Know How to Respond to the Dental Practice’s Most Common Injury: Needlesticks

The responsibilities of dental practice owners extend far beyond protecting the health of their patients. While dental offices are generally considered to be safe workplaces, dental practice employees can face exposure to numerous workplace hazards in the everyday workplace, not to mention in emergency situations. Employers must pay attention to the recommendations and requirements of federal, state and local public health officials to keep their employees and the public safe.

The federal Occupational Safety and Health Administration and some states have legal requirements for employers to create and maintain safe workplaces. OSHA maintains a webpage dedicated to dentistry, and many general industry standards also apply to dental offices, including those that address bloodborne pathogens and biological agents, ergonomic hazards and exposure to toxic chemicals.

The Most Common Workplace Injury

The Dentists Insurance Company handles a wide range of workers’ compensation claims related to workplace injuries, including everything from slip-and-fall accidents to strained muscles. But by far the most common type of injuries in the dental office are cuts, punctures, scrapes and needlestick injuries. In fact, more than 80% of all injury claims in 2025 fell into this category, according to TDIC data.

Most of these injuries occur when breaking down instrument trays following a procedure. In many cases, the employee was removing the anesthetic carpule or removing the needle from the syringe when the cap slipped off the needle and caused the puncture.

Needlestick injuries can put health care workers at risk of exposure to bloodborne pathogens, including hepatitis B, hepatitis C and HIV. According to the Centers for Disease Control and Prevention, the risk for infection after exposure is quite low, hovering around 1.8% for HCV and virtually zero for those who have received the HBV vaccine. For HIV, the average risk is about 0.3% after a needlestick injury or cut, according to the CDC.

A Case Study: Needlestick Injury

In one case reported to TDIC, a dental assistant had just completed assisting a dentist with a root canal procedure. In a rush to prepare the operatory for the next patient, the assistant failed to notice that the needle was not capped and she punctured her right thumb with the needle. She reported the incident to the dentist.

The dentist called TDIC’s Risk Management Advice Line for guidance on handling the incident. The analyst advised the dentist that wounds that have been in contact with blood or bodily fluids should be washed with soap and water. The analyst also reminded the dentist to properly document the needlestick incident in a sharps injury log, which is required by law in most jurisdictions.

The dentist inquired if it would be acceptable to contact the source patient and request that she undergo testing. Additionally, he inquired about his responsibility covering any cost associated with patient testing. The analyst advised the dentist that it is a best practice to send the source patient for testing and reassured him that TDIC covers source testing under TDIC’s Professional Liability policy.

Responding to Needlestick Injuries

When a sharps injury occurs, practice owners are responsible for managing the exposure. In some cases, post-exposure treatment may be recommended. TDIC advises practice owners to have a post-exposure plan in place and to train staff on the plan and its implementation.

The plan should include the following:

• Immediate reporting to the dentist of a contaminated sharps injury or any exposure to blood or saliva.
• Forms documenting the exposure and, when necessary, employee or source patient refusal of medical evaluation or testing.
• A review of state-specific workers’ compensation guidelines. In most states, workers’ compensation paperwork needs to be provided to an injured employee within 24 hours of the incident being reported.
• Contact information for the practice owner’s workers’ compensation insurance provider, so that a claim can be reported in the event medical treatment is needed.
• A sharps injury log, which includes information about the injury, the type and brand of device, the work area where the exposure occurred and an explanation of how the injury occurred.

Preventing needlestick injuries

When it comes to sharps injuries, the best cure is preventing them from occurring in the first place. The CDC offers the following recommendations in its downloadable brochure titled Preventing Needlestick Injuries in Health Care Settings:

• Dispose of used needles and other sharps in appropriate sharps disposal containers.
• Use appropriate barriers such as gloves and personal protective equipment.
• Use devices with safety features, such as engineered sharps injury protection.
• Provide education and training to employees on preventing injury.
• Avoid the use of needles when effective alternatives are available.
• Establish procedures and encourage reporting for sharps-related injuries.

In addition, dental employees should avoid bending or breaking needles before disposal, passing a syringe with an unsheathed needle and recapping needles prior to disposal.

While patient health is of paramount importance to dental professionals, ensuring the safety of employees is also a crucial component of practice ownership. Dental practices are not inherently dangerous, but like all workplaces, they do present risks. Taking precautions and educating staff on safety protocols as established by state and federal law not only keeps employees free from injury, but it can also protect you and your practice.

TDIC’s Risk Management Advice Line is a benefit to TDIC policyholders. To schedule a consultation with an experienced risk management analyst, visit tdicinsurance.com/RMconsult or call 1.877.269.8844.