Hepatitis B vaccinations and Tuberculosis testing in the Dental office

Let’s continue with our Infection Control series with a little Q&A…

Are Hep B vaccines required?

We receive a lot of inquiries through our website from dental offices wanting to know if Hepatitis B vaccinations (HBV) are required. The answer may surprise you. The answer is (drum roll, please):

No! Employers are required to offer the HBV, but employees are not required to receive it if the worker has previously received the vaccine series, antibody testing has revealed that the worker is immune, or the vaccine is contra-indicated for medical reasons.” – OSHA Fact Sheet, Hepatitis B Vaccination Protection. Employees can also decline the vaccine. In that case, employers need to keep documentation on hand of the employee declination. We recommend that in all situations employers maintain (in the employee OSHA medical file-not their regular employment file) a copy of vaccinations and/ or declinations for all employees.

Another question we get is, “Do front office staff  or admin staff need to receive HBV?” I turned to OSHA for the answer on this, so we are crystal clear. The answer, "healthcare workers (HCWs) who have blood or patient contact and are at ongoing risk for injuries with sharp instruments or needlesticks" as presented in CDC's Morbidity and Mortality Weekly Report (MMWR) Immunization of Health-Care Workers, December 1997 (Appendix [E] of the current Bloodborne Pathogens directive, [CPL 02-02-069]) must be offered the vaccine. Employers need to take these points into consideration when deciding on whether an employee should be offered HBV.

Need declination forms? Click here to visit our Resources Page. Scroll Down to Infection Control.

Need updated OSHA Training? Call our office for assistance. 817-755-0035.

Need an OSHA Manual? Click here to visit our web store.

What about testing for TB?

According to Guidelines for Infection Control in Dental Health-Care Settings 2003, Employers of Dental Health-Care Professionals should “conduct a baseline TST, preferably by using a two-step test, for all DHCP who might have contact with persons with suspected or confirmed infectious TB, regardless of the risk classification of the setting.” From that point, unless there is a suspected exposure employers may elect not to participate in annual testing if they are in a low-risk environment.

Need TB related forms? Click here to visit our Resources Page. Scroll Down to Infection Control.

Do we need Radiation and N2O Badges?

We receive calls inquiring whether radiation badges and/ or N2O badges are required. In Texas these devices are not required in dentistry. However, employers should have pregnant employees obtain an order from their OB/GYN if they are to refrain from taking radiographs during their pregnancy.


That’s it for today. Stay tuned for additional posts on Infection Control. Be sure to share this with your friends and colleagues on Facebook, LinkedIn, Google+ or by e-mail.

We’ll talk again soon!


       Tink (a.k.a. the “Toothcop”)