64B5-25.004. Licensees Infected With Hepatitis B Virus

(1) The Board of Dentistry is charged with the responsibility of protecting the public from dentists or dental hygienists who present a danger to the public. The Board finds that licensees who are infected with the Hepatitis B virus present a grave danger to the public by virtue of the communicability of this infectious disease in a clinical setting. Absent the identification of infected licensees and the implementation of proper barrier techniques, these practitioners represent an unacceptable risk to the health and safety of their patients. Licensees bear the ultimate responsibility for the safety of their patients when the licensee or personnel employed by the licensee represent a health risk through direct or indirect contact with patients. This rule assures the ability of infected licensees to practice so long as adequate safeguards are maintained.

(2) Any Florida licensed dentist or dental hygienist practicing in this State who is infected with the Hepatitis B virus is required to notify the Board of such in writing no later than 14 days after learning of his or her infection with the Hepatitis B virus. Such notice shall include a copy of the lab report showing the result of that dentist’s or dental hygienist’s Hepatitis B Surface Antigen (HBSAG) test results. The Board will respond to the licensee in writing acknowledging the notification and will provide the licensee with an outline of criteria to be complied with which are designed to limit the potential spread of the virus. The criteria are:

(a) All licensees infected with the Hepatitis B virus must successfully complete, no later than 6 months after receiving acknowledgment of their status from the Board, an educational program approved by the Board which will aid in a better understanding of the disease. In order to receive Board approval, the program must be at least 6 clock hours in duration and the program’s curriculum must include, but is not limited to:

1. History and nomenclature of Hepatitis B virus,

2. Clinical relationship of Hepatitis B virus to other forms of viral hepatitis,

3. Hepatitis B virus mode of transmission and replication,

4. Blood curves in the clinical course of the Hepatitis B virus,

5. Clinical and laboratory characteristics of Hepatitis B virus infections,

6. The Hepatitis B virus infected licensee and his or her lifestyle,

7. The Hepatitis B virus infected licensee as a practicing health care professional,

8. Barrier techniques,

9. The consequences of a break in barrier techniques,

10. Proper mechanisms for reporting breaks in barrier techniques,

11. Sterilization and disinfection procedures in the operatory,

12. Sterilization and disinfection procedures in the laboratory,

13. Insurance and legal problems of Hepatitis B virus infected licensees; and,

14. Hepatitis B virus vaccine.

Additionally, to obtain Board approval the program must also administer a written comprehensive examination covering each of the topics listed above which must be satisfactorily completed by a participant before the participant will be certified as having completed the program.

(b) Infected licensees will be monitored on a random basis at least once a year by Board approved consultants for the purpose of verifying compliance with sterilization, disinfection and barrier techniques. The monitors will verify compliance by utilizing the criteria set forth in Rule 64B5-25.005, F.A.C.

The random monitoring will be performed in addition to any checks conducted by any county health department. The monitor’s report shall be forwarded to the Board’s Executive Director within 14 days of the monitor’s visit.

(c) Infected licensees shall notify the patient, the Board’s Executive Director and the local county health department at any time a barrier technique has been or may have been broken. The patient must be notified immediately. Telephonic notification must be accomplished within 24 hours and must be followed up by written notification no later than 72 hours after the barrier technique has been broken. Notification by the infected licensees shall include, at a minimum, the following information:

1. What barrier technique was broken,

2. Steps undertaken to notify affected patient; and,

3. Steps undertaken to overcome the break in technique.

(3) A break in barrier technique includes but is not limited to any puncture, tear or cut in the gloves at any time during which contact with the patient is made or at any time a break, abrasion or cut of the skin occurs which could expose the patient to risk of infection.

(4) Each and every notice or report required pursuant to this rule or as a result of the application of this rule shall be confidential and exempt from the provisions of Section 119.07(1), F.S., as set forth in Section 466.041(3), F.S.

Rulemaking Authority 456.032, 466.004(4) FS. Law Implemented 456.032, 466.028(1)(t), (v), (y), 466.041(3) FS. History–New 7-12-88, Amended 10-28-91, Formerly 21G-25.004, Amended 8-12-93, Formerly 61F5-25.004, 59Q-25.004.