sterlisation in dentistry

1. STERILIZATION
PRESENTED BY
DR. SHISHIR KAMAT

2.  Many factors are important in helping to kill
microorganisms and making medical devices
safe to use on patients. Understanding these
factors will help in selecting the right process to
follow when cleaning and disinfecting or
sterilizing patient care equipment.
INTRODUCTION:

3. ORALMICROBIOLOGY
• Streptococcus mutans,streptococcus mitis
,S.milleri , S.mitior, S.salivarious
,A.actinomycetecommitans,Porphyromonas
gingivalis, A.israelii , A.viscosus, A.nasulandii ,
Lactobacillus ,diptheroids ,staphyllococcus ,
• All these micro organisms are opportunistic in
nature and cause in case of decreased immune
reaction of body.
• They can be reduced in number temporarily with
some chemical agents like biguanides
(chlorhexidine)

4. Bacteria Modes of
transmission
Modes of prevention
N.Gonorrhea Inoculation Gloves offer adequate protection
T. Pallidium Inoculation Gloves offer adequate protection,
highly heat labile
M.Tuberculosis Inoculation /
Inhalation
Immunization( BCG), gloves,face
mask,high level disinfectant(highly
heat & chemical resistant
Str. Pyogens Inhalation Gloves and face mask offer adequate
protection
INFECTIOUSAGENTSINDENTISTRY

5. INFECTIOUSAGENTSINDENTISTRY
Viruses Modes of
transmission
Modes of prevention
Cytomegalovirus Inhalation Gloves & mask provides adequate protection
Hepatitis Virus Inoculation Vaccination, Heat labile, Gloves & mask
provides adequate protection
Herpes simplex 1
& 2
Inoculation Gloves & mask provides adequate protection
HIV Inoculation Double gloves & mask provides adequate
protection,disposable gowns etc.
Measles virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
Mumps virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
Influenza virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection

6. Viruses Modes of
transmission
Modes of prevention
Rhino virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
Adeno Virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
Rubella Virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
EBB Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection
INFECTIOUSAGENTSINDENTISTRY
Influenza virus Inhalation Vaccination, Heat labile, Gloves & mask
provides adequate protection

7. HISTORY
 Hungarian & O. W. Holmes ( early 1950’s)
Used to wash hands in between deliveries
 Joseph Lister (1865 – 1891) :- Father of Asepsis
Used Phenols ( dilute carbolic acid)

8. SCIENTISTS:
 Antony van leewenhoek
1683 - little animalcules
Augustino bassi 1835
first pathogenic bacteria
 Oliver wendell Holmes in
USA 1843 and Ignaz
semmelweis in viena 1846 -
puerperal sepsis transmitted
by medicos.started washing
hands in between deliveries
leewenhoek

9.  Louis Pasteur (France) 1822-
1895 -microbiology emerged as
a scientific discipline during his
course of enquiry of origin of
organisms.
 Joseph Lister - aseptic
technique in surgery using
carbolic acid, shifted era of
laudable pus to modern aseptic
techniques
 Louis pasteur developed steam
sterilizer, autoclave and hot air
oven
SCIENTISTSCONTINUED…

10. TERMS&DEFINITIONS
Cleaning :- A process which removes visible
contamination but not necessarily destroy
microorganisms.Eg:wiping floor whiping wet cloth.
Asepsis :- A process which prevents contamination
of wounds & other sites by microorganisms.Eg:using
sterile instruments for surgery
Antisepsis :- A process of application of an
antiseptic agent which inhibits growth of
microorganisms but does not necessarily imply
sterility.Eg:wiping the floor with antiseptic like phenol.

11. TERMS&DEFINITIONS
Disinfection :- A process of destruction or
removal of all pathogenic
microorganisms.Eg:dipping the instrumentsin
disinfectant like savlon or detol
Sterilization :-It is defined as the process by
which an article ,surface or medium is made free
of all living microorganisms either in the vegitative
or spore state.Eg:autoclaving all instruments
before surgery

12. TERMS&DEFINITIONS
Bactericide:
A chemical that destroys bacteria except for those in
the endospore stage
Sporicide:
A agent capable of destroying the bacterial spores.
Bacteriostatic:
An agent that prevents growth of bacteria.

13. TERMS&DEFINITIONS
Antiseptics:
Any chemical agents used and applied directly
to the living tissues(skin and mucous
membranes), wounds and surgical incisions to
destroy or inhibit vegetative pathogens.
Sanitation:
Cleansing technique that mechanically removes
microorganisms to reduce the microbial load.

14. ANTISEPTICS

15.  Both patients and dental health care personnel
can be exposed to pathogens
 Contact with blood, oral and respiratory
secretions, and contaminated equipment occurs
 Proper procedures can prevent transmission of
infections among patients and dental health care
personnel.
WHY IS INFECTIONCONTROLIMPORTANT
IN DENTISTRY?

16. MODESOFTRANSMISSION:
 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
 Thus the risk of transmission of infection in a
dental setting is higher than any other health
care settings.

17.  The permanent loss of reproductive capability,
even under optimum growth conditions, has
become the accepted microbiological definition of
death.
 RATE OF MICROBIAL KILLING:
 N α 1/CT
 N- number of survivors
 C- concentration of the agent
 T - time of exposure
-Warren levinson
MICROBIALDEATH

18. AGENTS USED INSTERILISATION
I)PHYSICAL AGENTS:
1.SUNLIGHT:-
2.DRYING:-
3.DRY HEAT :-Flaming, Inceneration, Hot air
4.MOIST HEAT:- Pasteurisation tyndalisation
Boiling,Steam under normal
pressure ,Steam under pressure
5.FILTRATION:-Candles,Asbestose
Pads ,Membrane
6.RADIATION:-
7.ULTRASONIC AND SONIC:-

19. AGENTS USED INSTERILISATION
II)CHEMICAL AGENTS:
1.ALCOHOLS:- ethyl alcohol , isopropyl
alcohol, trichlorobutanol
2.ALDHYDES:- formaldehyde,glutaraldehyde
3.DYES:-
4.PHENOLS:-
5.SURFACE ACTIVE AGENTS:-
6.METLLIC SALT:-

20. PHYSICAL METHODS OF
STERILISATION

21. SUNLIGHT
 Possesses appreciable
bactericidal activity
 Action is primarily due to UV-
rays
 Mostly used in tropical
countries

22. DRYING
 Moisture is essential for growth of bacteria.
 4/5th wt. of bacterial cell is due to water
 Spores are not affected by drying

23. HEAT
 Most prominent anti microbial agent
HEAT
moist heat dry heat
Pasteurization Flaming
Boiling Incineration
Steam under pressure Hot air
Tyndallization

24. DRYHEAT
 DRY HEAT KILLS BY OXIDATION EFFECT:-
 1.FLAMING:-
 2.INCINERATION:-
 3.HOT AIR OVEN:-
 -holding period:-At 160 for 2hrs
At 170 for 1hr
At 150 for 2&1/2 hrs
 -materials sterilised in it
 -disadvantages
 -sterilisation control-nontoxic strain of CL.Tetani /
browne`s tube(green spot test)

25. HOTAIROVEN:
 Dry heat penetrates less
and less effective than
moist heat
 Higher temperatures and
longer time is required
 So it is essential that hot
air oven should have time
lock on the door
 320 F/160 c for 30 min
 370-375 f/188-191 c for
6min wrapped
 12 min wrapped

26. MOISTHEAT
 1.PASTEURISATION:-
 2.STEAM UNDER ATMOSPHERIC
PRESSURE(100°C)
 Koch or Arnold steamer is used
 Mainly used to sterilise culture media
 Holding time:20mins at 100ºC
 3.STEAM UNDER PESSURE:-AUTOCLAVE
 4.TYNDALILSATION :
 5.BOILING:

27. PASTUERISATION
Pasteurization(below 100 c):
heat is applied to liquids to
prevent food spoilage and
infection, by retaining the flavor
and food value.
 Flash method: 71.6 c for 15
seconds and cooling to 13 c
quickly
 Batch method: 63 c to 66 c for 30
minutes.(holder method)
non sporing pathogens are

28. AUTOCLAVE
 MOIST HEAT:STEAM UNDER PRESSURE
 PRINCIPLE:-
 TYPES OF AUTOCLAVE:-
 HOLDING TIME:-At 15psi 121ºC for 15mins
 At 15psi 126ºC for 10 mins
 At 15 psi 134ºC for 3mins
 ADVANTAGES:-
 DISADVANTAGES:-
 CONTROL TEST:- Thermo couple, Browns test ,bowie-
 dick test, steorothermophilus spores

29.  Autoclave: Chamber which is filled
with hot steam under pressure.
Preferred method of sterilization,
 Temperature of steam reaches
121oC at twice atmospheric
pressure.
 Most effective when organisms
contact steam directly or are
contained in a small volume of
liquid.
 All organisms and spores are
killed within 15 minutes.
 Require more time to reach
center of solid or large volumes
of liquid.

30. A TYPICALAUTOCLAVECYCLE:

31. STERILISATOIN CYCLE
Sterilization cycle includes,
 1. warming of the chamber
 2. vacuum extraction
 3. pre steam penetration time
 4. steam penetration time
 5. holding time
 6. cooling time

32. AUTOCLAVES

34. TYNDALLISATION
 substances that cannot be treated with very
high temperatures
 Intermittent sterilization
 Items exposed for free flow steam for 30 to 60
min
 Incubated for 23 to 24 hours at appropriate
temperatures
 Cycle repeated -3 days
 Temperature never above 100ºc
 USED FOR culture media containing egg,
sera, or carbhohydrates.

35. FILTRATION
Types of filters:-
 1)Candle filters: a)glazed-chamberland,doulton
b)unglazed-berkefeld,mandler
 2)Asbestose filters
 3)Sintred glass filters
 4)membrane filters:cellulose,ester
Used for sterilisation of :
culture media
enzymes
vaccines
antibiotics

37. RADIATION
 1.NON IONISING RADIATION:- A) Infrared radiation
 B) Ultraviolet radition
 2.IONISING RADIATION:- A) X-Rays
B) Gamma Rays
C) Cosmic Rays
D) High energy Electron
radiation(now a days
most widely used in
medicine)
Cause mutations in DNA and produce peroxides.
Disadvantages: Penetrates human tissues. May cause
genetic mutations in humans.

39. SONIC$ ULTRASONIC
 These waves are credited with bacterial action
 Microorganisms vary in there sensitivity towards
them
 It is still undertrial and unreliable for steriliation

40. SONIC$ ULTRASONIC

41. CHEMICLAVE:
 Chemical vapour sterilization.
 The combinations of formaldehyde 0.23%,
alcohols72.38%, acetone, ketones and steam at 138
kPa/20 psi serves as an effective sterilizing agent.
 Microbial destruction results from the dual action of
the toxic chemicals and heat.
 It takes more time than autoclave but less time than
hot-air oven that is 30 mins.
 127 -132 c at 20 to 40 psi for a period of 30 minutes.
 Instruments loosely packed.

42.  Advantage
 shorter cycle
 Lack of corrosion of instruments or burs
Availability of dry instruments as soon as cycle is
over
 NOTE:
Preheated before use, with the vapour reservoir
sealed.
 solid metal trays and sealed glass jars are
unacceptable
CHEMICLAVE:

43. BIOLOGICALMONITORINGOF STERLIZATION:
process species Incubation
temperature
Steam above
atmospheric
pressure
B.stearothermophilu
s
56 c
Dry heat B.Subtilis , Cl.tetani 37 c
Subatmospheric
steam and
formaldehyde
B.stearothermophile
s
56 c
Gamma radiation B.Pumilis E601 37 c
Dental offices and hospitals-atleast weekly spore test,
but preferably daily.

44. CHEMICAL METHODS OF
STERILISATION

45. CHEMICALSTERILISATION
• MECHANISM OF ACTION OF CHEMICAL AGENTS
• 1.Protein coagulation
• 2.disruption of cell membranes
• 3.removal of sulphydryl group.
• 4.substrate competition
A)ALCOHOLS:-
Ethyl & isopropyle alcohol.(60%-90%)
Used mostly as skin antiseptics
No action on spores.
Main action is by denaturation of proteins
Methanol is some times used to sterilise cabinets &
incubators

46. CHEMICALSTERILISATION
B)ALDEHYDES:-
Formaldehyde is active against amino group in protein
Markedly bactericidal , sporicidal & virucide
Its fumes are irritants if inhaled
Glutaraldehyde is simillar but more effective against
tubercle bacilli , used for sterilisation of cytoscopes &
beonchoscopes
C)DYES:-
Aniline dyes & acridine dyes are used mainly for skin
wound sterilisation.they have only bacteriostatic
action that too at high concentrations. It impairs the
bacterial DNA complexes thus it stops the replication

47. CHEMICALSTERILISATION
D)HALOGENS:-
Iodine in aqueous or alcoholic solution are widely used
as skin disinfectants.
Chlorine & its compounds are widely used as
disinfectant in water supplies, swimming
pools,etc.they have wide spectrum of action
(bactericidal,virucidal,sporicidal.)hypochlorites are
used in dentistry as antiseptic agent.also before
surgery as antiseptic agent.
E)PHENOLS:- (CARBOLIC ACID)
Lysols & cresols have wide range of action
(bactericidal,virucidal,&sporicidal) .Eg:-
HEXACHLOROPHENE,CHLORHEXIDINE(HIBITANE)

48. CHEMICALSTERILISATION
F)GASES:-
1)EHYLENE OXIDE: It is highly penetrating gas.boiling
point is 10.7ºC.It is highly inflamable & explosive so
it is mixed with inert gases like CO2 or N2.its
mechanism of action is due to its alkylating the
amino, hydroxyl& sulphydryl groups in proteins . It is
potentially toxic to humans due to its mutagenic
&carcinogenic potential.
Effective against wide range of bacterias , viruses &
spores.
It is used for sterilization of heart-lung machines,
respirators, sutures dental equipments . books &
clothes.

49. CHEMICALSTERILISATION
G)SURFACE ACTIVE AGENTS:-
1)The cationic compounds: Acetyl trimethyl
ammonium bromide(cetavlon/cetimide)
2)The anionic compounds: Soaps
3)The amphoteric compounds: Eg-TEGO compounds

50. ASEPTICTECHNIQUES
1.Touching as few surfaces as possible
2.Minimising of dental Aerosols & splatter
3.High volume evacuation
4.Saliva ejectors
5.Use of the rubber dam
6.Preprocedure mouth rinse
7.Use of disposables
8.Housekeeping & cleaning
9.Other aseptic techniques

51. STERILIZATIONOF INSTRUMENTSINDENTALPRACTICE:
Classification of instruments to be sterilized(spaulding classification)
 Critical
 Surgical and other instruments that penetrate soft tissue or bone are
classified as critical
 Sterilized after each useEg:periosteal elevator,bone file,forceps etc.
 Semi critical
 Instruments do not penetrate soft tissue or bone but contact oral
tissues are classified as semi critical.
 Sterilized after each use but if not possible minimum high level
disinfection for for 6-10 hours needed simple cold sterilization is no
longer advised.Eg:mouth mirrors ,cheek retractors etc.
 Non critical
 Items that do not come in contact with body fluids, are called non-
critical.Eg:,bowls etc

52. Critical Semi-critical Non-critical
Extraction forceps
Scalpels
Bone chisels
Scaling instruments
Surgical burs
Periosteal elevators
Gingivectomy knife
Bard parker handle
Scissors
Suction tips (metal)
Suture needles
Endodontic
instruments
Ultrasonic scaling tips
Elevators/cross bars
Mirrors
Cheek/lip retractors
Hand piece
Tweezers
Impression trays
restorative -
instruments
Rubber dam
equipment
Saliva
ejector/evacuator
Polishing wheels and
cups
Medicament jars
Cavity liners
Anaestheic spray tip
Light cure tips
Glass slab
Cement spatula
Instrument trays
Orthodontic pliers
Cotton dispensers
Dapen dish
Three way syringe tip
Wax knife
Cheatel forceps

53. STERILISATION INOPERATION THEATERS
 Operating room should have 2 sets of doors.
 Operation theater ceiling , walls & flooring
should be disinfected regularly with antiseptics &
fumigated regularly.
 Operation theater access should be restricted to
O T personels only.
 Operation theaters are disinfected by fumigation
 O T personel should do a special scrub &
dressing before entering to O T.

54. STERILISATION INOPERATION THEATERS
• PRINCIPLES IN DESISN OF OPERATION
THEATER:
A)OUTER RECEPTION AREA INCLUDES:
1.The reception office
2.The reception waiting room for patients & relatives
3.An area for troleys storage
4.An area of hanging gowns for relatives & parents
B)A “CLEAN ZONE”:
Which is wide clean corridor giving access to
anesthetic room ,recovery room,clean storage
area,emergency autoclave,x-ray machine

55. STERILISATION INOPERATION THEATERS
• PRINCIPLES IN DESISN OF OPERATION
THEATER:
• C)THE OPERATING THEATER :
1.OT should have a double door entrance from
anesthetic room & a double door entrance to the
clean corridor.
2.There should be 2 small doors one towards store
room from sutures dressings etc are taken &one
from srubb room into the OT.
3.Temperature should range from 19 C to 22 C with
humidity of 45-55%

56. STERILISATION INOPERATION THEATERS
• PRINCIPLES IN DESISN OF OPERATION
THEATER:
5.Operating table should be regularly checked for
smooth raising & lowering of table & for tilting of table
for trenderlenburg position & lateral tilt position
6.OT lights should also be adjustable easily with
removable handles so that it can be sterilized and
handled by OT personels
7.Tubings and devices should be covered with the
disposable sheets which can be removed easily after
use.
8.OTs should be spacious enough so that troleys and

57. After each patient use, run any handpiece that is
connected to the dental air/water system, to discharge
water and/or air for at least 30 seconds after each
patient use
Leave the bur in place while you clean the
outside of the handpiece with detergent and warm
water.
Sterilise in an autoclave.
If recommended by the manufacturer, lubricate
the handpiece with pressurised oil until clean oil
appears from the chuck.
STERILISATION OF HANDPIECES

58. AIR/WATERDENTALSYRINGE
ROUTINEDECONTAMINATIONMETHOD
Run any dental device connected to the dental air/water
system that enters the patient’s mouth, to discharge
water and/or air for at least 30 seconds after each
patient use1.
If the air/water syringe is permanently attached to the
air or water system, cover the air/water syringe with an
impervious cover and discard the cover after each
patient use. If the syringe becomes contaminated
despite the cover, clean and disinfect it before use on
the next patient.
Disposable three-in-one syringe tips are available. Use
single-use disposable tips if possible and discard them
after each use. Clean and sterilise any reusable
detachable tips2

59. STERILISATION INOPERATION THEATERS
FUMIGATION OF OPERATION THEATER
 The O T is disinfected by fumigation .
 Fumigation can be achieved by fumigators as well as
potassium permanganate reaction technique . some
times methanol is also used but highly inflamable
 Fumigation is done with the instrument STERITRAX
 Fumigation chemical used is 40% FORMALINE
 Fumigator is set for 30 mins with timer adjustments in
the instruments
 The operating room is kept closed with fumes in it for
12 to 24 hrs.then the fumes are let off.

60. STERILISATION INOPERATION THEATERS
FUMIGATION OF OPERATION THEATER
SR.NO PARAMETERS OPTIMUM LEVELS
FOR EFFECTIVE
FUMIGATION
1 RELATIVE HUMIDITY OVER 70%
2 TEMPERATURE 30-40ºC
3 FORMALDEHYDE 5ppm or more

61. STERILISATION INOPERATION THEATERS
• FUMIGATION OF OPERATION THEATRE
• Now a days in operation theatres we install ULTRA
VIOLET RADIATIONS systems for operation theatres
sterlisation.
• There is monochromatic U-V radiation used of 254nm
wavelength.
• It is used for 30 mins before surgery in operation
theatres from pre installed gadget in the ceiling of
O-T.
• Instead there we can install 1 simillar gadget known
as Charnley Howorth closed air enclosure which kills
bacteria viruses with UV radiation n circulate fresh air

62. STERILISATION INOPERATION THEATERS
• Effects of using a Charnley-Howorth enclosure in a district general
hospital. [J R Soc Med. 1983] PMID:6842497 Wound disinfection with
ultraviolet radiation. [J Hosp Infect. 1995] PMID:7673693Bintcliffe IW. A
high rate of infection was found to occur when total hip replacement were
performed in an operating theatre used by a variety of surgical
specialities . Because of this, a downward displacement laminar flow
enclosure was installed to provide ultraclean air operating conditions.
Retrospective examination of 419total hip replacements, carried out over
a six-year period during which the enclosure was installed, showed a
reduction in the infection rate from 3.2% to0.4% (P = 0.05) when using
the enclosure. The infections were associated with a postoperative
wound discharge and with revision surgery but were less frequent when
the enclosure was used. Prosthetic loosening was found to be common
when metal-to-metal prostheses were used. Working in an enclosure
with side panels, wearing body exhaust units, was generally considered
to be so noisy as to restrict communication.

63. STERILISATION INOPERATION THEATERS
• CONTROL OF AIR QUALITY :
1.In an univentilated operating areas colony
forming units are upto 3000 per cu.mtr., but with
proper ventilation it can be reduced upto 200
CFU per cu.mtr.
2.Single layer & double layer ventilation systems
are installed in OT`s now-a-days with micropore
system & unidirectional non turbulent flow
reduces CFU & controls temperature between
19 to 22 degree celsius & humidity 45 to 55 %

64. STERILISATION INOPERATION THEATERS
• THE SCRUB ROOM:
1.Itshould have 2 doors one from corridor & one to OT
2.Sinks with taps & soap holders that can be
manipulated with elbows should be present
3.Sink design should be such that splashing on clothes
is prevented
4.Antislip floors easily cleaned shelves for gown packs
& gloves should be present
5.Brushes for cleaning fingernails should be available

65. STERILISATION INOPERATION THEATERS
 CONTENTS OF SCRUB SUITE:
 A pair of pants/skirts/pyjamas & shirts;
 A pair of masks , a head cap & a pair of gloves
 A pair of O T shoes (conductive shoes are
preffered to avoid any explosion due to static
charges which may induce fire in inflamable
anesthetics gases.
 A surgical gown which are tied at its back by
some non scrubbed staff so it is non sterile at its
back & below the waist . so one should keep his
hands above waist when not operating.

66. STERILISATION BEFOREOPERATING
PROCEDURE
HAND SCRUB THECHNIQUES:
 It is the first &most important step towards aseptic
technique
 The purpose of hand scrub is a 2 fold technique:
 1.To remove the superficial contaminants & loose
epithelium by mechanical action of brush;
 2.To reduce the bacterial count on the skin
 All jewellery should be removed before washing
hands
 Nails are checked for cleanliness &all gross subnail
contaminants should be removed.

67. STERILISATION BEFOREOPERATING
PROCEDURE
 The scrub can be prepacked impregnated with soap
solution;
 The hands are wetted till few inches above the elbows
mostly two inches above the elbow.
 The scrubbing begins at the tip of fingers of one hand,
interfinger webbing continued uptill all surfaces of
hand & forearm are scrubbed;
 The scrubbed area should not be touched anywhere
else to avoid the contamination.
 After scrubbing the hands are washed with excess of
soap.Then wiped with sterilised towels 2side for 2arms

68. STERILISATION BEFOREOPERATING
PROCEDURE
PROPRIETARY PREPARATIONS FOR
PREOPERATIVE WASHING OF HANDS:
 1.Hibiscrub & phisomed :- 4%chlorhexidine gluconate
 2.Betadine :- contains 7.5% POVIDONE-IODINE
 3.Soaps containing hexachlorophene
 4.70%hibisol (2.5%chlorhexidine in 70%alcohol)

69. STERILISATION BEFOREOPERATING
PROCEDURE
GLOVING OF HANDS:
 Two types of gloves : 1.LATEX GLOVES
2.BROWN MILLED
RUBBER GLOVES
 The “hand to gloves & gloves to gloves “ technique is
used to glove up hands
 Double gloves affords extra protection but at the
expense of reduced tactile sensation & dexterity also
at possible discomfort.

70. GLOVINGTECHNIQUE

71. STERILISATION DURINGOPERATIVE
PROCEDURE
 Hair in the area of surgery are shaved off just before
the scrubbing of the skin
 A lubricating ointment is applied to eyes &they are
covered with sterile towel .
 The scrubbing should begin at the centre of surgical
site & moved outwards concentrically away from the
site of operation to avoid the contamination of already
scrubbed site.
 During intra oral procedures the mouth is rinsed with
chlorhexidine mouth wash to reduce the bacterial
count in oral cavity.

72. STERILISATION DURINGOPERATIVE
PROCEDURE
 Patient`s hair are covered with sterile head cover .
 Patient should be draped with sterile towels to
isolate the area of surgery & the suction tube is
clipped to this towel so as to prevent it from falling
down.
 The site of needle puncture is made dry &
 0.5 % chlorhexidine is applied at that site
 While operating the operating person can touch only
the sterilized drappings & sterile instruments handed
over by assisting staff.

73. COLOUR
CODING
TYPE OF CONTAINER WASTE CATEGORY TREATMENT OPTIONS
Yellow Plastic bag Waste
•Animal waste
•Microbiology and
bio technology
waste
•Solid waste containing blood
and other body
•Human anatomical
fluids
Incineration/deep burial
Red Disinfected container/plastic bag •Microbiology and
bio technology
waste
•Solid waste
containing blood
and other body
fluids
•Solid waste from
disposables other
than sharps
Autoclaving/microwaving/chem
ical treatment
Blue/white
/translucent
Plastic bag/puncture proof container •Waste sharps
used/unused,
•Solid waste from
disposables other
than sharps
Autoclaving/microwaving/chem
ical treatment and
destruction/shredding
Black Plastic bag •Discarded medicines
and cytotoxic drugs,
•Incineration ash,
•Chemicals used in
disinfection,
insecticides .
Disposal in secured landfill
- park’s

74. Recent advances
Inthefieldof sterilisation

75. ROTATORY SUPER WATER
STERILIZER
Model:XG
Export area:Central-South America ASIA
Europe
Introduction:The sterilization car is driven by
magnetic drive device with the positive and
negative rotation. The speed is adjustable.
Mainly used for maintaining the stability and
uniformity of magma or emulsion; quick
bactericidal vacuum leak hunting of ampoule
injection or oral solution; sterilizing the heat
sensitive product in short time.

76. RAPIDCOOLINGSTERILIZER
Model:KG
Introduction:Full automatic program control,
full stainless steel double fly leaf rectangular
pressure steam sterilizing cabinet. Full range
automatic portray recording of temperature
and time curve, manual control or automatic
control, equipped with GMP demonstration
interface. With the function of forevacuum,
high temperature quick sterilization and rapid
cooling after sterilization, unique counter
pressure protection way, processing reliable
sterilization on the different kinds of goods in
bulk, bottling and canning etc.

77. Introduction:Suitable for
sterilization drying of
clothings, dressing, metal
instrument, culture medium
and glass utensil etc.
Adopting PLC, man-
machine interface fully
automatic control, with the
function of automatic
pyretography, vacuum
drying etc. Widely used for
sterilization in hospital
PULSATINGNACUUMSTERILIZER

78. Bibliography:
MICROBIOLOGY AN INTRODUCTION
-Barry L.Batzing
MEDICAL MICROBIOLOGY
-Cedric mims, Hazel M.Dackrey, Richard V.Goeing,Ivann
Roitt,Deret Wakelin, 3rd edition.
MICROBIOLOGY
-Prescott, Harleys, Kleins, 6th edition.
MEDICAL MICROBIOLOGY
-Jawetz, Melenick, Adelberg
MEDICAL MICROBIOLOGY
-David Greenwood
MEDICAL MICROBIOLOGY AND IMMUNOLOGY<
-Warren Levinson.
Text book of MICROBIOLOGY,
-Ananthanarayanan, C J Paniker
•INTRODUCTION TO STERLIZATION, DISINFECTION, AND INFECTION
CONTROL
-Joan F.gardner,Margaret M.peel

79. Bibiliography…
STUVERDENTS ART AND SCIENCE OF OPERATIVE DENTIVE
DENTISTRY
TEXT BOOK OF ORAL SURGERY
-Neelima anil malik