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Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy
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Asepsis sterilization and infection control /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. ASEPSIS STERILIZATION AND INFECTION CONTROL INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. • Sterilization: Complete destruction of all micro-organisms on an inanimate object or instrument. • Disinfection : The destruction of organisms in the non-sporing or vegetative state. www.indiandentalacademy.com
  • 3. INTRODUCTION • The concept of asepsis and its role in the prevention of infection was put forward nearly • Two centuries ago. The general principles for asepsis were laid down by Hungarian abstetrician, Ignaz semmelweiss in europe in early 1850’s and Oliver Holmes in USA. These principles were accepted after Joseph Lister’s studies on prevention of wound infection carried out between 1865-91. Lister, working on antisepsis, initially used phenol (dilute carbolic acid) for contaminated wounds, later applied it in all surgical wounds, also in operating room by nebulization of the solution. Further developments occurred with the introduction of steam sterilization surgical masks, sterile gloves, sterile gowns and drapes etc. www.indiandentalacademy.com
  • 4. IMPORTANT DEFINITIONS • ASEPSIS: It is the avoidance of pathogenic organisms from coming in contact with the wound and other sites and ensuring that only sterile objects and fluids come into contact. • STERILIZATION: It is a process by which articles are freed of all microorganisms both in vegetative or spore state. • *DISINFECTION: It is a process, which reduces the number of viable microorganisms to an acceptable level, but may not in activate some viruses and bacterial spores. • CDC Dental Guidelines For Sterilization Instruments -As with other medical and surgical instruments, dental instruments are classified into three categories - critical, semi critical, or no critical - depending on their risk of transmitting infection and the need to sterilize them between uses. www.indiandentalacademy.com
  • 5. CLASSIFICATION OF METHODS OF STERILIZATION • • A. PHYSICAL • Sun Light • Drying • • Heat – Dry – Moist • Filtration • Gas • Irradiation • Ultra sonic cleaning • Oil www.indiandentalacademy.com
  • 6. • B. CHEMICAL • Phenol Derivatives : Phenol, Cresol, resorcinol, chloroxylenol • Oxidizing agents : Pot. Permanganate, Hydrogen Peroxide, Benzoyol Peroxide • Halogens : Iodine, chlorine • Biguanide : Chlorhexidine • Quarternary Ammonium (Cationic) : Cetrimide, Zephiran • Soaps : of Sodium & Potassious • Alcohols : Ethanol, Isopropanol. • Aldehydes : Formaldehyde, Glutaraldehyde • Acids : Boric acid, acetic acid • Metallic salts ; Silver Nitrate, Zince Sulfate, Zinc Oxide, calamine, Ammoniated mercury. • Dyes : Gentian violet, proflamine, Acriflamine • Furan derivatives : Nitro flurazonewww.indiandentalacademy.com
  • 7. PHYSICAL METHODS • Sunlight : Most old & still effective. It possesses appreciable bactericidal activity. The action is due to ultra violet rays. This is one of the natural methods of sterilization in case of water in tanks, rivers and lakes. • Drying : It air has deleterious effect on many bacteria. Spores are unaffected by drying. Hence it is very unreliable method. • Heat : Is the most common and one of the most effective methods of sterilization. Factors influencing sterilization by heat are : - – Nature of heat • Dry • Moist – Temperature & time – No of organism present – Whether organism has sparing capacity • Type of material from which organism is to be eradicatedwww.indiandentalacademy.com
  • 8. • DRY HEAT • Killing is due to : • Protein denaturation • Toxic effects of elevated levels of electrolytes • a. Red Heat : It is used to sterilize metallic objects by holding them in flome bill they are red hot. Example : inoculating wires, needles, forceps etc. • b. Flaming : The article is passed over flame without allowing it to become red hot. Example : Glass plates, Cotton wool plays and glass slides. • c. Hot Air Oven: It is used to sterilize items, which do not get damaged by high temp. such as laboratory glass wave, flasks, scissors, impression trays (metal), all stainless steel instruments with sharp cutting edges, (preferred) B.P. handles, Dapen dishes, mouth mirrors and poles. Hot air is poor conductor of heat and poor penetrating capacity. So grease, oils, powders plastics, rubber-containing substances should be sterilized by other methods. High temp. can damage fabrics or melt them. • Temp. & Time: The sterilization is complete if these two factors are achieved throughout the load. • Temp. Time (Min.) • 160oC 320oF - 120/60 • 170oC 340oF - 60 • 150oC 300oF - 150 • 140oC 280oF - 180 www.indiandentalacademy.com
  • 9. • Precautions • The heat should be uniformly distributed in side the oven. • All the instruments must be clean of dry prior to wrapping. • It should not be over loaded. • Oven must be allowed to cool for about 2 hours before opening other wire glass will crack. • • Sterilization Control of Hot Air Oven • Detectors as spores of non-pathogenous strains of clostridium tetani are used to test dry heat efficiency. • Browne’s tube (green spot) is available for checking sterilization by dry heat. A green color is produced after 60 min. at 160oC. • Thermocouples may be used. www.indiandentalacademy.com
  • 10. • GLASS BEADS STERILIZER: • This method employs a heat transfer device. The media used are glass beads, molten metal and salt. The temperature achieved is of 220oC. The method employs submersion of small instruments such as endodontic files and burs, into the beads; and are sterilized in 10 seconds provided they are clean. A warm-up time of at least 20 minutes is recommended to ensure uniform temperatures in these sterilizers. • Some hand piece can be sterilized by dry heat. The hand pieces should be carefully cleaned and lubricated with special heat resistant oils. www.indiandentalacademy.com
  • 11. • • MOIST HEAT: • Effective by denaturation and coagulation of proteins. • • a. Temperature below 100oC. – Pasteurization – milk by Hold Method and Flash Method. – Vaccine bath – for vaccines – Inspissation • • • b. Temperature at 100oC • Tyndallization • Boiling • Steam Baths • • c. Temperature above 100oC www.indiandentalacademy.com
  • 12. • AUTOCLAVE • These are three major factors required for effective autoclave ; Pressure, temperature and Time. • Pressure: It is expressed in pressure (Pounds) pre square inch and it is 15-PSI pressure. • Temperature: To achieve required pressure, the temp. must be reached and maintained at 121oC with the increase in temperature and pressure super heated steam is formed and removed Air from chamber and this brings about sterilization. • Time: Wrapped loads require a minimum of 20 min. after reaching full temperature • and time cycle, a wide variety of materials can be sterilized by this method. • Example: Diagnostic and prognostic Instruments, plastic filling Instrument, impression trays, laboratory equipments, surgical instruments etc. Higher temperature and greater pressure shorter the time required for sterilization.www.indiandentalacademy.com
  • 13. • • also varies with the amount of material for the thickness of the wrap. Pressure Temperature Time (Min.) 15psi 121oC 15 20 psi 126oC 10 20 psi 134oC 3 www.indiandentalacademy.com
  • 14. . IRRADIATION • Radiation used for sterilization is of two types • Ionizing radiation, e.g., X-rays, gamma rays, and high speed electrons and • Non-ionizing radiation, e.g. ultraviolet light, and infrared light. These forms of radiation can be used to kill or inactivate microorganisms www.indiandentalacademy.com
  • 15. • It is effective for heat labile items. Bellamy (1959) reported that it has great penetrating properties. It is commonly used by the industry to sterilize disposable materials such as needles, syringes and swabs. Ionizing Radiation www.indiandentalacademy.com
  • 16. Ultraviolet • It is absorbed by proteins and nucleic acids and kills microorganisms by the chemical reactions it sets up in the bacterial cell. It has low penetrating capacity and its main application is purification of air in operating rooms; viz, to reduce the bacteria in air, water and on the contaminated surfaces. All forms of bacteria and viruses are vulnerable to ultraviolet rays below 3000 atmospheric pressure. Excessive exposure of skin can produce serious burns. Care must be taken to protect the eyes while using U-V radiation for sterilization. www.indiandentalacademy.com
  • 17. ULTRASONIC CLEANING • Several studies have shown that, when performed correctly, ultrasonic cleaning will remove dried serum, whole blood, plaque, zinc phosphate cement, and polycarboxylate cement from instruments, metal surfaces and dentures. It has been found to be more effective than manual cleaning. www.indiandentalacademy.com
  • 18. ULTRASONIC CLEANERS AND SOLUTIONS • The Clinical Research Associates (CRA) recommended the following ultrasonic cleaners: • BIOSONIC – Whaledent • T33C – Health Sonics Group • CLOSTER 3 – Provides ultrasonic clean, rinse and dry, but is noisy www.indiandentalacademy.com
  • 19. OIL • Hot oils baths have been used for sterilization of metallic instruments. At a temperature of 175oC, submersion for 15 minutes is required for sterilization. The disadvantages of using oil include; poor penetration, poor sporicidal activity, presents a fire hazard, and is difficult to remove from instruments such as hand pieces without recontamination. It should not be used for hypodermic syringes or needles because of the danger of oil embolization www.indiandentalacademy.com
  • 20. CHEMICAL METHODS • ALDEHYDE COMPOUNDS • Aqueous solution of formaldehyde (formalin) and • Glutaraldehyde (cidex) are effective disinfectants www.indiandentalacademy.com
  • 21. ALCOHOLS • Ethanol and isopropyl alcohols are frequently used as antiseptic. Alcohols possess some antibacterial activity, against some Gram- positive and negative bacteria, and especially against M tuberculosis. Alcohols act by denaturing proteins. They are not effective against spores and viruses. • The alcohols do not function as disinfectants when instruments, hand pieces, or other equipment are simply wiped with them, since they evaporate quickly www.indiandentalacademy.com
  • 22. PHENOLIC COMPOUNDS • Phenol itself toxic to skin and bone marrow. The phenolic compounds were developed to reduce their side effects but are still toxic to living tissues. These compounds, in high concentration, are protoplasmic poison, and act by precipitating the proteins and destroy the cell wall. www.indiandentalacademy.com
  • 23. AQUEOUS QUARTERNARY AMMONIUM COMPOUNDS • Benzalkonium chloride (Zephiran) is the most commonly used antiseptic. Its spectrum of activity is primarily Gram- positive bacteria. It is well tolerated by living tissues. It is not widely used because of its narrow spectrum of activity www.indiandentalacademy.com
  • 24. IODOPHOR COMPOUNDS • These compounds are effective against most bacteria, spores, viruses, and fungi. These are the most commonly used surface disinfectants along with hypochlorite. Concentrated solutions have less free ioidine. Iodine is released as the solution is diluted. An appropriate dilution is 1 : 2 : 3 parts of iodophor and distilled water, respectively. • Advantages are • Low toxicity. • Prolonged residual effect • Inexpensive and • Odorless. www.indiandentalacademy.com
  • 25. ASEPSIS IN DENTISTRY: BARRIER TECHNIQUES www.indiandentalacademy.com
  • 26. GLOVES • PRACTICAL POINTS ESSENTIAL FOR GLOVE USE • Wash hands before doing gloves • Choose a glove that fits tightly • Replace gloves immediately if born • Ensure chair side assistants wear gloves • Wash hands immediately after glove removal. • Treat gloves as surgical waste and dispose of them accordingly. www.indiandentalacademy.com
  • 27. • OSHA ADVISE THE FOLLOWING CONCERNING GOWNS • 1.The clinic attire should be worn only in the dental environment and should be changed at the end of the treatment schedule. 2. The day should begin with freshly laundered garments and the garments should be changed immediately it soaked or spattered with blood or other contaminants.3. Clinic attire should be handled separately from family laundry. www.indiandentalacademy.com
  • 28. MASKS • PROPER MASK SHOULD BE • Fit comfortably • Not look air out the sides • Fit around the entire periphery of the face • Not touch lips or nostrils • Not irritate skin • Provide breath ability • Not cause jogging or protective eyewear. • Not have an object able odor. www.indiandentalacademy.com
  • 29. • PROTECTIVE EYE WEAR • Protective eyewear in combination with a mask must be worn to protect the eye when spatter and splash of body fluids is anticipated and a fan shield is not used www.indiandentalacademy.com
  • 30. ANTISEPTICS USED IN HAND WASHING • Chlorhexidine: i.e. 2-4% Chlorhexidine gluconate with 4% isopropyl alcohol in a detergent solution with a pH of 5.0 to 6.5. • Povidone iodine: 7.5 to 10% Povidone iodine (3 minutes duration) • Phenolic compound: Hexachlorophene (it is toxic if the blood concentration rises with repeated exr.) Parachlorometexylenol (is bactericidal and fungicidal at 2% concentration). • Alcohols: Ethyl alcohol and isopropyl alcohol used in 70% concentration • www.indiandentalacademy.com
  • 31. • FOOTWEAR • A pair of smooth, ship on shoes should be kept exclusively for use in the surgery. These should be cleaned at the end of each clinical session. • HEAD COVERS • Head covers provide an effective barrier. They are recommended during invasive dental procedures, which are likely to involve extensive blood splatter. www.indiandentalacademy.com
  • 32. • DRAPING THE PATIENT • The purpose of draping a patient is to isolate the field of surgery from other parts of body that have not been prepared for surgery, and also from non-sterile equipment and equipment. www.indiandentalacademy.com
  • 33. DISINFECTION OF IMPRESSIONS • Immersion disinfection has been preferred to spraying. This is based on the assumption that immersion is more likely to assure exposure of all surfaces of the impression to the disinfectant for the recommended time. • Spraying disinfectants onto the surface of the impression reduces the chance of distortion, especially in the case of alginate, hydrocolloid, and polyether materials, but may not adequately cover areas of undercut. Two studies have indicated that there is no difference in accuracy of casts obtained by spraying with or immersion in recommended disinfectants. www.indiandentalacademy.com
  • 34. • Thorough rinsing of the impression is necessary before and after disinfection. Rinsing before re moves the bioburden present, which may exposure of the surface to the disinfectant. Rinsing after disinfection removes residual disinfectant, which may affect the stone surface after casting. www.indiandentalacademy.com
  • 35. • ADA recommended disinfectants must be used. • Chlorine compounds • Iodophors • Combination synthetic phenolics • Glutaraldehydes • Distortion of impressions following disinfection is determined by the brand of impression material and the disinfectant used. • When an alginate is disinfected the choice of product is very important.www.indiandentalacademy.com
  • 36. POLYSULPHIDES AND ADDITION-CURED SILICONES • Addition-cured silicone materials appear to be able to withstand damage by disinfectants, exception of neutral glutaraldehyde. • Alternative disinfectant: iodophore www.indiandentalacademy.com
  • 37. Immersion of alginate • Immersion of alginates in disinfectants is very much dependant on the product used. • Algioplast and New Kromopan may be immersed in sodium hypochlorite solution (1:10) for 10 minutes without distortion. • Jeltrate Plus may be immersed in iodophor (wesco- dyne) for 10-15 minutes, or for 10 minutes in sodium hypo chlorite, without distortion. • It is strongly recommended that alginate impressions are cast as soon as possible after disinfection. This is possible if the dental office has its own laboratory, but difficult if commercial laboratories are employed. www.indiandentalacademy.com
  • 38. IMPRESSION TRAYS • If plastic disposable trays are used, the handle is removed and heat sterilized. • If aluminum or chrome-plated trays are used, routine examination of the trays is essential to monitor corrosion if sodium hypochlorite is used. If corrosion occurs, use an alternative disinfectant. www.indiandentalacademy.com
  • 39. CHOICE OF DISINFECTANT • METAL DENTURES • Some concern has been expressed over the use dilute sodium hypochlorite on metal dentures. Recent research indicates that the use of sodium hypochlorite for 10 minutes will not damage denture base metals. One study recommends 2% hypochlorite 1: 5 for 5 minutes, as 1% does not remove all micro-organisms • Iodophor or 1:10 diluted sodium hypochlorite be used for single or infrequent disinfection cy However, both disinfectants should be used :;are as either can be corrosive with repeated or prolonged exposure www.indiandentalacademy.com
  • 40. ACRYLIC DENTURES • Sodium hypochlorite is recommended for disinfection of complete acrylic dentures. Glutaraldehyde with phenolic buffer (Sporacidin) should not be used. • “In-office” adjustments • Care must be taken with in-office adjustments. Use sterilized rag wheels and unit doses of pumice and polishing compounds. These will prevent cross contamination of prostheses and the need for multiple disinfections when repeat try-ins are necessary www.indiandentalacademy.com
  • 41. BURS • Steel Burs:- Single use. Dispose of these in Sharps bin • Diamond Burs • Clean with bur brush. • Place in ultrasonic bath. • Dry, bag and autoclave. www.indiandentalacademy.com
  • 42. DISPOSAL OF WASTES • Contaminated sharp disposable objects, (broken glass, disposable sharp blades), must be handled with extreme care to avoid injuries. They must be placed in a rigid impervious container which can be sealed prior to disposal. • Liquid wastes should be disposed of by carefully pouring into the mains drainage system followed by a free flow of running water. www.indiandentalacademy.com
  • 43. • CONCLUSION • Prevention is better than cure. The main way of control is by discarding all the contaminated instruments and materials and try to use as much as disposable items. The dentist and assistant should take proper vaccination in proper time. It should be done any treatment with minimal instruments using. • The material, which is sent to the laboratory, should be disinfected before the technician contact it should be kept in a separate room for disinfection, for all the patients’ work, which is sent. For each patient the material used should be separate or it should be discarded after each patient work or disinfect it before use of it. www.indiandentalacademy.com
  • 44. • The dentist should not think only their health, they should consider the environment also when the dispose of the used materials. They should be discarded in sturdy, impervious plastic bags to minimize human contact. Blood and disinfectants be carefully poured into a drain connected to a sanitary sewer system. Sharp instruments should be paced in puncture resistant containers marked with the bio hazard label. www.indiandentalacademy.com
  • 45. www.indiandentalacademy.com Thank you For more details please visit www.indiandentalacademy.com

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