Abstract
BACKGROUND: Cross-infection control is essential for high-quality oral health care. Dental technicians, as key members of the dental team, handle clinical materials and manage laboratory processes that pose biological risks. Despite their university-level training in Bulgaria, little is known about their awareness, attitudes, and compliance with infection control standards. METHODS: A nationwide cross-sectional study was conducted from August 2024 to March 2025 among dental technicians registered with the Bulgarian Dental Technician Association. An online questionnaire was used to assess their knowledge, attitudes, and practices (KAP) regarding cross-infection control. The sample included 203 technicians, or (17%) of the ones registered with the professional organization. Data were analyzed with descriptive statistics and multiple linear regression to identify predictors of guidelines compliance. RESULTS: While 85% of respondents rated their infection control knowledge as good or excellent, and 75% correctly defined cross-infection, actual compliance with recommended practices was low. Only 10.8% demonstrated adequate adherence to guidelines, based on an 18-point practice score. Major deficiencies were identified in regard to the disinfection of dental materials, use of personal protective equipment, and it was established that the hepatitis B vaccination coverage was low (44.3%). Nearly 90% reported frequent or occasional sharp object injuries. Communication failures between dental laboratories and clinics were notable: 48.5% of the materials received lacked disinfection status information. Regression analysis showed that lower self-assessed implementation of infection control measures, older age, and poor knowledge of cross-infection definitions significantly predicted poorer practice scores (R² = 0.316, p < 0.001). CONCLUSION: The study revealed a significant discrepancy between perceived knowledge and actual practice regarding cross-infection prevention among Bulgarian dental technicians. Although participants expressed positive attitudes and recognized the importance of infection control, their reported practices often fell short of international standards. These findings underscore the urgent need for continuous education, better interprofessional communication,, and regulatory oversight to enhance infection prevention and control in dental laboratories.