RESEARCH PROPOSAL

AWARENESS, KNOWLEDGE AND ATTITUDES

TOWARDS INFECTION CONTROL MEASURES
AMONG DENTAL ASSISTANTS IN
SELANGOR PRIVATE DENTAL CLINICS

AWARENESS, KNOWLEDGE AND ATTITUDE TOWARDS INFECTION

 CONTROL MEASURES AMONG DENTAL ASSISTANTS
IN SELANGOR PRIVATE DENTAL CLINICS

1. INTRODUCTION

Infection control is essential in providing a secure environment for patients and oral
healthcare workers within a dental practice. Oral healthcare worker are at high risk of
exposure to cross infection with blood-borne pathogens, such as hepatitis B virus (HBV),
hepatitis C virus, and human immunodeficiency virus (HIV), Mycobacterium tuberculosis,
streptococci, and other viruses and bacteria that colonize the oral cavity and the upper
respiratory tract (McCarthy GM, 2000). Transmission of infection within dental surgery may
occur by direct contact of tissue with secretions or blood, from droplets containing infectious
agents, or via contaminated sharps or dental instruments that have been improperly
sterilized (Mousa AA, 1997). During this rapidly emerging infectious disease COVID-19, the
risk of infection to the oral healthcare worker is highly significant. If effective infection
prevention and control measures are carried out, the risk of infection transmission is
reduced by at least 30% (Ge ZY et.al 2020).

In 2017, Malaysian Dental Council has updated its guidelines on infection control to
ensure a safe working environment and prevent the potential transmission of occupational
and nosocomial infections among oral health care workers and their patients. All dental
team members regardless in the public or private sector must adhere to the guidelines and
ensure that standard precautions are practiced in the clinic. According to Occupational
Safety and Health Act 1994 [Act 514], it is the responsibility of all healthcare organizations
or employers to ensure that the members of their staff have adequate and continual training
in infection control procedures.

Dental assistants play a crucial role in maintaining high level of infection control in the
dental clinic. They are the major link between oral healthcare workers and the patient. Their
responsibilities include preparing the appropriate dental equipment needed, tidying the
dental surgery and sterilizing the equipments used before and after each patient. They may
also play some roles at the reception counter such as giving appointment for patients,
collect payment and educating patients about oral health care. Currently, only a few dental
assistants in the private sector have formal training from private universities such as
MAHSA University and SEGi College while the majority of them undergo on-the-job training
only.

Globally, many studies reported low infection control compliance in private dental
practice (Al Dharrab et al., 2012; Cheng et al., 2012; Mutters et al., 2014; Su et al., 2012).
Oosthuysen et al. 2014 reported that there was lack of infection prevention and control
knowledge and education in oral healthcare facilities especially in developing countries. In
2001, Gordon et al. reported lacks of adequacy in performance of infection control
procedure by dental assistant. Part of the problem lies in the failure of dental assistant to
implement effective standard precautions and adherence to infection control guidelines and
policy (Mustafa EA et al. 2015). AbdolrezaGilavand et al., 2017 reported low level of
awareness and performance of dental assistants about infection control and suggested
continuous theoretical and practical training programs regarding infection control.

1.1 RATIONALE OF STUDY

Compliance to infection control is challenging because it requires knowledge and

supportive environment. Therefore, it is crucial that dental assistants at all levels continually
update their knowledge and skills in infection control measures to minimize the risk of
infection transmission to the patients.

To the best of our knowledge, there is lack of evidence on level of awareness,

knowledge and attitudes towards infection control measures among dental assistants at
private sector in Malaysia. The previous studies focused more on dentists and university
dental students. No local study targeted on this group has been published before. Therefore
it is timely to take up this study.

1.2 SIGNIFICANCE OF STUDY

The data will be useful as baseline data regarding the level of awareness, knowledge
and attitude towards infection control measures among dental assistants. The findings may
provide insights for the development of a targeted education and training strategy to
enhance the compliance of infection control. It may also be beneficial to stakeholders and
policy makers for the improvement and better future planning of oral healthcare workers in
the government and private sector.

1.3 AIM AND OBJECTIVES

Aim:

To determine the current status of awareness, knowledge and attitude towards infection
control measures among dental assistants at Selangor private dental clinic.

Objectives:

1. To assess the level of awareness among dental assistant towards infection control
2. To assess the knowledge of infection control among dental assistant
3. To assess the attitude of dental assistant towards infection control measures
4. To identify the need for continuous professional education/training in infection control

2. METHODOLOGY

2.1 STUDY DESIGN

The study design is a cross sectional study design which will be conducted at registered
private dental clinics in Selangor.

2.2 SAMPLING METHOD

i. A list of active private dental clinics in Selangor will be obtained from Private Medical
Practice Control Section (CKAPS), Selangor Oral Health Department.
ii. Randomized sampling will be performed to identify the study sample.
iii. Inclusion criteria is dental assistant (doing clinical work eg: assisting doctors and doing
instrument sterilization process).
iv. Exclusion criteria is non-clinical staff (doing administration duty only).
v. A structured questionnaire survey is designed to obtain information of socio-
demographic profile, level of awareness, knowledge and attitude towards the infection
control measures.
vi. The questionnaire will be validated and pre-tested.
vii. The questionnaire will be translated into several languages (Bahasa Malaysia, English,
Chinese and Tamil).

2.3 DATA ENTRY AND ANALYSIS

The data collected will be entered, cleaned and analyzed using SPSS software package.

3. REFERENCES

1. Mustafa EA, Humam AK, Al-Mosuli TA. Evaluation of dental assistant awareness
concerning infection control policy of blood borne diseases. Journal of International
Dental and Medical Research. 2015;8(1):21

2. Mousa AA, Mahmoud NM, Tag El-Din AM. Knowledge and attitudes of dental
patients towards cross-infection control measures in dental practice. East Mediterr
Health J 1997;3:263-73.

3. AbdolrezaGilavand et al, Evaluating the Awareness and Performance Ratio of Dental

Assistants working in Dentistry Centers of The City of Ahvaz in Southwest Iran, about
Infection Control, Indo Am. J. P. Sci, 2017; 4(09).

4. Ge ZY, Yang LM, Xia JJ, Fu XH, Zhang YZ. Possible aerosol transmission of COVID-
19 and special precautions in dentistry. J Zhejiang UnivSci B. 2020;16:1–8.

5. Nico T. Mutters, Ulrike Hägele, Daniel Hagenfeld, ElmarHellwig, Uwe Frank.

Compliance with infection control practices in an university hospital dental clinic,
GMS Hygiene and Infection Control. 2014; 9(3): Doc18.

6. Muawia A. Qudeimat, Razan Y. Farrah, Arwa I. Owais. Infection control knowledge

and practices among dentists and dental nurses at aa Jordanian university teaching
center, Am J Infection Control 2006; 34:218-22.

7. W.A.WanNoorina, D. Abdullah, C.L.Goo, M.M.Rahman. European Journal of

Dentistry and Medicine. 2016; 8:6-11. Practice of infection control amongst clinical
dental students of three public universities in Malaysia.
 8. Oosthuysen J, Potgieter E, Fossey A. 2014; Compliance with infection prevention
and control in oral health-care facilities: a global perspective". International Dental
Journal. 64 (6): 297–311

9. Malaysian Dental Council, 2017; Guidelines On Infection Control In Dental Practice.

10. Occupational Safety And Health Act, 1994 [Act 514]

4. WORK SCHEDULE

Year/Months 2020 2021

Sept Okt Nov Dis Jan Feb Mac April Mei Jun July

Literature review

Questionnaire design

Validation
Questionnaire by
DPHS
Validation
Questionnaire by Pre-
test

Data Collection

Data Entry

Data Analysis

Report Writing