INFECTION CONTROL IN OMFS

1. INFECTION CONTROL IN
OMFS
BY- DR. AMODH CHOURASIA

2. CONTENTS
2
 Introduction
 Mode of Transmission
 Standard Precautions
 Personal protective equipment ( PPE )
 Clinical Waste Disposal.

3. Infection
Invasion or multiplication of micro organisms in body
tissues especially that causing local cellular injury due
to competitive metabolism, toxins, intercellular
replications or antigen or anti body response.
Caused by viruses,bacteria,parasites,fungi etc

4. CLASSIFICATION OF INFECTION

5. 5
• INFECTION CONTROL – is a
required
designed
office
to
program that is
protect personnel
against risks of exposure to infection.

6. 6
STERILIZATION:
•Use of a
procedure
physical or chemical
to destroy all
microorganisms including substantial
numbers of resistant bacterial spores.

7. 7
• STERILE:
–Free from all living microorganisms;
usually described as a probability (e.g.,
the probability of a surviving
microorganism being 1 in 1 million).

8. 8
DISINFECTION:
•Destruction of pathogenic and other kinds
of microorganisms by physical or chemical
means.

9. 9
• 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).

10. 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).

11. 11
• ASEPSIS: prevention microbialof
tissues or
removing or
contamination of living sterile
killingmaterials by excluding,
microorganisms.

13. 13
 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
Modes of Diseases Transmission

15. STRATEGY
PPE
Aseptictechniques
Sterilization&
disinfection
disposal
RT/5/INLFaEbCoTrIaOtNoCryONaTsReOpLsLisINOMFS/72
Screening

16. 16
•These guidelines should be followed each
time treatment is performed because we
are never certain of the patient's status,
either because they themselves do not
know or because they have chosen not to
inform their healthcare providers of their
condition.
•Following these guidelines for every
patient is called "Standard Precautions".

17. 1. Immunization
2. Patient screening
3. Hand washing
4. Barrier techniques -
• Personal Protective Equipment (PPE)
• Rubber dam, Pre-procedural rinsing
5. Needle & sharp instrument safety
• Occupational Exposure ToBlood/Body Fluids
6.Instruments sterilization and disinfection
7.Surface disinfection
8. Radiographic asepsis
9. Laboratory asepsis
10.Infectious dental waste management & disposal
Standard Precautions
17

18. 18
Personal protective equipment ( PPE )
•OSHA requires the employer to provide employees
with appropriate personal protective equipment .
•Examples of PPE:
1 Protective clothing
2 Surgical masks
3 Face shields
4 Protective eyewear
5 Disposable patient treatment gloves
6- Heavy-duty utility gloves

19. 19
These PPE must be used whenever you :
 Performing tasks that could produce
splash or spatter .
 Any contact with body fluids
 Perform other clinical activities that require handling
contaminated items e.g. radiographs , impressions ,
dentures or contaminated equipment and surfaces .

20. 20
The most effective ways to prevent the
transmission of diseases includes :
1) Hand washing
2) Protective clothing
3) Gloves
4) Face masks
5) Protective eye wear
6) Instrument sterilization and disinfection

22. 22
HAND HYGIENE
Hand washing is the single most important
procedure for preventing the spread of
infection. So , you must wash your hands each
time before you put on gloves and immediately
after you remove gloves .

23. 23
• Hand washing is also required if you touch
contaminated instruments or surfaces during
working
• We should always use liquid soap during hand
washing . Bar soap should never be used
because it may transmit contamination.

24. • Povidone-iodine and chlorhexidine gluconate are
the current agents of choice
• Scrubbing for at least 2 minutes is as effective as
the traditional 10-minute scrub in reducing hand
bacterial colony counts.

28.  another source of contamination
 hands and wrist cannot be cleaned
unless they are clean and bare.
 no jewellery including bracelets
/watches/rings.

29.  protect from aerosols+splatter

30.  Consist of nose piece which is made of
malleable aluminium and can be adapted to
facial contours ‘this prevents fogging

31. • Untie the bottom, then top,
tie
• Remove from face
• Discard

32. TYPES:
• Latex- Most common ,superior
tactile sensitivity
• Polyisoprene- without risk of rubber
latex sensitivity

33. • Grasp outside edge near
wrist
• Peel away from hand,
turning glove inside-out
• Hold in opposite gloved
hand

34. • Slide ungloved finger
under the wrist of the
remaining glove
• Peel off from inside,
creating a bag for both
gloves
• Discard

35.  There is maximum chances of infection spread
during procedures to eye.
Causes :
 Sharp objects
 Turbine water spray
 Ultrasonic hand pieces and syringes
 Blood and saliva.

37. STERILIZATION AND DISINFECTION

38. 38
DENTAL INSTRUMENTS
Classification based on risk of transmission and
need of sterilization
-CRITICAL
-SEMI-CRITICAL
-NON-CRITICAL

39. CRITICAL INSTRUMENTS
• Penetrate MUCOUS MEMBRANES or CONTACT
BONE, BLOODSTREAM, or other normally sterile
tissues
• HEAT STERILIZE between uses or use sterile single-
use, DISPOSABLE devices
• Examples include SURGICAL INSTRUMENTS,
SCALPEL BLADES, PERIODONTAL SCALERS, AND
SURGICAL DENTAL BURS
39

40. SEMI-CRITICAL INSTRUMENTS
• Contact MUCOUS MEMBRANES but do NOT
PENETRATE SOFT TISSUE
• HEAT STERILIZE or HIGH-LEVEL DISINFECT
• Examples: DENTAL MOUTH MIRRORS,
AMALGAM CONDENSERS, AND DENTAL
HANDPIECES
40

41. NONCRITICAL INSTRUMENTS
AND DEVICES
• Contact intact SKIN
• Clean and disinfect using a LOW TO
INTERMEDIATE LEVEL DISINFECTANT
• Examples: X-RAY HEADS, FACEBOWS, PULSE
OXIMETER, BLOOD PRESSURE CUFF
41

43. DRY HEAT
Flaming
Incineration
Hot air oven
MECHANISM OF ACTION:
Protein Denaturation
Oxidative damage
Toxic effect of elevated level of
electrolytes

45. INCINERATION

47. Articles to be sterilized:
• Scissors
• Scalpels
• Glass syringes
• Swabs
• Liquid paraffin
• Dusting powder
• Fats & Grease
• Glassware
• Forceps

48. MOIST HEAT
Pasteurization
Boiling
Autoclave
MECHANISM OF ACTION:
-Denaturation of proteins
-Coagulation of proteins

49. PASTEURIZATION (BELOW 100°C)

50. BOILING (AT 100°C)

51. AUTOCLAVE (ABOVE 100°C)

53. FILTRATION
Used to sterilize heat labile liquids like sera, sugar
solutions.
Bacteria free filtrate of Virus sample is obtained.
TYPES:
(a)Candles filters
(b)Asbestos disc filters.
(c)Sintered glass filters
(d)Membrane filters.

54. RADIATIONS
Non Ionizing radiation
U V rays:
Bring down the number of microorganism
present in air.
Sterilization of Operation theatres and biological
safety cabinets.
Disadvantage: Low-penetrating power.

55. RADIATIONS
Ionizing radiation
X- rays ,gamma rays, cosmic rays.
• cold sterilization.
• very high penetrating power.
• lethal to DNA and other cell constituents
• effective for heat labile items

56. CHEMICAL AGENTS
The main modes of action are:
1) Protein coagulation.
2) Disruption of cell membrane
3) Removal of free sulfhydryl
groups
4) Substrate competition for
enzyme.

57. Alcohols
Aldehydes
Dyes
Halogens
Phenols
Gases
Surface active agents
Metallic salts

58. Ethylene oxide
Highly penetrating gas
Highly inflammable.
Mixing with carbon dioxide or nitrogen 10%
eliminates explosive tendency
Mutagenic & carcinogenic
ARTICLES STERILISED:
Respirators
Sutures
Dental equipments
Glass, metal & paper surface

59. 59
STORAGE AND CARE OF STERILE
INSTRUMENTS
• Storage areas should be dust proof, dry,
well ventilated and easily accessible for
routine dental use.
• Sterile materials should be stored atleast
8-10 inches from the floor, atleast 18
inches from the ceiling, and atleast 2
inches from the outside walls.

60. 60
• Items are not stored in any location where they
can become wet.
• Items should be positioned so that
packaged items are not crushed, bent,
crushed, compressed or punctured.

61. • Outside shipping containers and corrugated
cartons should not be used as containers in
sterile storage areas.
• Ultra violet chambers and formalin chambers
are now commonly used for storage of
instruments.

63. 63
REFERENCES:
• Operative dentistry, infection
edition, sturdevent.
• Sterilization and disinfection
instruments by ADA
control, 4th
of dental
• Disinfection & sterilization of dental
instruments TB MED 266, 1995
• CDC, guidelines for disinfection &
sterilization in health care facilities 2008.
• CDC guidelines for infection control in dental
health care settings, Dec19, 2003/vol.52.