sterilization in periodontal practice

1. STERILIZATION IN
PERIODONTAL PRACTICE
PRESENTED BY-
Dr. SASWATI MOHANTY
MDS 1ST YEAR

3. content
•INTRODUCTION
•DEFINITION
•HISTORY
•CLASSIFICATION
•PHYSICAL STERILIZATION
•CHEMICAL STERILIZATION
•MECHANICAL STERILIZATION
•STERILIZATION IN
PERIODONTAL PRACTICE
•INDIVIDUAL INSTRUMENT
STERILIZATION
•COVID-19 AND
STERILIZATION
•CONCLUSION

4. INTRODUCTION
 For protection of both the doctor and patient ,
sterilization techniques are most important in preventing
the spread of infectious disease. This is of special
significance in dentistry because more microorganisms are
found in the oral cavity than in any part of the body.
 Saliva is about half as infectious as blood and the most
likely modes of transmission in dental offices are through
wounds, skin abrasion or lesions.

5. WHAT IS STERILIZATION?
Sterilization is the
process by which all
living cells, spores, and
acellular entities are
either destroyed or
removed from an object
or habitat. A sterile
object is totally free of
viable microorganisms,
spores, and other
infectious agents.
( Prescott, 2011)

6. What is disinfection?
• Disinfection means the
destruction of all
pathogens or organisms
capable of producing
infections but not
necessarily spores.
• All organisms may not be
killed but the number is
reduced to a level that is no
longer harmful to health.
( Prescott, 2011)

7. • Sanitation- The process by which the number
of microorganisms on inanimate objects is
reduced to a safe level. It does not imply
freedom from microorganisms, and generally
refers to a cleaning process.
• Decontamination- The process of rendering
an article or area free of danger from
contaminants, including microbial, chemical,
radioactive and other hazards.
• Antiseptic- A substance that prevents or
arrests the growth of action of microorganisms
either by inhibiting their activity or by destroying
them. Term used especially for preparations
applied topically to living tissues.
DISINFECTION
STERILIZATION

8. • Antisepsis- is the prevention of infection, usually by
inhibiting the growth of bacteria in wounds or tissues
• Infection Control- The selection and use of
procedures and products to prevent the spread of
infectious diseases.
• Bactericidal agents- These are agents which are able to
kill bacteria.
• Bacteriostatic agents- These agents prevent the
multiplication of bacteria

9. history
• Acharya Sushruta, Dhanwantari and other surgeons
during their practice had a clear idea regarding specific
methods of sterilization to prevent the development of
any form of complications post-operatively.
• Sushruta has also explained the various method of
sterilization. Main method for sterilization in Ayurveda
is Dhupana, Parisheka ,Pralepa, Pradeha and
Agnitapana.
• Hippocrates (460-377 BC), disproved the idea that
disease was punishment for sin. He also advocated
irrigation of wounds with wine or boiled water,
foreshadowing asepsis.
• Anthony Van Leuwenhock first described
microorganisms in 1667.

10. • Ignaz Semmelweis an Hungarian
obstetrician, advocated in 1847 the value of
hand washing and fingernail scrubbing.
• Paul Ehrlich (1854-1915) discovered
“Salvarsan” . It was capable of destroying
spirochete of syphilis. Later discovered
“neosalvarsan”. He is also known as Father
of Chemotherapy.
• Joseph Lister - Father of Antiseptic Surgery. He
applied Pasteur’s work and introduced antiseptic
techniques in surgery in 1867. His surgery
involved the use of- Carbolic Acid

11. • Louis Pasteur, French chemist and
microbiologist, in 1862 publishes his findings
on how germs cause diseases & develop the
pasteurization process. He is known as Father
of Microbiology.
• Robert Koch and his associates in 1881
discover of the disinfecting properties of
steam and hot air and mark the beginning of
the science of disinfection and sterilization.
They devised the first non pressure flowing
steam sterilizer. He is also known as- Father
of bacteriology.

12. CLASSIFICATION
PHYSICAL METHOD
SUNLIGHT OZONE
DRY MOIST IONIZING NONIONIZING
HEAT RADIATION
INCINER
ATION
DRY
OVEN
STEAM
UNDER
PRESSURE
• BOILING
WATER
•PASTURIZA
ION
•X RAYS
•CATHODE
•GAMMA
RAYS
ULTRA
VIOLET
RAYS

13. CHEMICAL METHOD
GAS LIQUID
MECHANICAL METHOD
FILTRATION
ANIMATE INANIMATE
AIR LIQUID

14. Sun light
 Sun light has an active germicidal effect due to its
content of ultraviolet rays.
 It is a natural method of sterilization in case of water in
tanks, river and lakes.
 Direct sunlight as in tropical countryside where it is not
filtered by impurities in the atmosphere
has an active germicidal effect due to
the combined effect of ultraviolet and
heat rays. It is checked by samonella
Bacteria on a filter paper.

15. heat
Heat is the most reliable and commonly employed method of
sterilization . There are 2 types heat used – dry heat and moist heat
Dry heat- It kills the organisms by Denaturation of bacterial
protein, oxidative damage and by the toxic effect of elevated levels of
electrolytes.
Moist heat- It kills the micro organisms by coagulation of protein
and Degrading nucleic acids and Denaturing enzymes and other
essential proteins. It also disrupts cell membranes.

16. Dry heat
Red heat- Incubation wires or loops, Tips of forceps and Needles
are held in the flame of a Bunsen Burner till they become red hot.

17. Flaming
• Glass slides, Scalpel and Mouths of culutural tubes are passed
through Bunsen flame without allowing them to become red hot.

18. Incineration
• By this method , infective material is reduced to ashes by burning.
Instrument named Incinarator may be used for this purpose.
Soiled dressing, Animal carcasses, Bedding and Pathological
materials burn with this method. Temperature- 800
o
C to 1200
o
C
(Datta et al. 2018,wang et al. 2020)

19. Hot air oven
TEMPERATURE AND TIME-
160
o
C for 2 hours
USES
• Glass wares like glass syringe,
petridishes, flasks, pipettes, test tubes
• Surgical instruments like scalpels,
scissors, forceps
It is the most widely used method of sterilization by dry heat. The oven
is fitted with a Fan and a Thermostat

20. Precautions-
• Should not be overloaded
• Allow free circulation of air
• Materials to be sterilised should be
perfectly dry
• Test tubes should be fitted with cotton
plug
• Allowed to cool for 2 hr before opening
the door
Sterilization control-
• The spores of nontoxic strain of
clostridium tetani will be destroyed if
sterilization is proper.
• Thermocouples
• Browne’s tube After proper sterilization
a green colour is produced.

21. Moist heat
• AT A TEMPERATURE BELOW 100
o
C
• Pasteurisation
• Inspissation
• Vaccine bath
• AT A TEMPERATURE OF 100
o
C
• Boiling
• Tyndallization
• Steam sterilizer
• AT A TEMPERATURE ABOVE 100
o
C
• Autoclave

22. Pasteurisation
• 2 types of method. Holder method ( 63
o
C for 30 minute) and Flash
method ( 72
o
C for 20 seconds followed by cooling quickly to 13
o
C or
lower) are used.
• Ultra high temperature used to kill- salmonella brucella, mycobacteria
• Coxillla burnetti- survive by holder method

23. Inspissation
• Some serum or egg media, such as Lowenstein-jensen’s and
Loeffler’s serum are rendered sterile by heating at 80-85
o
C
temperature for half an hour daily on three consecutive days. The
instrument used is called- Inspissator.

24. Vaccine bath
• Bacterial vaccines are sterilized in special vaccine baths at 60
o
C
for 1 hour.

25. Boiling
Boiling for 10 to 30 minutes may kill most of the vegetative forms but
many spores withstand boiling for a considerable time. When better
methods are not available, boiling may be used for glass syringes and
rubber stoppers. Not recommended for surgical instruments

26. Tyndallization
• Steam at 100
o
C for 20 minutes on 3 successive days is used. Also
known as intermittent sterilization. It is used for sterilization of egg,
serum or sugar containing media which are damaged at higher
temperature of autoclave.

27. Steam sterilizer
• Koch’s or Arnold’s steam sterilizer used at 100
o
C for 90 minutes- is
usually used for media which are decomposed at high temperature of
Autoclave. The materials are kept on a perforated tray through which
steam can pass.

28. AUTOCLAVE
• Water is boiled to produce steam, which is released
into the autoclave's chamber.
• Developed by Charles Chamberland in 1884.
• Bacteria are more susceptible to moist heat as bacterial
protein coagulates rapidly.
• Saturated steam can penetrate porous material easily.

29. Component of autoclave
• It consists of a vertical or horizontal
cylinder .
• The lid is fastened by screw clamps and air
tight by asbestos washer.
• The lid bears a discharge tap for air and
steam, a pressure gauge and a safety valve.
• The steam circulates within the jacket and is
supplied under high pressure to inner
chamber where materials are kept for
sterilization.

30. Automatic autoclave
• It is used in all laboratory application
and pharmaceutical companies.
• Sterilization of liquids such as
nutrient and culture media
• Solids such as instrument, pipettes
• chamber sizes available in 65 and 85
Liter

31. Semiautomatic autoclave
• Applicable in all hospitals and
microlaboratory
Features-
• Unique lable wall design
• Heavy duty jacket
• Semi automatic operation
• Excellent performance of
drying

32. Classification of autoclave
• Autoclaves are categorized according to
the method of removing air from the
chamber- type N, B, and S.
• Type N autoclaves are designed only for
non-wrapped solid instrument.
• Type B autoclaves are considered
appropriate for sterilization of all heat-
stable materials with or without use of a
sterilization pouch.
Jun-Ichi Sasaki and Satoshi Imazato, Autoclave sterilization,
journal of periodontology , 2019

33. Class Air removal Sterilizing object
Type B Vacuum deaeration Any materials including
packaged, hollow, and porous
structure
Type S Manufacturer's specification Device and instrument
designated by manufacturer
Type N Passive displacement with
steam
Unpackaged, solid, and non-
porous materials

34. Type ‘B’ autoclaves
• sterilization efficiency of type B autoclaves evaluated with both
Chemical Indicator and Biological Indicator
• Anderson et al. in 1997 sterilized dental air turbines contaminated
with G. stearothermophilus and Streptococcus salivarius with
a type B autoclave and using sterilization pouches.
• Larsen et al. in 1999 reported the sterilizing effects of type B
autoclaves according to processing time. In that study, air turbines
inoculated with G. stearothermophilus or S. salivarius were treated
with a type B autoclave for 6 min or 20 min.
• G. stearothermophilus was detected in the turbine chamber after 6
min of autoclave treatment, but there were no surviving bacteria
after 20 min of processing.

35. Type ‘S’ autoclaves
• Kolstad Ra in 1998 evaluated the efficiency of type S
autoclaves in sterilizing low-speed handpieces .
• In that study, a slip containing G. stearothermophilus was
inserted in the handpiece, which was then sterilized in a type S
autoclave.
• The results showed that complete sterilization was achieved
with a processing time of 105 s, regardless of whether a
sterilization pouch was used.

36. Type ‘N’ autoclaves
• Winter S and Smith A in 2017 the
sterilizing effects of type N
autoclaves was evaluated with
Chemical Indicator and Biological
Indicator. There is no surviving s.
salivarius found.
• In the experimental study of
Anderson et al., air turbines were
inoculated with G.
stearothermophilus or S. salivarius .
No surviving bacteria found.

37. Use-
• To sterilize culture media, rubber material, gown, dressing, gloves etc.
• It is particularly useful for material which can not withstand the
higher temperature of hot air oven.
Precautions-
• The air must be allowed to escape from the chamber as temperature
of air steam mixture is lower than that of pure steam.
• Materials should be arranged in such a manner as to ensure free
circulation of steam inside the chamber.

38. Sterilization control
• Thermocouple- It is to record the temperature directly by a
potentiometer.
• Bacterial spores- Spores of Bacillus stearothermophilus
are used as the test organism . The spores of this organism
are killed in 12 minutes at 121
o
C.

39. • Chemical indicator- Browne’s tube contains red
solution which turns green, when exposed to temperature of
121
o
C for 15 minute in autoclave.
• Autoclave tapes- works by changing colour after exposure
to temperature 121
o
C

40. ozone
• Ozone sterilizer uses oxygen, water and
electricity to produce ozone within the
sterilizer and provide sterilization.
• It runs at lower temperature – 25
o
C-
35
o
C
• In this device, oxygen molecules(O2
) are
separated in to atomic oxygen(O) in the
presence of intense electrical field.
• The ozone provides a sterility assurance
approximately 4 hour.

41. radiations
Ionising Radiation- It include gamma rays, x-rays and cosmic
rays.
• They have high penetrating power.
• They damage DNA like- variety of lesions DNA including single and
double strand breaks, DNA protein cross links, oxidized bases and abasic
sites. (Cadet et al. 1999)
• Gamma radiation are commercially used for sterilization of disposable
items such as- plastic syringes, swab, culture plate, catheters.
Chamber with radiation shieldRadiation room

42. Non ionising Radiation- These include Infrared and ultraviolet
radiation.
• Infrared is used for rapid mass sterilization of syringes and catheter .
• UV radiation with wavelength of 240 to 280 nm has marked
bactericidal activity.
• Its acts by denaturation of bacterial protein and interfere with DNA
replication
• It is used for bacteriological laboratory, inoculation hoods, laminar flow
and operation theatres.

43. Chemical method
•Chemicals are more often employed in disinfection and antisepsis.
•Ideally the disinfectant must be effective against a wide variety of
infectious agents (Gram-positive and negative bacteria, acid-fast
bacteria, bacterial spores, fungi, and viruses) at low concentrations and
in the presence of organic matter.
•Chemicals are used as antiseptics. It should reduce the number of
pathogens on human tissue to prevent infection. Examples of
antiseptics include hand sanitizers, silver threads woven into clothing,
and dilute iodine solutions that can be sprayed onto wounds.

44. Phenolics
• Phenol was the first widely used antiseptic
and disinfectant.
• In 1867, Joseph Lister employed it to
reduce the risk of infection during surgery.
• Phenol derivatives such as cresols,
xylenols, and orthophenyl phenol are
used as disinfectants in laboratories and
hospitals.
• Lysol is made of a mixture of phenolics.
• The newer phenolic, triclosan is often
used in hand sanitizers

45. Alcohols
• Alcohols are among the most widely used
disinfectants and antiseptics.
• They are bactericidal and fungicidal and some
enveloped viruses are also destroyed.
• The two most popular alcohol germicides are
ethanol and isopropanol, usually used in about
60 to 80% concentration.
• They act by denaturing proteins and possibly by
dissolving membrane lipids.

46. Halogens
Iodine
• It is used as a skin antiseptic and kills by oxidizing
cell constituents and iodinating cell proteins.
• Iodine often is applied as tincture of iodine, 2% or
more iodine in a water-ethanol solution of
potassium iodide.
• Iodophors are water soluble, stable, and
nonstaining, and release iodine slowly to minimize
skin burns and irritation.
• Some popular brands are Wescodyne for skin and
laboratory disinfection, and Betadine for wounds

47. Chlorine
• It is the usual disinfectant for municipal
water supplies and swimming pools, and is
employed in the dairy and food industries.
• Death of almost all microorganisms
usually occurs within 30 minutes
• Halazone(parasulfone
dichloramidobenzoic acid) slowly releases
chloride when added to water and disinfects
it in about a half hour.

48. Heavy Metals
• The ions of heavy metals such as mercury,
silver, arsenic, zinc, and copper were used
as germicides.
• 1% solution of silver nitrate is added to
the eyes of infants to prevent ophthalmic
gonorrhea.
• Silver sulfadiazine is used on burns.
• Copper sulfate is an effective algicide in
lakes and swimming pools.

49. Quaternary Ammonium Compounds
• These are detergents that have broad
spectrum antimicrobial activity
• Detergents (Latin- detergere, to wipe
away) are organic cleansing agents that are
amphipathic, having both polar hydrophilic
and nonpolar hydrophobic components.
• Their antimicrobial activity is the result of
their ability to disrupt microbial membranes
• Benzalkonium chloride and
Cetylpyridinium chloride kill most
bacteria but not M. tuberculosis or spores.

50. Aldehydes
• Most used aldehydes are formaldehyde
and glutaraldehyde
• Formaldehyde is usually dissolved in
water or alcohol before use.
• A 2% buffered solution of
Glutaraldehyde is an effective
disinfectant.
• Glutaraldehyde usually disinfects objects
within about 10 minutes but may require
as long as 12 hours to destroy all spores.

51. Sterilizing Gases
• Many heat-sensitive items such as disposable
plastic Petri dishes and syringes, heart-lung
machine components, sutures, and catheters
are sterilized with ethylene oxide gas.
• Formaldehyde gas use for fumigation.
• Betapropiolactone is occasionally employed
as a sterilizing gas. In the liquid form, it has
been used to sterilize vaccines and blood
products
• Vaporized hydrogen peroxide can also be
used to decontaminate biological safety
cabinets, operating rooms, and other large
facilities.

52. Mechanical method
filtration
• Sbestos disc filter 9Earthenware candeles - Use in purification of water for
industrial and drinking purposes. These filters made in hollow
candels. Available in different grades of porosity. 2 types- 1.
Diatomaceous earth filter (Berkefeld) and 2. Unglazed
porcelain filter (Chamberland )

53. Asbestos disc filter (seitz)- Made up of Magnesium silicate.
Filter attached to a vaccum flask through silicone rubber bung.
After use , the filter disc is discarded.

54. • Membrane filters- Made up of cellulose ester.
Nitrocellulose membrane filters are widely used. Pore sizes-
0.015 to 12 micrometer.
• 0.22 mostly used because the pore size is smaller than that
of bactereria.

55. Sintered glass filter- Prepared by fusing finely powdered
glass particles. Available in different size

56. Sterilization in periodontal clinic
WHY IS INFECTION CONTROL IMPORTANT IN THE
DENTAL OFFICE?
• During dental treatment, both patients and dentist can be
exposed to pathogens through contact with blood, oral and
respiratory secretions, and contaminated equipment.
• Infection control protocols described in the 2003 CDC
guidelines and 2016 CDC summary, prevent transmission of
infectious organisms among both patients and Dentist was
described.

57. • Dental patients and Dentist may be exposed to a variety of
disease-causing microorganisms that are present within the
oral cavity and respiratory tract.
• These pathogens include –
 cytomegalovirus
 HBV
 HCV
 HSV types 1 and 2
 HIV
 Mycobacterium tuberculosis
 staphylococci
 streptococci

58. The chain of infection
•Infection control strategies prevent
disease transmission by interrupting 1
or more links in the chain of infection.
•CDC recommendations on infection
control for dentistry in 1986 and 1993
described the use of universal
precautions to prevent transmission of
blood-borne pathogens.
•In 1996, the CDC replaced universal
precautions with standard precautions.
Francesco R. Sebastiani, Harry Dym, Tarun Kirpalani, Infection Control in the Dental Office
,USA, 2016

59. Categorization of instruments
• CDC divide instruments in 3 category
 Critical
 Semi critical
 Non critical
• It is Modified from Centers for Disease Control and
Prevention Guidelines for infection control in dental health-
care settings - 2016

60. (BY MMWR Morb Mortal Wkly Rep by CDC 2016)
Category Definition Dental Instrument Management
Critical •Penetrates soft
tissue
• Contacts bone
• Enters
bloodstream
surgical instruments,
periodontal scalers,
scalpel blades, burs
Sterilization is achieved by
steam autoclaving, dry
heat, or heat/chemical
vapour.
Semi critical •Contacts mucous
membranes or non
intact skin
• Do not penetrate
soft tissue
Mouth mirror,
amalgam
condenser, impression
trays, hand pieces
For heat tolerant —heat
sterilize.
For heat sensitive-
high-level disinfection
(glutaraldehyde,
Peracetic acid hydrogen
peroxide).
Noncritical •Contacts intact skin Radiograph head and
cone, pressure cuff,
facebow, pulse
oximeter
Clean and disinfect using
a low- to intermediate level
disinfectant.

61. • Disinfection of instruments in 2-step process .
• The initial step involves vigorous 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.
• The spray-wipe-spray technique enhances decontamination
through mechanical cleansing with a paper towel followed
by the chemical action of the disinfectant solution.

62. (BY JOAN F GARDNER, INTRODUCTION TO
STERILIZATION AND INFECTION CONTROL,2ND EDITION)

63. RECOMMENDED CONCENTRATIONS
DISINFECTANT CONCENTRATI ON
EthylAlcohol 70%
Gluteraldehyde 2%
Lysol 2.5%
Savlon 2%
Dettol 4%
Bleaching powder (Calcium
hypochlorite)
14 gm in 1 Lwater
Sodium hypocholorite 1%, 0.1%
Betadine (Iodophore) 2%

64. Asepsis of operating field
• In the dental operatory, operatory surfaces that are repeatedly
touched or soiled are best protected with disposable covers that
can be discarded after each treatment.
• For dental unit trays, paper, plastic film or surgical pack wraps
should cover the entire tray.
• Clear plastic 15-gallon waste container bags fit many chair backs ,
control units , and x-ray equipment.
• Plastic silver foils use in suction handles and air water syringe
handles.

65. • Gigasept which contains succindialdehyde and
dimethoxytetrahydrofuran are used for disinfection of
plastic and rubber materials like- dental chair

66. Asepsis of surgery theaters
• Fumigation is done by two methods:
 Electric boiler method-
500 ml of formaldehyde(40%) added to distilled
water in electric boiler. When the water heats fumes
are generated.
Potassium permanganate –
Heat is induced by oxider action of potassium
permanganate. 500ml of formaldehyde is added
to potassium permanganate which reacts and
generates fumes

67. Periodontal instruments
• Sharp instrument sterilize by-
Hot air oven
Ex-
• Knives
• Scissors
• Files
• Tissue holding forceps

68. Blunt instruments are
sterilized by- autoclave
• Mouth mirrors
• Tweezers
• Artery forceps
• Suture holding forceps
• periosteal elevator

69. ULTRASONIC SCALERS
• Soak inserts in a container containing
70% isopropyl alcohol for removal of
organic debris.
• Rinse cleaned inserts thoroughly in warm water
to remove all chemicals. As a final rinse, replace
the insert into the scaler handpiece and operate
the scaler for 10 seconds
• Package in proper wrap, bags, pouches, trays,
or cassettes. Add spore tests and chemical
indicators.
• Ethylene Oxide is the preferred method of
choice

70. Sutures
• Sutures are pre sterilized by gamma
radiation
• Sutures are resterilized by two
recommed methods are
1.Soak for a full 10 minutes
completely immersed in
povidone iodine 10% solution,
then rinse in sterile
saline/water.
2.Ethylene Oxide – gas sterilisation.

71. IMPLANTS
• Pre sterilized with Gamma radiation
• Steam sterilization should not be used
as it results in contamination of
surfaces with organic substance.
• Radio frequency used in this
• In this, material to be cleaned is
bombarded by high energetic ions
formed in gas plasma in a vacuum
chamber..

72. HANDPIECE
• Dental handpieces can be sterilized with type B or type S
AUTOCLAVE sterilizers, regardless of the use of a sterilization
pouch.
• Type N autoclaves are capable of sterilization of general bacteria
such as S. salivarius even in a sterilization pouch if instruments are
washed
• It is noted in the UK guideline that use of type N autoclaves is
not appropriate for wrapped instruments.

73. ROTARYINSTRUMENTS - BURS
Diamond and carbide burs:
• After use they are placed in 0.2%
gluteraldehyde and sodium phenate
(Sporicidin) for at least 10 minutes,
• Cleaned with a bur brush or in an
ultrasonic bath.
• Sterilize in an autoclave or dry heat
Steel burs:
• May get damaged by autoclaving. Can be
sterilized by using a chemical vapor sterilizer
or glass bead sterilizer at 2300C for 20-30
seconds.

74. Impression trays are sterilized-
• Metallic - autoclave
• Plastic – ethylene oxide
Dental casts are sterilized-
• Spraying until wet or
Immersing in a 1:10 dilution
of sodium hypochlorite or
an iodophor then rinse

75. INSTRUMENT PROCESSING
To prevent cross-contamination, the instrument processing area should be
physically and spatially divided into areas
1. Cleaning – reusable contaminated instruments are received, cleaned,
decontaminated, and sorted.
2. Packaging – Critical and semicritical items should be wrapped or placed
in containers before sterilization, and hinged instruments should be
opened and unlocked so that all surfaces are exposed.
3. Sterilization – contains sterilizers and incubators for analyzing spore
tests.
4. Storage – Sterile instruments must be at least 8 inches from the floor, 18
inches from the ceiling, and 2 inches from the walls. Items should be
positioned so that packaged items are not crushed, bent, compressed, or
punctured.

76. Covid-19 and sterilization
•The novel coronavirus, SARS-CoV-2, Spreads mainly
from person to person, mainly through respiratory droplets
produced when an infected person coughs or sneezes.
• Preventive measures are the current strategy to limit the
spread of cases. Early screening, diagnosis, isolation, and
treatment are necessary to prevent further spread.
•So, we have to take special care in this pandemic situations.
Now a days Infection control is important in dental office.

77. Rahmet Guner, Imran Hasanoglu1, Firdevs Aktas, COVID-19:
Prevention and control measures in community, Turkish Journal of
Medical Sciences,2020
• “EXPOSURE CONTROL PLAN” by OSHA is a required office
program that is designed to protect personnel against risks of exposure
to infection.
 Preprocedural mouth rinse
 Hand sterilization
 Hand cleansers
 Personal barrier protection
 Eye wear
 Gloves
 Mask
 Foot ware

78. Preprocedural mouth rinse
Cholrhexidine use as
Preprocedural mouthrinse
in reducing the levels of
spatter bacteria generated
during ultrasonic scaling.

79. Hand sterilization
•For routine dental examination procedures, hand washing is
achieved by using either a plain or antimicrobial soap and
water.
•The purpose of surgical hand antisepsis is to eliminate
transient flora and reduce resident flora.
• Hands must be lathered for at least 10 seconds, rubbing all
surfaces and rinsed.
•Clean brushes can be used to scrub under and around the
nails.

80. “Life is better with clean hands” (cdc’s hand washing campaign )

81. Hand cleansers
• 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.
But it can be hazardous to eyes.
• Povidone iodone – contain 7.5-
10% povidone iodine, used as a
surgical hand scrub.

82. •Parachlorometexylenol(PCMX) –
they are bactericidal and fungicidal at
2% concentration.
• Alcohol hand rubs- ethyl alcohol
and isopropyl alcohol are widely used
at 70% concentration. They are rapidly
germicidal when applied to the skin.

83. Personal barrier protection
• Personal protective equipment 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.

84. Protective eyewear
• With side shields, this protects
from aerosols and spatter that
transmit infection, from debris
projected from the mouth, and
from injuries caused by sharp
instruments.
• Face shields can be considered
for procedures that involve a great
potential for splatter or aerosol
generation.

85. masks
surgical masks that are fluid-resistant and
isolation masks that cover the nose and
mouth.
Layers include an outer layer, a
microfiber middle layer, and a soft inner
layer that absorbs moisture.
There are different types of masks.
•Filtering facepiece
•Medical face mask
•Other face masks

86. Filtering facepiece
• Also known as- respirator
• It is designed to protect the
wearer from exposure to
airborne contaminants.

87. Medical face mask
• Also known as surgical mask or
procedure mask.
• It is classified as a medical
device that covers the mouth,
nose and chin ensuring a
barrier that limits the transition
of an infective agent between
the hospital staff and the
patient.

88. conclusion
• A steady increase in the serious transmissible diseases over the last few
decades and now covid- 19 have created a 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.
• The dental health care provider has to follow high standards of
infection control for the safety of the patients and the dental health
care workers.
“PREVENTION IS BETTER THAN
CURE’’

89. references
• Chris H. Miller, Sterilization and disinfection , JADA Vol-123
• Juan Carlos Rubio-Romero, Maria del Carmen Pardo-Ferreira, Juan
Antonio Torrecilla-Garcia,Santiago Calero-Castro , Disposable
masks: Disinfection and sterilization for reuse, and non-certified
manufacturing, in the face of shortages during the COVID-19
pandemic, 2020
• Roger B. Parkes and Robert A. Kolstadf ,Effects of Sterilization
on Periodontal Instruments, August 1981
• Francesco R. Sebastiani, Harry Dym, Tarun Kirpalani, Infection
Control in the Dental Office ,2016
• Carranza N, Takei HH, Shin K, Dwaraknath CD: Clinical
Periodontology: 13th edition, Elseiver USA; 2019
• C P Baveja : textbook of microbiology, arya publication, himachal
pradesh 4th edition 2013

90. • Joanne M. Willey, Linda M. Sherwood, Christopher J. Woolverton,
Prescott's Microbiology, 9th edition,2011
• Rahmet Guner, Imran Hasanoglu1, Firdevs Aktas, COVID-19:
Prevention and control measures in community, Turkish Journal of
Medical Sciences,2020
• Infection control recommendations for the on Dental PracticeCouncil
on Scientific Affairs and ADA Council dental office and the dental
laboratory. ADA, 2014
• Lakshya Rani, Dr.Pradeep, Sterilization Protocols in Dentistry – A
Review, 2016
• Moi Lin Ling, Patricia Ching, Ammar Widitaputra, Alison Stewart,
Nanthipha Sirijindadirat and Le Thi Anh Thu, APSIC guidelines for
disinfection and sterilization of instruments in health care facilities