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DEPARTMENT OF PROSTHODONTICS –
DIEKIOHS

“CROSS INFECTION CONTROL”

BY
SUMAIYA HASAN
 Cross infection = Transfer of infectious agents among people either
directly from person to person or indirectly e.g through instruments
 Cross infection control = Measures taken to prevent cross infection

Dr Sumaiya Hasan
DIEKIOHS
Herpes Simplex

Pseudomonas

HBV

HIV

Klebsiella

Dr Sumaiya Hasan
DIEKIOHS

Mycobacterium
tuberculosis
Dr Sumaiya Hasan
DIEKIOHS
WAYS OF TRANSMISSION
 Direct transmission

 From patient to dental worker

 Indirect transmission

 From dental worker to patient
 From one patient to another
 From dental office to commuity

Dr Sumaiya Hasan
DIEKIOHS
GROUPS OF ITEMS INVOLVED

Non critical

Critical
Semi critical

Dr Sumaiya Hasan
DIEKIOHS
CROSS INFECTION CONTROL PROTOCOLS
In 1996 CDC (Centre for Disease Control USA) and the Hospital
Infection Control Practice Advisory Committee (HICPAC) introduced
infection control precautions.
 Standard
 Additional

Dr Sumaiya Hasan
DIEKIOHS
STANDARD PRECAUTIONS
 Apply to all body fluids

 Developed as a response to the understanding that other body fluids
besides blood are potentially infectious, and that anyone with patient
contact could be at risk

Personal
protection

Aseptic
environment

Dr Sumaiya Hasan
DIEKIOHS

Basic cross
infection
control
PERSONAL PROTECTION

Dr Sumaiya Hasan
DIEKIOHS
Ref: (2005, April). Hand hygiene guidelines from
http://www.manchesterpct.nhs.uk/document_uploads/Infection_Guidelines/handhygiene.pdf

Dr Sumaiya Hasan
DIEKIOHS
SANITIZER TYPE

MECHANISM

DISADVANTAGES

Antibacterial soaps
(Triclosan)

Attacks cell membrane

Toxicity against infant
dermal fibroblast

Alcohol based

Destruction of proteins of
bacterial cell

Causes dry and flaky skin

Iodine based

Acts as an oxidizing agent

Contact dermatitis

Hydrogen peroxide based

Acts as an oxidizing agent

Toxicity against
keratinocytes

Ammonium based

Destruction of cell
membrane

Skin irritation

Ref: Moore, D. , Toreki, W. , Carr, R. , Liesenfeld, B. , Schultz, G. , Batich, C. , Mikhaylova, A. , Dominguez, P. ,
Vella, J. , Olderman, G. (2009). Hand sanitizer technology and progress towards a more functional concept.
Symposium on advanced wound care and wound healing society meeting. Florida: Quick Med Technologies.
Dr Sumaiya Hasan
DIEKIOHS
Dr Sumaiya Hasan
DIEKIOHS
ASEPTIC ENVIRONMENT

In surgery
environment

Instruments and
appliances

Dr Sumaiya Hasan
DIEKIOHS
DISPOSABLE ITEMS

Dr Sumaiya Hasan
DIEKIOHS
Dr Sumaiya Hasan
DIEKIOHS
STERILIZATION OF INSTRUMENTS
 Pre-sterilization cleaning

Manual / Washer disinfectors /
Ultrasonic bath

 Disinfection
 Sterilization
 Aseptic storage

Dry heat /
Moist heat /
Gaseous
sterilization

Dr Sumaiya Hasan
DIEKIOHS

Downward displacement
autoclaves
Positive pressure
displacement autoclaves
DISINFECTANT

EXPOSURE TIME

ACTIVITY LEVEL

Formaldehyde

30 minutes or more

Intermediate

Glutaraldehyde

10 minutes or more

Intermediate
(If used with alcohols for 4
hrs above room
temperature then high
level)

Chlorine compounds

30 minutes or more

Intermediate

Iodophors

30 minutes or more

Intermediate

Alcohol compounds

10 minutes or more

Intermediate

Ref: Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial Surgery (5th
edition pg. 65). India: Elsevier
Dr Sumaiya Hasan
DIEKIOHS
TEMPERATURE (DEGREES
CENTIGRADE)

TIME DURATION
DRY HEAT

121

6-12 hours

140

3 hrs

150

2 and a half hrs

160

2 hrs

170

1hr
STEAM

116

60 min

118

36 min

121

24 min

125

16 min

132

4 min

138

1 and a half min

Ref: Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial
Surgery (5th edition pg. 63). India: Elsevier

Dr Sumaiya Hasan
DIEKIOHS
ENVIRONMENT OF DENTAL CLINIC
 Cleaning of surfaces

 Covering of surfaces using disposable covers
 Cleaning of dental unit water supplies
 Proper disposal of wastes

Dr Sumaiya Hasan
DIEKIOHS
ADDITIONAL MEASURES
 For “at risk” patients
 Airborne precautions
 Contact precautions
 Sterilization precautions

Dr Sumaiya Hasan
DIEKIOHS
REFERENCES
 Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial Surgery (5th
edition ). India: Elsevier
 Seymour, S. (2001). Disinfection, sterilization and preservation. Philadelphia: Lippincott
Williams & Wilkins
 Shah, H. A. & Wyne, A. H. (2010 July). Cross infection control in dentistry: A review.
Pakistan Oral And Dental Journal, Vol. 35
 Moore, D. , Toreki, W. , Carr, R. , Liesenfeld, B. , Schultz, G. , Batich, C. , Mikhaylova, A. ,
Dominguez, P. , Vella, J. , Olderman, G. (2009). Hand sanitizer technology and progress towards
a more functional concept. Symposium on advanced wound care and wound healing society
meeting. Florida: Quick Med Technologies.
 Rampal, N. (2010). Infection control in prosthodontics. Journal of oral health and community
dentistry, Vol. 4 (Issue 1)
 Truscot, W. & Stoessel, K. (2001). Potential consequences of glove powder. Northampton:
Kimberley-Clark Healthcare UK. From https://www.kchealthcare.com

 (2005, April). Hand hygiene guidelines from
http://www.manchesterpct.nhs.uk/document_uploads/Infection_Guidelines/handhygiene.
pdf
Dr Sumaiya Hasan
DIEKIOHS
 Curtis, L. (2006 July). Aseptic technique from
http://www.docstoc.com/docs/86653540/ASEPTIC-TECHNIQUE[1]
 Open gloving technique from http://cal.vet.upenn.edu/projects/surgery/4969.html
 Cross infection control from http://www.schulke-mayr.co.uk
 Pre sterilization cleaning and disinfection of instruments from
http://www.dentaquip.co.uk/Autoclaves
 Steriization equipment from http://globe-tek.com/sterilization-equipment
 Guidelines on infection control practice in dentistry from
http://www.dentalcouncil.ie/files/Cross%20Infection%20Control.pdf
 Cross infection control from
http://www.deitsch.plus.com/Cross%20Infection%20Control.html
 Disinfection and sterilisation of dental materials and instruments from
http://www.fas.org/irp/doddir/milmed/dental.pdf
 Latex and nitrile gloves from http://www.glovenation.com/index.html
Dr Sumaiya Hasan
DIEKIOHS
Cross infection control in dentistry (Few basic points)

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Cross infection control in dentistry (Few basic points)

  • 1. DEPARTMENT OF PROSTHODONTICS – DIEKIOHS “CROSS INFECTION CONTROL” BY SUMAIYA HASAN
  • 2.  Cross infection = Transfer of infectious agents among people either directly from person to person or indirectly e.g through instruments  Cross infection control = Measures taken to prevent cross infection Dr Sumaiya Hasan DIEKIOHS
  • 3. Herpes Simplex Pseudomonas HBV HIV Klebsiella Dr Sumaiya Hasan DIEKIOHS Mycobacterium tuberculosis
  • 5. WAYS OF TRANSMISSION  Direct transmission  From patient to dental worker  Indirect transmission  From dental worker to patient  From one patient to another  From dental office to commuity Dr Sumaiya Hasan DIEKIOHS
  • 6. GROUPS OF ITEMS INVOLVED Non critical Critical Semi critical Dr Sumaiya Hasan DIEKIOHS
  • 7. CROSS INFECTION CONTROL PROTOCOLS In 1996 CDC (Centre for Disease Control USA) and the Hospital Infection Control Practice Advisory Committee (HICPAC) introduced infection control precautions.  Standard  Additional Dr Sumaiya Hasan DIEKIOHS
  • 8. STANDARD PRECAUTIONS  Apply to all body fluids  Developed as a response to the understanding that other body fluids besides blood are potentially infectious, and that anyone with patient contact could be at risk Personal protection Aseptic environment Dr Sumaiya Hasan DIEKIOHS Basic cross infection control
  • 10. Ref: (2005, April). Hand hygiene guidelines from http://www.manchesterpct.nhs.uk/document_uploads/Infection_Guidelines/handhygiene.pdf Dr Sumaiya Hasan DIEKIOHS
  • 11. SANITIZER TYPE MECHANISM DISADVANTAGES Antibacterial soaps (Triclosan) Attacks cell membrane Toxicity against infant dermal fibroblast Alcohol based Destruction of proteins of bacterial cell Causes dry and flaky skin Iodine based Acts as an oxidizing agent Contact dermatitis Hydrogen peroxide based Acts as an oxidizing agent Toxicity against keratinocytes Ammonium based Destruction of cell membrane Skin irritation Ref: Moore, D. , Toreki, W. , Carr, R. , Liesenfeld, B. , Schultz, G. , Batich, C. , Mikhaylova, A. , Dominguez, P. , Vella, J. , Olderman, G. (2009). Hand sanitizer technology and progress towards a more functional concept. Symposium on advanced wound care and wound healing society meeting. Florida: Quick Med Technologies. Dr Sumaiya Hasan DIEKIOHS
  • 13. ASEPTIC ENVIRONMENT In surgery environment Instruments and appliances Dr Sumaiya Hasan DIEKIOHS
  • 14. DISPOSABLE ITEMS Dr Sumaiya Hasan DIEKIOHS
  • 16. STERILIZATION OF INSTRUMENTS  Pre-sterilization cleaning Manual / Washer disinfectors / Ultrasonic bath  Disinfection  Sterilization  Aseptic storage Dry heat / Moist heat / Gaseous sterilization Dr Sumaiya Hasan DIEKIOHS Downward displacement autoclaves Positive pressure displacement autoclaves
  • 17. DISINFECTANT EXPOSURE TIME ACTIVITY LEVEL Formaldehyde 30 minutes or more Intermediate Glutaraldehyde 10 minutes or more Intermediate (If used with alcohols for 4 hrs above room temperature then high level) Chlorine compounds 30 minutes or more Intermediate Iodophors 30 minutes or more Intermediate Alcohol compounds 10 minutes or more Intermediate Ref: Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial Surgery (5th edition pg. 65). India: Elsevier Dr Sumaiya Hasan DIEKIOHS
  • 18. TEMPERATURE (DEGREES CENTIGRADE) TIME DURATION DRY HEAT 121 6-12 hours 140 3 hrs 150 2 and a half hrs 160 2 hrs 170 1hr STEAM 116 60 min 118 36 min 121 24 min 125 16 min 132 4 min 138 1 and a half min Ref: Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial Surgery (5th edition pg. 63). India: Elsevier Dr Sumaiya Hasan DIEKIOHS
  • 19. ENVIRONMENT OF DENTAL CLINIC  Cleaning of surfaces  Covering of surfaces using disposable covers  Cleaning of dental unit water supplies  Proper disposal of wastes Dr Sumaiya Hasan DIEKIOHS
  • 20. ADDITIONAL MEASURES  For “at risk” patients  Airborne precautions  Contact precautions  Sterilization precautions Dr Sumaiya Hasan DIEKIOHS
  • 21. REFERENCES  Tucker, M. , Ellis III, E. , Hupp, J. 2009. Contemporary Oral And Maxillofacial Surgery (5th edition ). India: Elsevier  Seymour, S. (2001). Disinfection, sterilization and preservation. Philadelphia: Lippincott Williams & Wilkins  Shah, H. A. & Wyne, A. H. (2010 July). Cross infection control in dentistry: A review. Pakistan Oral And Dental Journal, Vol. 35  Moore, D. , Toreki, W. , Carr, R. , Liesenfeld, B. , Schultz, G. , Batich, C. , Mikhaylova, A. , Dominguez, P. , Vella, J. , Olderman, G. (2009). Hand sanitizer technology and progress towards a more functional concept. Symposium on advanced wound care and wound healing society meeting. Florida: Quick Med Technologies.  Rampal, N. (2010). Infection control in prosthodontics. Journal of oral health and community dentistry, Vol. 4 (Issue 1)  Truscot, W. & Stoessel, K. (2001). Potential consequences of glove powder. Northampton: Kimberley-Clark Healthcare UK. From https://www.kchealthcare.com  (2005, April). Hand hygiene guidelines from http://www.manchesterpct.nhs.uk/document_uploads/Infection_Guidelines/handhygiene. pdf Dr Sumaiya Hasan DIEKIOHS
  • 22.  Curtis, L. (2006 July). Aseptic technique from http://www.docstoc.com/docs/86653540/ASEPTIC-TECHNIQUE[1]  Open gloving technique from http://cal.vet.upenn.edu/projects/surgery/4969.html  Cross infection control from http://www.schulke-mayr.co.uk  Pre sterilization cleaning and disinfection of instruments from http://www.dentaquip.co.uk/Autoclaves  Steriization equipment from http://globe-tek.com/sterilization-equipment  Guidelines on infection control practice in dentistry from http://www.dentalcouncil.ie/files/Cross%20Infection%20Control.pdf  Cross infection control from http://www.deitsch.plus.com/Cross%20Infection%20Control.html  Disinfection and sterilisation of dental materials and instruments from http://www.fas.org/irp/doddir/milmed/dental.pdf  Latex and nitrile gloves from http://www.glovenation.com/index.html Dr Sumaiya Hasan DIEKIOHS