Accidental Punctures in the Dental Office


In the busy dental office environment, it can be easy to forget that accidental punctures are a constant hazard. Even for the most experienced professionals, the risk is always present. Policy and procedures should be thorough, up to date, reviewed regularly, and complied with uniformly by all staff at all times. Preventing accidental punctures in the dental office requires education, training, and planning that involves every member of the dental team.  

Infection Control and Prevention Tips 

In infection control, the general principle holds true in dental offices — assume everything is contaminated and treat it accordingly. Any sharp item in the dental office, such as needles, scalers, burs, lab knives, and wires, should be considered potentially infective.1 

Transmission of bloodborne pathogens is rare in dental offices. However, failures are likely to be a result of breakdowns in procedures and processes designed to keep staff and patients safe. All staff, regardless of the level of training or work duties, should be prepared, informed, and compliant with infection control policies.2  


Safe Needle Recapping Techniques 

Needle recapping is one of the riskiest steps of dental procedures in terms of accidental needlestick injuries. It is imperative that staff understand and follow best practices to minimize the risk. Following are tips and techniques for needle recapping:1,2 

  • Always point the needle away from the body when recapping needles. 
  • Using one hand to recap needles reduces the risk of injury. Never use two hands to recap needles.
  • Use the one-handed scoop technique to recap needles. This involves laying the needle cap on a flat surface and then holding the syringe to scoop up the cap with one hand to cover the sharp point. 
  • If a needle cap is required between multiple injections, use a device specifically designed to hold the needle cap. 
  • Dispose of needles directly into the sharps container. Never break, bend, or recap needles before disposal into a designated sharps container. Doing so increases the likelihood of an accidental puncture. 
  • Aspirating-type syringes should be handled the same way as other syringes. 
  • When multiple injections are required during a procedure for the same patient, it is best to place the needle in a sterile field between injections rather than to recap it. 


Safe Needle Disposal 

Sharp items in the dental office should be considered potentially infective and should be handled with the utmost care and caution. These include needles, scalpel blades, and other sharp instruments.  

Disposable sharp items should be placed in a designated puncture-resistant sharps container located near the practice area. To prevent accidental puncture, disposable needles should be deposited directly into the sharps container. Make sure all staff understand that it increases the risk of injury to recap, bend, break, or remove needles from syringes before disposal.  

Sharps should never be disposed of in a regular or medical waste container. The sharps container should never be over-filled past the specified capacity, and full sharps containers should be sealed and disposed of according to safe handling protocols. 


Staff Training to Prevent Accidental Needlesticks 

Dental offices should have detailed written protocols to prevent needlestick injury. The policy should be reviewed and updated regularly. New guidance should be incorporated, and new equipment, procedures, and office workflow should be considered in the revision of safety procedures. 

All staff, regardless of the level of training or experience, should be thoroughly trained in safety procedures to minimize the risk of accidental needlestick injuries. It should never be assumed that a staff member knows or remembers techniques. New employees should be thoroughly trained, and periodic retraining should be conducted with all staff. Regardless of how rarely a staff member may interact with sharp objects in their role, all team members should be trained thoroughly. 

With the busy workflow of dental offices, it can be easy to drift from best practices over time. However, it is imperative that safety procedures are followed at all times by all staff, regardless of the circumstances. Consistently good habits and practices provide an important component of an overall strategy to reduce the risk of accidental punctures. 



  1. American Dental Association. Do’s and Don’ts for the Safe Handling of Instruments and Sharps; 2017. American Dental Association’s Guidelines for Practice Success. Accessed from:  
  1. Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; October 2016. Accessed from: