Objective:To compare infection control (IC) knowledge, attitudes and practice of dentists across eight countries.Methods: Self-administered infection control surveys were completed by 1,874 clinicians in eight countries. Practitioner's knowledge, attitudes, and practice of infection control were examined using over 100 variables. Chi-squared statistics (α = 0.05) were used to compare respondents from different national groups. Results:Immunizations rates varied significantly across the eight countries (p < 0.01) with Asian countries having a lower rate of immunization against HBV than the United States practitioners. Perceived risk of acquiring HIV varied significantly across the study groups (p < 0.01); China had the lowest portion (75%). Dentists in the US reported 92% surface barrier use; only 15% in China reported use. Only 58% of practitioners in Pakistan reportedly used disposable exam gloves; 97% of US practitioners regularly use these gloves. For all groups assessed, including the United States, little over 50% of practitioners understood and practiced Universal/Standard (UP/SP) precautions effectively. Conclusion:Analyses from this study suggest that the dental IC knowledge and practice varied widely across the eight countries of interest. Many of the countries were found to have barriers to access IC materials. Results indicate that all eight countries could use improved education standards for universal precautions.Clinical significance: Knowledge, attitudes and practice of dental safety vary in different parts of the world. This study compares the compliance rates in dental safety among countries and pegs them to the level of practice in the United States. This study also provides evidence-based data on the needs in the regions surveyed and could be used to implement remedial educational measures in improving safe practices.

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Aim: To highlight the potential difficulties in diagnosing neoplastic lesion of the head and neck in children within autism spectrum. Background: Ameloblastic fibromas are a variation of odontogenic tumors that are located in the posterior mandible in 70% of cases. The tumors may be either unilocular or multilocular when observed radiographically. Ameloblastic fibromas tend to have well-defined, scalloped margins radiographically but may also be corticated. In close to 75% of all cases, an impacted tooth is associated with the lesion. Although not confined to patients who are in their first or second decades of life, ameloblastic fibromas most often arise in this population. Case description: A 9-year-old male diagnosed with autism presented with tenderness in the left mandible. The parents were able to elucidate the child's problem as tingling rather than pain. The patient was referred for histopathological diagnosis and treatment. After evaluation and biopsy, the lesion was identified as a pediatric ameloblastic fibroma. He subsequently underwent the conservative approach of marsupialization and curettage without complication. Six-month follow-up revealed no evidence of recurrence and normal eruption patterns of the succedaneous teeth in the affected area. Conclusion:In this specific case, the conservative approach to treatment appears to have been appropriate. This may not be the appropriate course for every case; as such, each case will have an individualized approach. Earlier recognition with careful inspection can reduce potential complications. Clinical significance: We might be missing early diagnosis of ameloblastic fibroma and other significant orofacial neoplasms in patients who are nonverbal or nondescriptive such as those with autism. Moreover, careful inspection of radiographic and clinical signs cannot be overemphasized.

Dental infection control and occupational safety are very important aspects of dentistry. It is quintessential to provide safe care to patients and at the same time not to be affected personally by occupational hazards. While patient safety addresses control of disease transmission to patients during care, occupational safety addresses control of occupational hazards to the care provider. Collectively, we can refer to both patient safety and occupational safety as “dental safety”. “Primum non nocere” or “first, do no harm” is the key to providing safe dental care. Dentistry has evolved in science, technology and esthetics over the years, and around making various types and options of treatments available, but dental safety has not kept pace with changes and advancements. This is not due to lack of availability of information, materials and equipment, but due to lack of importance given to safety in comparison with other fields of dental sciences. While dental care is important in improving oral health, dental safety is important in controlling morbidity and mortality that is more important than improving oral health. In this manuscript, we address the rationale for understanding the need for dental safety. We address recent status in epidemiology of infectious diseases, including HIV, infectious diseases commonly encountered during provision of dental care, routes of disease transmission, Spaulding's classification of surfaces, universal and standard precautions, additional precautions while anticipating certain diseases or during certain endemics and epidemics, and finally infectious disease related stigma impacting universal precautions.