1.infection control

1
CHAITANYA.P
I MDS
Dept of Public Health Dentistry

• Mention different sources & mode of spread of hep.B
infection encountered in dental practice & add a note on
laboratory diagnosis & prophylaxis of hepatitis. APR
2011
• Post exposure prophylaxis of HIV. OCT 2013
• Bio-medical waste management. OCT 2012, APR 2014
• Dry sterilization of instruments. APR 2014
• Infection control in dental practice. DEC 1997, FEB 2013
• Methods of sterilization. AUG 2013, OCT 2011
• Sterilization & disinfection in paediatric dentistry. 2007-
2008
• Occupation hazards among oral health care
professionals. OCT 2011
2

• INTRODUCTION
• TRANSMISSION OF INFECTION
• MODE OF TRANSMISSION
• INFECTION CONCERN IN DENTISTRY
• OBJECTIVES OF INFECTION CONTROL
• PERSONAL BARRIER PROTECTION
• EMERGENCY & EXPOSURE INCIDENT PLAN
• OPERATORY ASEPSIS
3

• DISINFECTION
• INSTRUMENT HANDLING & CLEANING
• STERILIZATION
• MONITORS OF STERILIZATON
• STORAGE OF STERILIZED ITEMS
• HANDPIECE ASEPSIS
• CLINICAL WASTE DISPOSAL
• CONCLUSION.
4

• Microorganisms are ubiquitous.
• Since pathogenic microorganisms cause
contamination, infection and decay, it becomes
necessary to remove or destroy them from
materials and areas.
• This is the objective of infection control and
sterilization.
5
Ref: C.P BAVEJA, Text book of microbiology, pg:-20-22,2nd edition, 2006
Ref : Chrish H.Miller, Charles John Palenik, infection control, pg;-4-6, 3rd
edition, 2005

 INFECTION CONTROL – Also called “exposure control
plan” by OSHA, is a required office program that is designed
to protect personnel against risks of exposure to infection.
 EXPOSURE – is defined as specific eye, mouth, other mucous
membrane, non intact skin, or parenteral contact with blood or
other potentially infectious materials.
Occupational Safety & Health Administration(OSHA)
6
Ref : C.P BAVEJA, Text book of microbiology, pg:-20-22,2nd edition, 2006
edition, 2005
Ref ; Daniel M. Laskin, oral and maxillofacial surgery, pg:-346-355, vol 1, 2013

 UNIVERAL BIOSAFETY PRECAUTIONS - means that all
patients and blood contaminated body fluids are treated as
infectious.
 CONTROLWORK PRACTICE AND ENGINEERING –
are terms that describe precautions(e.g; careful handling of
sharps) and use of devices to reduce contamination risks(high
volume suction)
7
Ref : Chrish H.Miller, Charles John Palenik, infection control, pg;-4-6, 3rd edition,
2005
Ref : Chitra Chakravathy, textbook of oral & maxillofacial surgery, pg:-3-12, 2nd
edition,2011

 PERSONAL PROTECTIVE EQUIPMENT (PPE) –
is a term used for barriers, such as gloves, gown, or
mask.
 HOUSEKEEPING – is a term that relates to cleanup
of treatment-soiled operatory equipment, instruments,
counters, and floors, as well as to management of used
gowns and waste.
8
2005
edition,2011

 STERILIZATION: Use of a physical or chemical
procedure to destroy all microorganisms including
substantial numbers of resistant bacterial spores.
 Sterilization means the destruction of all life forms.
(Ronald B Luftig)
 Sterilization is the process of killing or removing all
viable organisms.
(MIMS – PLAYFAIR)
9
2005
edition,2011

 DISINFECTION: Destruction of pathogenic and other
kinds of microorganisms by physical or chemical means.
Disinfection is less lethal than sterilization, because it
destroys the majority of recognized pathogenic
microorganisms, but not necessarily all microbial forms
(e.g., bacterial spores).
 Disinfection is a process of removing or killing most, but
not all, viable organisms.(MIMS-PLAYFAIR).
 Disinfection refers to the destruction of pathogenic
organisms.(Ronald B Luftig).
10
edition, 2005
edition,2011

 DISINFECTANT: A chemical agent used on inanimate
objects to destroy virtually all recognized pathogenic
microorganisms, but not necessarily all microbial forms
(e.g., bacterial endospores).
• DECONTAMINATION: Is the process of removal of
contaminating pathogenic microorganisms from the
articles by a process of sterilization or disinfection. It is
the use of physical or chemical means to remove,
inactivate, or destroy living organisms on a surface so
that the organisms are no longer infectious.
• ASEPSIS: Is the employment of techniques (such as
usage of gloves, air filters, uv rays etc) to achieve
microbe-free environment
11
2005
edition,2011

• Antisepsis is the use of chemicals (antiseptics) to make
skin or mucus membranes devoid of pathogenic
microorganisms.
• Bacteriostasis is a condition where the multiplication
of the bacteria is inhibited without killing them.
• Bactericidal is that chemical that can kill or inactivate
bacteria. Such chemicals may be called variously
depending on the spectrum of activity, such as
bactericidal, virucidal, fungicidal, microbicidal,
sporicidal, tuberculocidal or germicidal.
2005
edition,2011
12

 Infection transmission during dental procedures is
dependent on four factors:
1. Source of infection – may be a patient or a member of
the dental team who is suffering from, or is a carrier of
an infectious disease.
SOURCE
13
Patients suffering from acute
infection
Patients in prodromal
stage
carriers
known unknown
Ref ; C.P.Baveja, text book of microbiology, 2nd edition, pg:-49-50, 2006
Ref : Chrish H.Miller, Charles John Palenik, infection control, pg;-33-35 , 3rd
edition, 2005

2. Means of transmission – Micro organisms capable of
causing disease are present in human blood and saliva.
Contact with blood or saliva may transmit such
pathogenic organisms causing infection.
3. Route of transmission – Transmission may occur due to
inhalation or inoculation.
4. Susceptible host – Is a person who lacks effective
resistance to a particular micro organism. E.g immuno
compromised patients, pregnant women and children.
14
edition, 2005

• Direct contact with blood or body fluids
• Indirect contact with a contaminated
instrument or surface
• Contact of mucosa of the eyes, nose or
mouth with droplets or spatter
• Inhalation of airborne microorganisms
15

Infection through any of these routes requires
that all of the following conditions be present:
 An adequate number of pathogens, or
disease-causing organisms.
 A reservoir or source that allows the pathogen
to survive and multiply (e.g., blood).
 A mode of transmission from the source to
the host.
 An entrance through which the pathogen may
enter the host.
 A susceptible host (i.e., one who is not
immune).
16
edition, 2005

17
TRANSMITTED BY INHALATION
Varicella virus Chicken pox
Paramyxovirus Measles & mumps
Rhino/ adeno virus Common cold
Rubella German measles
Mycobacterium Tuberculosis
Candida sp. Candidosis.

18
TRANSMITTED BY INOCULATION
Hepatitis B,C,D virus Hepatitis B, hep C,
Hepatitis D
Herpes simplex I Oral herpes, herpetic
whitlow
Herpes simplex II Genital herpes
HIV AIDS
Neisseria gonorrhoeae Gonorrhea
Treponema pallidum Syphilis
S.aureus/albus Wound abscesses

19
Disease Work restriction Duration
Hepatitis A Restrict from patient contact,
contact with patient’s environment,
and food-handling.
Until 7 days after onset of
jaundice
Hepatitis B
Personnel with acute or
chronic hepatitis B surface
antigenemia who do not
perform exposure-prone
procedures
No restriction
Personnel with acute or
chronic hepatitis B
antigenemia who perform
exposure-prone procedures
Do not perform exposure-prone
invasive procedures
Until hepatitis B antigen is
negative
Hepatitis C No restrictions on professional
activity. HCV-positive health-care
personnel should follow aseptic
technique and standard
precautions.
Hands (herpetic whitlow) Restrict from patient contact and
contact with patient’s environment.
Until lesions heal
Ref : Cross infection control, journal of dental nursing, pg:-392-397, vol 9, no.7,
july 2013

20
HIV Do not perform
exposure-prone invasive
procedures.
Rubella
Active Exclude from duty Until 5 days after rash
appears
Postexposure (susceptible
personnel)
Exclude from duty From seventh day after
first exposure through
twenty-first day after last
exposure
july 2013

 To protect the patient and members of the
dental team from contacting infections during
dental procedures
 To reduce the numbers of pathogenic micro-
organisms in the dental operatory to the
lowest possible level.
 To implement a high standard of infection
control when treating every patient (universal
precautions)
 To simplify infection control, thus allowing the
dental team to complete treatment with
minimal inconvenience.
21
edition, 2005

22
Screening
PPE
Aseptic techniques
Sterilization &
disinfection
disposal
Laboratory asepsis

• Personal protective equipment (PPE), or barrier
precautions, are a major component of Standard
precautions.
• PPE is essential to protect the skin and the mucous
membranes of personnel from exposure to infectious or
potentially infectious materials.
• The various barriers are gloves, masks, protective eye
wear, surgical head cap & overgarments
23
edition, 2005

 CHLORHEXIDINE BASED – these contain 2- 4%
chlorhexidine gluconate with 4% isopropyl alcohol in a
detergent solution with a pH of 5.0 to 6.5. They have
broader activity for special cleansing(e.g: for surgery,
glove leaks, or when clinician experiences injury). But it
can be hazardous to eyes.
 POVIDONE IODONE – contain 7.5-10% povidone
iodine, used as a surgical hand scrub.
25
2005
Ref : Chitra Chakravathy, textbook of oral & maxillofacial surgery, pg:-12-13 ,2nd
edition,2011

PARACHLOROMETEXYLENOL(PCMX) – these
are bactericidal and fungicidal with 2%
concentration. Non irritating and recommended for
routine use.
ALCOHOL HAND RUBS- ethyl alcohol and
isopropyl alcohol are widely used at 70%
concentration. They are rapidly germicidal when
applied to the skin.
26
edition, 2005
edition,2011

 All clinical personnel must wear treatment gloves
during all procedures.
 Types:
1. Latex gloves
2. Vinyl gloves
3. Nitile gloves
4. General purpose
utility gloves
27
edition,2011

29
edition,2011
• Masks protect the face from splatter and prevent
inhalation of aerosols.
• Aerosols are airborne debris, smaller than 5ųm in
dia, that remain suspended in air.
• Splatter are larger blood contaminated droplets
which may contain sharp debris.
• A mask should have a bacterial filtration efficiency
of 95% or more.
• It should have a close fit around the entire
periphery.

CAUSES OF EYE DAMAGE:
Aerosols and spatter may transmit infection
Sharp debris projected from mouth while using air turbine
handpiece, ultrasonic scaler may cause eye injury.
Injuries to eyes of patients caused by sharp instruments
especially in supine position.
Therefore both the clinician and patients must use protective
eyewear.
30
edition,2011

31
Gown type Situation and Rationale
Cotton/linen, reusable or
disposable, long-sleeved isolation
gowns
Use if contamination of uniform or
clothing is likely or anticipated
Fluid resistant isolation gown or
plastic apron over isolation gown
Use if contamination of uniform or
clothing from significant volumes
of blood or body fluids is likely or
anticipated (fluids may wick
through non-fluid resistant
reusable or disposable isolation
gowns)
impervious gowns e.g., Gortex®
Fluid
Use if extended contact or large
volume exposure (e.g., large
volume blood loss during
resuscitation of MVA victim or
surgical assist)
edition,2011

32
 Most hospitals have their own policies regarding footwear.
 Footwear with open heels and/or holes across the top can
increase the risk of harm to the person wearing them due to
more direct exposure to blood/body fluids or of sharps being
dropped for examples.
edition,2011

33
• Engineering controls are the primary method to
reduce exposures to blood from sharp
instruments and needles
• Work-practice controls establish practices to
protect personnel whose responsibilities include
handling, using, or processing sharp devices.
• Sharp end of instruments must be pointed away
from the hand
• Avoid handling large number of sharp
devices.
edition, 2005

• Management of exposure includes:
A. General wound care and cleaning.
B. Counseling of the exposed worker regarding blood
borne pathogens.
C. Source patient testing for HBV,HCV and HIV (consent
required).
D. Documentation of the incident and review.
E. Post exposure assessment and prophylaxis for the health
care worker.
F. Baseline and follow up serology of the worker.
34
2005
Ref : Neelima malik, textbook of oral & maxillofacial surgery, pg:-70-101 ,2nd
edition,2011

35
IF AND THEN
Source pt is
+ve for
HBsAG
Exposed worker not
vaccinated
Worker should receive
vaccine series
 should receive single dose
of HB immunoglobulin within
7 days.
Exposed worker has
been vaccinated
Should be tested for anti-HBs
& given 1 dose of vaccine & 1
dose of HBIG if < 10 IU

36
IF AND THEN
Source pt
is –ve for
HBsAg
Exposed worker not
vaccinated
Worker should be encouraged to
receive hepatitis B vaccine.
Exposed worker has
been vaccinated
No further action is needed.
Source pt
refuses
testing or
not
identified
Exposed worker not
vaccinated
Should receive HB series
HBIG should be considered
Exposed worker has
been vaccinated
Management should be
individualized.

37
IF THEN AND
Source pt has AIDS
OR
Source pt is HIV+ve
OR
Source Pt refuses to
be tested
Exposed worker should be
counseled about risk of
infection.
Should be tested for HIV
infection immediately
Should be asked to seek
medical advice for any febrile
illness within12 weeks
Refrain from blood donation
& take appropriate
precautions
Exposed worker
testing –ve
initially should be
retested 6 weeks,
12 weeks & 6
months after
exposure.

38
IF THEN AND
Source pt is tested
& found -ve
Baseline testing
of the exposed
worker with
follow up
testing 12
weeks later
Source cannot be
identified
Serological
testing must be
done &
decisions must
be
individualized
edition, 2005
edition,2011

• In the dental operatory, environmental surfaces (i.e., a
surface or equipment that does not contact patients
directly) can become contaminated during patient care.
• Certain surfaces, especially ones touched frequently (e.g.,
light handles, unit switches, and drawer knobs) can serve
as reservoirs of microbial contamination, although they
have not been associated directly with transmission of
infection to either personnel or patients.
39
2005
edition,2011

• Transfer of microorganisms from contaminated
environmental surfaces to patients occurs primarily
through personnel hand contact.
• Dr. E. H. Spaulding(1939) proposed a classification
system for disinfecting and sterilizing medical and surgical
instruments. This system, or variations of it, has been used
in infection control over the years.
Disinfection of surgical instruments in a chemical solution
40
2005
edition,2011

41
Category Definition Dental instrument or item
Critical Penetrates soft tissue, contacts
bone, enters into or contacts the
bloodstream or other normally
sterile tissue.
Surgical instruments, periodontal
scalers, scalpel blades, surgical
dental burs
Semicritical Contacts mucous membranes or
nonintact skin; will not penetrate
soft tissue, contact bone, enter into
or contact the bloodstream or other
normally sterile tissue.
Dental mouth mirror, amalgam
condenser, reusable dental
impression trays, dental handpieces
Noncritical Contacts intact skin. Radiograph head/cone, blood
pressure cuff, facebow, pulse
oximeter
Ref : Chrish H.Miller, Charles John Palenik, infection control, pg;-24-26, 3rd edition, 2005
Ref : Neelima malik, textbook of oral & maxillofacial surgery, pg:-70-101 ,2nd edition,2011

• Disinfection is always at least a two-step procedure:
• The initial step involves scrubbing of the surfaces to be
disinfected and wiping them clean.
• The second step involves wetting the surface with a
disinfectant and leaving it wet for the time prescribed by
the manufacturer.
• There is no such thing as a “one-step disinfectant” The
disinfectant step must always be preceded by cleaning.
42

• The ideal disinfectant has the following properties:
 Broad spectrum of activity
 Acts rapidly
 Non corrosive
 Environment friendly
 Is free of volatile organic compounds
 Nontoxic & nonstaining
43
2005
edition,2011

44
LEVEL SPECTRUM USE EXAMPLES
Low level Bacteria except
mycobacteria
and spores.
Some fungi and
some
Viruses.
Surfaces without
blood
Quaternary
ammoniums,
some phenolics,
some iodofors
Intermediate
level
Mycobacteria,
not spores.
Most fungi and
most viruses.
Surfaces with
blood
Quaternary
ammoniums
with alcohol,
chlorines,
phenolics,
iodofors
High level All microbes
except spores
Immersion Glutaraldehyde,
strong
peroxides,
ophthaldehyde
Ref: Cohen: Pathways of the Pulp, 9th Edition pg:-1-9,2007

• Strategies for decontaminating spills of blood and other
body fluids differ by setting and volume of the spill.
• The person assigned to clean the spill should wear gloves
and other PPE as needed.
• Visible organic material should be removed with
absorbent material
e.g., disposable paper towels discarded in a leak-proof,
appropriately labeled container.
45

• Nonporous surfaces should be cleaned and then
decontaminated with either an hospital disinfectant
effective against HBV and HIV or an disinfectant with a
tuberculocidal claim (i.e., intermediate-level
disinfectant).
• However, if such products are unavailable, a 1:100
dilution of sodium hypochlorite (e.g., approximately ¼
cup of 5.25% household chlorine bleach to 1 gallon of
water) is an inexpensive and effective disinfecting agent.
46
2005
edition,2011

47

48
Steam sterilization cellulose, cotton/polyester
cloths, window packs,
perforated rigid containers with
bacterial filters, glass
containers for liquids
Dry heat (hot air oven) Metal canisters and tubes of
aluminium foil, glass tubes, bottles
ETO Paper & Plastic, perforated rigid
containers with bacterial filters
Low temperature steam Paper, cloth
Radiation sterilization Polyethylene, PVC, polypropylene,
foil.

• Ultrasonic cleaning is the safest and most efficient way
to clean sharp instruments.
• An ultrasonic cleaning device should provide fast and
thorough cleaning without damage to instruments; have
a lid, well-designed basket, and audible timer; and be
engineered to prevent electronic interference with other
electronic equipment
49

• Operate the tank at one-half to three-fourths full of cleaning
solution at all times- Use only cleaning solutions
recommended by ultrasonic device manufacturers.
• Operate the ultrasonic cleaner for 5 minutes or longer as
directed by the manufacturer to give optimal cleaning.
• Devices, that-have less than two transducers do not pass the
foil test and are not suitable for instrument cleaning.
50
edition, 2005
edition,2011

51
Stages for instrument sterilization:
1. Presoaking
2. Cleaning
3. Corrosion control and lubrication
4. Packaging
5. Sterilization
6. Handling sterile instruments
7. Storage
8. Distribution
2005

Physical agents:
1. Sunlight
2. Drying
3. Dryheat: flaming,
incineration, hot air
4. Moist heat: pasteurization,
boiling, steam under pressure,
steam under normal pressure.
5. Filtration: candles asbestos
pads, membranes
6. Radiation
7. Ultrasonic and sonic
vibrations
Chemical agents:
1. Alcohols: ethyl, isopropyl,
trichlorobutanol
2. Aldehydes: formaldehyde,
glutaraldehyde
3. Dyes
4. Halogens
5. Phenols
6. Surface-active agents
7. Metallic salts
8. Gases: ethylene oxide,
formaldehyde, beta
propiolactone. 53

The four accepted methods of sterilization are :
A. Steam pressure sterilization (autoclave)
B. Chemical vapor pressure sterilization- (chemiclave)
C. Dry heat sterilization (dryclave)
D. Ethylene oxide sterilization
54
2005
edition,2011

Advantages of Autoclaves.
 Autoclaving is the most rapid and effective method for
sterilizing cloth surgical packs and towel packs.
 Is dependable and economical
 Sterilization is verifiable.
56
2005
edition,2011

Disadvantages of Autoclaves.
 Items sensitive to the elevated temperature cannot be
autoclaved.
 Autoclaving tends to rust carbon steel instruments and
burs.
 Instruments must be air dried at completion of cycle.
57
2005
edition,2011

Advantages
1. Carbon steel and other
corrosion-sensitive
instruments are said to be
sterilized without rust.
2. Relatively quick turnaround
time for instruments.
3. Load comes out dry.
4. Sterilization is verifiable.
Disadvantages
1. Items sensitive to the
elevated temperature will
be damaged. Vapor odor
is offensive, requires
aeration.
2. Heavy cloth wrappings of
surgical instruments may
not be penetrated to
provide sterilization.
59
2005
edition,2011

60
• Conventional Dry Heat Ovens
• Short-Cycle, High-Temperature
Dry Heat Ovens

Advantages
1. Carbon steel instruments and
burs do not rust, corrode, if
they are well dried before
processing.
2. Industrial forced-draft hot air
ovens usually provide a larger
capacity at a reasonable
price.
3. Rapid cycles are possible at
high temperatures.
4. Low initial cost and
sterilization is verifiable.
Disadvantages
1. High temperatures may
damage more heat-sensitive
items, such as- rubber or
plastic goods.
2. Sterilization cycles are
prolonged at the lower
temperatures.
3. Must be calibrated and
monitored
61
edition, 2005

METHOD TEMPERATURE(ºc
)
HOLDING
TIME(MINS)
AUTOCLAVE 121 15
126 10
134 3
HOT AIR OVEN 160 45
170 18
180 7.5
190 1.5
62

Advantages:
1. Operates effectively at
low temperatures
2. Gas is extremely
penetrative
3. Can be used for sensitive
equipment like
handpieces.
4. Sterilization is verifiable
Disadvantages:
1. Potentially mutagenic and
carcinogenic.
2. Requires aeration
chamber ,cycle time lasts
hours
3. Usually only hospital
based.
64
edition, 2005
edition,2011

Sterilization Type of instrument
Stainless steel Carbon steel
Saturated steam at 250°F Amorphous substance
formed near cutting edge;
no dulling.
Dulling and oxidation of
cutting surfaces
Formalin-alcohol vapor at
270°F
Cracking of wire edge; no
dulling.
Some oxidation of surfaces;
no dulling.
Dry heat at 320°F Chipping of wire edge; no
dulling.
No visual change.
Dry heat at 340°F Chipping of wire edge; no
dulling.
No visual change
65Ref : C.P BAVEJA, Text book of microbiology, pg:-20-27,2nd edition, 2006

• Gamma radiation
• Dry-Heat Sterilizers
• Liquid Chemicals
• Performic Acid
• Filtration
• Microwave
• U.V radiation
• Flash sterilization
• Glass Bead “Sterilizer”
• Vaporized Hydrogen
Peroxide
• Formaldehyde Steam
• Gaseous Chlorine
Dioxide
• Vaporized Peracetic Acid
• Infrared radiation
• Oxygen plasma
sterilization
66
Ref : C.P BAVEJA, Text book of microbiology, pg:-20-27,2nd edition,
2006

 Various new methods of sterilization are under
investigation and development.
1. Peroxide vapor sterilization - an aqueous hydrogen
peroxide solution boils in a heated vaporizer and then
flows as a vapor into a sterilization chamber containing
a load of instruments at low pressure and low
temperature
2. Ultraviolet light - exposes the contaminants with a
lethal dose of energy in the form of light. The UV light
will alter the DNA of the pathogens. Not effective
against RNA viruses like HIV.

• Ozone sterilization is the newest low-
temperature sterilization method
recently introduced in the US and is
suitable for many heat sensitive and
moisture sensitive or moisture stable
medical devices
• Ozone sterilization is compatible with
stainless steel instruments.
• Ozone Parameters • The cycle time is
approximately 4.5 hours, at a
temperature of 850F – 940F.
68

69
INSTRUMENTS NORAMAL IF NOT TIME
Mouth mirrors,
condensers, ball
burnisher, tweezer,
explorer.
Autoclave / dry heat
sterilization /
Boiling water,
savlon, lysol, dettol.
H2O2, spirit lamp,
Gluteraldehyde
Boiling water-1hr
lysol- un diluted
30mins. Diluted
1:100 for 1-2hrs.
Extraction forceps,
elevators, scalar tips
Autoclave / dry heat
sterilization /
Boiling water,
savlon, lysol, dettol.
H2O2, spirit lamp,
Gluteraldehyde,
Savlon –35ml
savlon with 1lit for
30mins.
Cotton , pt drapes. Autoclave , ETO ETO Korsolex-
disinfection – 5% for
30 minutes.
sterilization – 10 %
for 5 hours
Burs ,files Glass bead
sterilizer, dry heat
sterilization(except
hand files)
Gluteraldehyde
(KORSOLEX)
Ref: A MANUAL OF INFECTION CONTROL, pg:11-25, 2013

• The storage area should contain enclosed storage for
sterile items and disposable (single-use) items.
• Storage practices for wrapped sterilized instruments can
be either date- or event-related
• Dental supplies and instruments should not be stored
under sinks or in other locations where they might become
wet.

• There are 3 methods of monitoring sterilization:
• Mechanical techniques
• Chemical indicators
1. Internal
2. External
• Biological indicators

STERILIZATION METHOD SPORE TYPE INCUBATION TEMPERATURE
AUTOCLAVE Bacillus stearothemophilus 56°C
CHEMICAL VAPOR
DRY HEAT Bacillus subtilis 37°C
ETHYLENE OXIDE
Gamma radiation B. Pumilus E601 370C
Sterilization monitoring has four components:
1. A sterilization indicator on the instrument bag, stamped with the date it is sterilized,
2. Daily color-change process-indicator strips,
3. Weekly biologic spore test, and
4. Documentation notebook.

• Oral fluid contamination problems of rotary equipment and
especially the high-speed handpiece involve:
• contamination of hand-piece external surfaces and
crevices,
• turbine chamber contamination that enters the mouth,
• water spray retraction and aspiration of oral fluids into the
water lines of older dental units
• growth of environmental aquatic bacteria in water lines
• exposure of personnel to spatter and aerosols generated by
intraoral use of rotary equipment.
73Ref : Cross infection control, journal of dental nursing, pg:-392-397, vol 9, no.7,
july 2013

july 2013
74

75
YELLOW
BAG
RED BAG BLUE BAG BLACK
BAG
ORANGE
BAG
•Human
anatomical
waste
•Animal
waste
•Microbiolog
y and
biotechnolog
y waste
•Solid
waste( items
contaminate
d with body
fluids)
•Microbiolog
y and
biotechnolog
y waste
•Solid waste
(tubings, iv
catheters)
•Waste
sharps
•Solid waste
(tubings, iv
catheters)
•Discarded
medicines
and
cytotoxic
drugs
•Incineration
ash
•Chemicals
used in
disinfection
&
insecticides
• Animal and
slaughter
house waste
Ref. Guidelines on HIV testing, National AIDS Control Organization (NACO), march
2007, pg :-32
Ref. Preventive and social medicine, K.PARK, pg.738-739, 22nd edition, 2013

• Ibrahim Ali Ahmad, Elaf Ali Rehan and Sharat Chandra
Pani conducted A pilot-tested questionnaire concerning
various aspects of infection control practices was
distributed to 330 dental students. The response rate was
93.9% (n = 311). About 99% of students recorded the
medical history of their patients and 80% were vaccinated
against hepatitis B. The highest compliance (100%) with
recommended guidelines was reported for wearing gloves
and use of a new saliva ejector for each patient. Over 90%
of the respondents changed gloves between patients, wore
face masks, changed hand instruments, burs and hand
pieces between patients, used a rubber dam in restorative
procedures and discarded sharp objects in special
containers. A lower usage rate was reported for changing
face masks between patients (81%), disinfecting
impression materials (87%) and dental prosthesis (74%)
and wearing gowns (57%). Eye glasses and face shield
were used by less than one-third of the sample
76Ref: International Dental Journal 2013; 63: 196–201

1. Protect every dental film with plastic barrier previously to
its use.
2. Place carefully the protected film inside the patient’s
mouth wearing glove;
3. Take the patient to the work area and place the lead
apron and thyroid collar;
4. After the exposure, take the dental film out of the
patient’s mouth and remove the plastic barrier, avoiding
touching the dental film package
5. Place the uncontaminated film inside a plastic cup
6. Discard contaminated gloves and wash hands
7. Take the cup with uncontaminated films to the processing
chamber
77Ref:RGO - Rev Gaúcha Odontol., Porto Alegre, v.61, n.4, p. 607-612,
2013
Luciana Maria Paes da Silva Ramos FERNANDES
Ronald Ordinola ZAPATA
Izabel Regina Fischer RUBIRA-BULLEN
Ana Lúcia Álvares CAPELOZZA discussed various steps in
Infection control in dental radiology

• Pervasive increases in serious transmissible diseases over
the last few decades have created global concern and
impacted the treatment mode of all health care
practitioners.
• Emphasis has now expanded to assuring and demonstrating
to patients that they are well protected from risks of
infectious disease.
• Infection control has helped to allay concerns of the health
care personnel and instill confidence and in providing a
safe environment for both patient and personnel.
78

1. C.P BAVEJA, Text book of microbiology, pg:-20-27,2nd edition,
2006
2. Chrish H.Miller, Charles John Palenik, infection control, pg;-4-50,
3rd edition, 2005
3. Daniel M. Laskin, oral and maxillofacial surgery, pg:-346-355, vol
1, 2013
4. Chitra Chakravathy, textbook of oral & maxillofacial surgery, pg:-
3-12, 2nd edition,2011
5. Neelima malik, textbook of oral & maxillofacial surgery, pg:-70-
101 ,2nd edition,2011
6. Cohen: Pathways of the Pulp, 9th Edition pg:-1-9
7. Guidelines on HIV testing, National AIDS Control Organization
(NACO), march 2007, pg :-32
8. Preventive and social medicine, K.PARK, pg.738-739, 22nd
edition, 2013.
9. A MANUAL OF INFECTION CONTROL, pg.no.11-25, 2013
10. Cross infection control, journal of dental nursing, pg:-392-397, vol
9, no.7, july 2013
11. International Dental Journal 2013; 63: 196–201
12. RGO - Rev Gaúcha Odontol., Porto Alegre, v.61, n.4, p. 607-612,
2013
79

1.infection control

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to 1.infection control

Similar to 1.infection control (20)

More from Chaitanya Pendyala

More from Chaitanya Pendyala (10)

Recently uploaded

Recently uploaded (20)

1.infection control