5-point Likert-scale (1=very important/willing, 5=very unimportant/unwilling) survey was mailed to practicing dental hygienists in the US. Descriptive statistics are presented. Result: Of 1687 respondents, 99% were female, 60% were 41-60 years old, and 72% were practicing >10 years. The majority felt it was important for oral health care providers to conduct chairside screening for cardiovascular disease (86%), hypertension (94%), diabetes mellitus (90%), HIV infection (79%), and hepatitis (80%). Respondents were willing to conduct chairside screening that yields immediate ...
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Papers by Helene Bednarsh