ICE is the exam where the answers are already written down.

01 — What it is

Concrete rules, strict compliance.

ICE is the Infection Control component of the DANB CDA and NELDA tracks. The exam is delivered through Pearson VUE testing centres as a 75-item, 60-minute, computer-adaptive multiple-choice test. Every item is single-best-answer with four options. The content draws from CDC dental infection-prevention guidelines and OSHA bloodborne-pathogen regulations — both of which are concrete enough that ICE rewards methodical study more than clinical intuition.

CDC guidance is advisory; OSHA regulation is mandatory. ICE items often hinge on whether a control is required by 29 CFR 1910.1030 or recommended by CDC. Knowing the boundary is examinable on its own.

02 — What is tested

Four domains, processing dominates.

• Prevention of Disease Transmission

  Standard/transmission-based precautions, PPE selection (donning/doffing), hand hygiene, exposure risk categories. Per DANB outline.

• Prevention of Cross-contamination

  Top

  DUWL biofilm management, evacuation lines and traps, impression and appliance disinfection, surface barriers, environmental cleaning, biohazard waste handling. Per DANB outline.

• Process Instruments and Devices

  Top

  Instrument processing sequence, autoclave parameters, biological/chemical/mechanical sterilization monitoring, ultrasonic cleaning, packaging. Per DANB outline.

• Occupational Safety and Administration Protocols

  OSHA Bloodborne Pathogens (29 CFR 1910.1030), Hazard Communication Standard (29 CFR 1910.1200), post-exposure management, immunizations, CDC 2003 (MMWR 52 RR-17), CDC 2016 Summary, OSAP (now ADS), exposure-control plan, sharps handling, regulated waste, record-keeping.

03 — The high-yield core

Six concepts drive most of the points.

• Spaulding classification. Critical (penetrates soft tissue or bone — surgical burs, scalers) requires sterilisation. Semi-critical (contacts mucosa — mirror, impression tray) requires sterilisation or high-level disinfection. Non-critical (contacts intact skin only — HVE, blood-pressure cuff) requires intermediate-level disinfection. Misclassifying an instrument is a classic distractor.
• Autoclave parameters. 121°C at 250 kPa for 30 minutes for wrapped instruments. 132°C at 250 kPa for roughly 10 minutes for unwrapped flash sterilisation. Memorise both cycles cold.
• Sterilisation monitoring. Biological indicator (Bacillus atrophaeus spores for dry heat / EO; Geobacillus stearothermophilus for steam) run weekly is the only true test of sterility. Chemical integrators confirm exposure to heat and steam — not sterility. Mechanical logs (time / temp / pressure) are the third leg.
• Instrument processing sequence. Pre-clean → ultrasonic / instrument washer → rinse and dry → pack and label → sterilise → cool → store. Any out-of-order sequence is a distractor.
• OSHA 29 CFR 1910.1030. Engineering controls (sharps containers, safer needles) are first-line. Work-practice controls (no recapping, hands-free transfer) are second. PPE is third. Exposure-control plan reviewed annually. Hepatitis B vaccine offered free within ten working days of assignment.
• Surface disinfection. EPA-registered intermediate-level disinfectants (often quaternary ammonium with alcohol) for clinical contact surfaces. Contact time around ten minutes — or per the manufacturer's label, whichever is the actual answer the stem is asking.

04 — A working study plan

Three to four weeks, methodical.

1. Week 1 — diagnostic + processing. Sit a 20-question diagnostic cold. Then sweep Domain II (the 35% weight) — Spaulding, sterilisation cycles, monitoring — with topic drills.
2. Week 2 — surface asepsis + waterlines. Domain III. Disinfectant categories, contact times, dental unit waterline biofilm and treatment systems, environmental cleaning sequence.
3. Week 3 — OSHA + disease transmission. Domains I and IV. Read 29 CFR 1910.1030 once, end to end. Hand hygiene, PPE hierarchy, post-exposure protocol, immunisations.
4. Week 4 — mixed mocks. Two full 75-item timed mocks at sixty minutes. Targeted re-drill on the lowest-scoring domain after each.

05 — Sample question style

Direct stems, regulatory language.

ICE items are short and direct. Lead-ins commonly read “According to OSHA / CDC guidelines, what is required…?” or “The PRIMARY purpose of…” or “Which of the following is…” Items often quote regulatory language verbatim, so reading the source documents pays off. Negation (NOT, EXCEPT) is capped at roughly five to ten per cent of items per form. Lumen does not reproduce real ICE items; every Lumen item is written against the published blueprint and reviewed by a clinician.

06 — Exam-day notes

Sixty minutes for 75 items.

• Bring two valid IDs (one government-issued photo) plus your DANB confirmation. Without both you will not be seated.
• Pace at roughly thirty-five seconds per item. ICE is the densest of the DANB sittings on items-per-minute.
• Computer-adaptive delivery means you cannot revisit flagged items. Commit before you click.
• Preliminary scaled score is shown at the testing centre. The official report follows within a few business days.