This document provides an overview of infection control in dentistry. It discusses the development of infectious diseases, oral microbiology, and rationales for infection control regulations. The key points are: infection occurs when a pathogen enters the body and grows, causing damage; dental practices implement preventive measures to break the chain of infection; and the goal of infection control is to reduce pathogen exposure and transmission between patients and staff through measures like sterilization, barriers, and hygiene.

1. SCHOOLOFDENTALSCIENCES
Department Of Periodontology
“ INFECTION CONTROL”
BY
DR. AYUSHI SINGH
MDS 1ST YEAR

2. CONTENTS-
• Introduction
• Development of infectious diseases
• Oral microbiology and plaque- associated diseases
• Infection control- Rationale and Regulations
• Immunization
• Hand hygiene
• Protective barriers
• Sterilization and disinfection of dental instruments
• Waste management
• American Dental Association Infection Control Recommendations
for the dental office and the dental laboratory
• Conclusion
• References.

3. INTRODUCTION
DEFINITION - Also called “ exposure control plan” by OSHA is
a required office program that is designed to protect personnel
against risks of exposure to infection1.

4. • These preventive measures include actions taken to eliminate
or contain reservoirs of infection, interrupt the transmission of
pathogens, and protect persons (patients, employees, and
visitors) from becoming infected.
• They are ways to break various links in the chain of infection.

5. DEVELOPMENT OF INFECTIOUS
DISEASES
• An infectious disease occurs when a microorganism (pathogen)
in the body multiplies and causes damage to the tissues .

6. [fromMillerCH,CottoneJC:DentClinNorthAm37:1-20,1993]
Source of microorganism
Escape of microorganism from the source
Spread of microorganism to a new person
Entry of microorganism into the person
Infection ( survival and growth of microorganism)
Damage to the body

7. • SOURCE OF MICROORGANISM IN DENTAL OFFICE
• Mouths of patients ( major source)
• Dental office as in water,air,dust,surfaces and the dental
team( asymptomatic carrier)
• STAGES OF AN INFECTIOUS DISEASE-
There are 4 stages of an infectious disease –

8. • Incubation stage - period from the initial entrance of
infectious agent into the body to the time when the first
symptom of disease appear.
• Prodromal stage - involves the appearance of early symptoms
Microorganism multiplies to numbers large enough to cause
the first symptom “ malaise (not feeling well)”.Symptoms may
include slight fever, headache, stomach upset.

9. • Acute stage – symptoms of disease are maximal .This patient
certainly has a potential to spread disease agents but the person
may not be the most important source in dental office except
for emergency.
• Convalescent stage – recovery phase of a disease .Number of
microorganism may be declining, harmful microbial products
are being destroyed rapidly as the body defence successfully
combat the disease. Infectious agents are present and may
spread during this stage.

10. MODE OF
TRANSMISSION EXAMPLE
Direct contact
Contact with microorganism at
the source such as in patient’s
mouth.
Indirect contact
Contact with items contaminated
with a patient’s microorganisms
such as surfaces, hands,
contaminated sharps.
Droplet infection
Contact with the larger droplet in
sprays , splashes or spatter .
Airborne infection
Contact with smaller droplet
nuclei (aerosol particles).

11. ROUTES OF ENTRY OF MICROORGANISM INTO THE
BODY
ROUTES EXAMPLES
Inhalation Breathing aerosol particles
Ingestion Swallowing droplets of
saliva/blood spattered into the
mouth
Mucous membranes Droplets of saliva/blood spattered
into the eyes, nose or mouth
Breaks in the skin Directly touching microorganisms
or being spattered with
saliva/blood onto skin with cuts or
abrasions ; punctures with
contaminated sharps.

12. ORAL MICROBIOLOGYAND
PLAQUEASSOCIATED DISEASES
NORMAL ORAL MICROBIOTA
• The normal oral microbiota consist mostly of bacteria ,
although about 1/3rd of population also has yeast candida
albicans in their mouth.
• It is complex with about 30 genera of bacteria comprising of
several species resulting in complex group of gram positive
and gram negative bacteria .

13. • A gram of dental plaque (about ¼ th of a teaspoonful) contains about
200 billion bacteria and saliva contains 10 million to 100 million
bacteria per milliliter.
• Bacteria genera in the mouth
Gram negative
• Actinobacillus
• Bacteroides
• Camphylobacter
• Fusobacterium
• Haemophilus
• Neisseria
• Porphyromonas
• Prevotella

14. • Selenomonas
• Treponema
• Veillonella
• Gram positive
• Actinomyces
• Bifidobacterium
• Corynebacterium
• Eubacterium
• Lactobacillus
• Micrococcus
• Peptostreptococcus
• Streptococcus.

15. DENTAL PLAQUE ( ORAL BIOFILM) –
• Plaque is a biofilm composed of bacterial cells embedded
in an intercellular matrix. Plaque accumulates most
rapidly in the non-self cleansing areas of the dentition
where the tip of the tongue , the musculature of the
cheeks, and the occlusion of the teeth cannot remove the
accumulating bacteria.

16. • Plaque accumulates in the absence of oral hygiene, potentially
harmful products from the multiplying bacteria accumulate and
may cause damage to the teeth (caries) or to the nearby
periodontal tissues (gingivitis or periodontitis).
• Although dental plaque contains many different species of
bacteria which are more important than others in directly
contributing to the initiation or progression of dental caries. Ex
mutans streptococci (streptococcus mutans, streptococcus
sobrinus) , lactobacillus species.

17. MICROBIOLOGY OF PERIODONTAL DISEASES
• Periodontal diseases are infectious diseases caused by
members of normal oral microbiota accumulated in gingival
sulcus plaque.
• As the bacteria multiply, they produce histolytic enzymes,
toxic metabolites, exotoxins, endotoxins, and
immunosuppressive and antiphagocytic factors.

18. • The accumulation of these bacteria and their harmful products
and antigens produce periodontal diseases by the following
mechanisms –
• Direct damage to the tissue
• Inflammation
• Interfere with some host defence mechanisms
• Stimulation of the immune response in the periodontal
tissues , which can cause damage.

19. • Plaque associated periodontal diseases include –
• Necrotizing ulcerative gingivitis
• chronic periodontitis
• rapidly progressive periodontitis
• juvenile periodontitis
• prepubertal periodontitis
• Some periodontopathogens are as –
• Actinobacillus actinomycetemcomitans
• Actinomyces species
• Bacteroides forsythus
• Capnocytophaga ochraceus

20. • Fusobacterium species
• Peptostreptococcus micros
• Porphyromonas gingivalis
• Prevotella intermedia
• Streptococcus species
• PREVENTION OF PLAQUE ASSOCIATED DISEASES
• Regular brushing and flossing
• Fluorides
• Pit and fissure sealants
• Antimicrobial mouth rinses

21. INFECTION CONTROLRATIONALE
AND REGULATIONS
• RATIONALE FOR INFECTION CONTROL
The logic for routinely practicing infection control is that the
procedures involved interfere with the steps in development of
diseases that may be spread in the office.

22. • PATHWAYS FOR CROSS CONTAMINATION
A total office infection control program is designed to prevent or
at least reduce the spread of disease agents from the following :
• Patient to dental team
• Dental team to patient
• Patient to patient
• Dental office to community , including the dental team’s
families
• From community to patient

23. GOAL OF INFECTION CONTROL
• After microorganism enter the body , 3 basic factors
determine whether an infectious disease will develop :
• Virulence(pathogenic properties of invading microorganism)
• Dose( the number of microorganisms that invade the body),
and
• Resistance ( body defence mechanism of the host).
• Health or disease = ( virulence * dose ) / (body resistance)

24. • Health is favored by low virulence , low dose, and high
resistance ; disease is favored by high virulence , high dose,
and low resistance.
• Goal of infection control is to reduce the dose of
microorganisms that may be shared between individuals or
between individuals and contaminated surfaces.
• The more the dose is reduced , the better the chances for
preventing disease spread.

25. • Procedures that minimize spraying or spattering of oral fluids
(e.g . rubber dam, high volume evacuation ,and pre-procedure
mouth rinse) reduce the dose of microorganisms that escape
from the source.
• Hand washing and surface pre-cleaning and disinfection
reduce the number of microorganisms that may be transferred
to surfaces by touching. Barriers such as masks, gloves and
protective eyewear and clothing reduce the number of
microorganisms that contaminate the body or other surfaces.

26. • Instrument pre-cleaning and sterilization eliminate or reduce
the number of microorganisms that may be spread from one
patient to another.
• Proper management of infectious waste by using appropriate
containers for disposal eliminates or reduces the number of
microorganisms that may contaminate persons or inanimate
objects.

27. RECOMMENDATIONS AND REGULATIONS
• Recommendations are made by individuals or groups that have
no authority for enforcement.
• Regulations are made by groups that do have the authority to
enforce compliance, usually under the penalty of fines,
imprisonment, or revocation of professional licenses.
• Centres for infection control recommendations-
• Centre for Disease Control and Prevention ( CDC) – part of public
health service division of U.S Department of health and human
services.
• American Dental Association (ADA)
• Organization for Safety and Asepsis Procedures
• Association for Advancement of Medical Instrumentation .

28. • Centres for infection control regulations-
• Occupational Safety and Health Administration (OSHA) – is
a division of US Department of Labour
• Food and Drug Administration(FDA) – Part of the US
Department of Health and Human Services
• Environmental Protection Agency

29. UNIVERSAL PRECAUTIONS-
• Is the concept that all human blood and certain human body
fluids that may contain blood are treated as if known to be
infectious for HIV and HBV.
• CDC has expanded the concept of universal precautions int
what now is called standard precautions.
• Standard precautions apply not just to contact with blood but
also to
• All body fluids,secretions and excretions (except sweat)
regardless of whether they contain blood
• Nonintact skin
• Mucous membranes.

30. • Elements of standard precautions – these include
• Immunization
• Patient screening
• Hand hygiene
• Barrier techniques - including personal protective
equipment(Use of gloves, masks, eye protection and gowns)
• Needle and sharp instrument safety – occupational exposure
to blood/body fluids.
• Instruments sterilization and disinfection
• Surface disinfection
• Radiographic asepsis
• Laboratory asepsis
• Infectious dental waste management and disposal

31. IMMUNIZATION
• It is recommended that all clinical and non clinical healthcare
workers, trainees and students are up to date with routine
vaccinations against tetanus, diphtheria, polio and measles,
mumps and rubella (MMR).
• All dental healthcare workers and students who have close
contact with patients will require additional BCG
immunization that protects against TB.

32. STRONGLYRECOMMENDED IMMUNOBIOLOGICALS
AND IMMUNIZATION SCHEDULES FOR DENTAL
HEALTH CARE PERSONNEL

35. (From Miller Palenik Infection Control 3rd edition)

36. Exposure prone procedures – ‘bleed back’
• EPPs include procedures where the worker’s gloved hands
may be in contact with sharp instruments, needle tips or sharp
tissues inside a patient’s open body cavity, wound or confined
anatomical space where the hands or fingertips may not be
completely visible at all times.

37. Classification of exposure prone procedures (EPPs) and non EPPs
CATEGORY DEFINITION
ASSOCIATED
RISKS
EXAMPLES OF
PROCEDURES
1
Procedures where the
hands and fingertips of
the worker are
usually visible and
outside the body most
of the time and the
possibility of injury to
the worker’s gloved
hands from sharp
instruments and/or
tissues is slight.
Low
Local anaesthetic
Injections Polishing of
teeth or restorations
using finishing
burs in highspeed
handpieces
2
Procedures where the
fingertips may not be
visible at all times
but injury to the
worker’s gloved
hands from sharp
instruments and/or
tissues is unlikely
Intermediate Extraction of a
Tooth ,Root canal
Therapy

38. 3
Procedures where the
fingertips are out of
sight for a significant
part of the procedure,
or during certain
critical stages, and in
which there is a distinct
risk of
injury to the worker’s
gloved hands from
sharp instruments
and/or tissue
Highest osteotomy
Non EPP
Procedures where the
hands and fingertips of
the worker are visible
and outside the patient’s
body at all times, and
internal examinations or
procedures donot
involve possible injury
to the worker’s gloved
hands from sharp
instruments and/or
tissues
Are considered not to be
exposure prone provided
routine infection
prevention and
control procedures are
adhered to at all times
Incision of
external
abscesses
Taking
impressions

39. HIV infected healthcare workers-
• HIV positive healthcare workers are permitted to treat patients
undergoing EPPs as long as they comply with the following
guidance.
• On effective cART and have a plasma viral load <200
copies/mL (or be an elite controller with a viral load of <200
copies/mL).
• Be subject to plasma viral load monitoring every three
months.
• Be under joint supervision of their treating physician and a
consultant occupational health physician.
• Be registered with the UKAP‐OHR.

40. HAND HYGIENE
• HANDS AS A SOURCE OF INFECTION-
• Skin of the hands harbours two main types of microorganisms
Resident
(mainly Gram positive, low
virulence micro organisms that
are rarely transmitted by hand
contact and are not easily
removed through hand hygiene.)
Transient
(mainly Gram negative bacteria
that are an important cause of
nosocomial infections that can
be removed by hand hygiene.)

41. When to clean your hands
• The World Health Organization (WHO) actively promotes the
concept of ‘five moments for hand hygiene’.
1. before touching a patient
2. before clean/aseptic procedures
3. after body fluid exposure/risk, e.g. saliva, blood or other
bodily fluid
4. after touching a patient
5. after touching patient surroundings.

42. Choosingthecorrecthandhygieneproduct
Type of
handcleanin
g
agent
Action Inhibited
by
organic
material
Active
against
C. difficle
Limitation Type of
hand
hygiene
Chlorhexidi
ne
and
Triclosan
Rapid Binds
to
skin;remains
active for up
to 6
hours
no yes Chlorhexidin
e may cause
irritant/
allergic
dermatitis in
some people
Hygienic
Surgical
Iodophors Rapid yes yes Inhibited by
organic
material. May
cause skin
irritation in
some people.
Staining of
skin
Surgical
Alcohol
based
hand rubs
and gels
Very rapid
Short lived
yes no Inhibited by
organic
material, e.g.
blood
Hygienic
Surgical

43. PROTECTIVE BARRIERS
• Areas of the body that are particularly heavily colonized with
microbes are areas exposed to splatter such as forearm, upper
chest and face and those parts most frequently touched by our
hands, i.e. below the waist, sleeves and pockets.
• During dental treatment, other items worn by the dental team,
such as badges ,jewellery and even mobile phones kept in a
pocket become contaminated.
• Wearing a plastic apron or gown forms a physical barrier and
significantly reduces contamination of workwear.
• This is the reason why infection control policies require the
dental team to wear personal protective equipment (PPE) such
as plastic aprons, impermeable gowns, goggles, masks and
disposable gloves.

44. • Most PPE is single use, so when we dispose of the PPE as
hazardous infectious waste, we simultaneously dispose of the
body fluid splatter and pathogens on the PPE, thereby
eliminating the cross infection risk.
These are as-
• Gloves – When used correctly, wearing gloves:
• protects hands from contamination with blood, saliva and
micro‐organisms
• reduces the risk of cross‐infection
• protects hands from toxic and irritant chemicals

45. • Gloves should be worn during routine dental and surgical
treatment, when treating patients, handling waste or mopping
up spills. Sterile gloves are worn for invasive surgical
procedures.
• Good practice guide: safe use of gloves in the dental surgery
• Hands must be washed before and after donning gloves.
Never consider gloves to be an alternative to hand washing.
• Changing your gloves between patients prevents
cross‐transmission between patients and contamination of
hard surfaces in the surgery.
• Do not touch patient’s notes, pens, computer keyboards,
door or drawer handles or your face with gloved hands

46. • Never reuse single‐use disposable gloves.
• Keep glove wear to a minimum. Gloves should be applied
immediately before starting treatment and removed as soon as the
activity is complete.
• Dispose of gloves as hazardous infectious waste.
• Change gloves during very long procedures. After prolonged use,
approximately 9–12% of gloves develop perforations or become
porous due to hydration of the latex, and may leak. Hepatitis
viruses have been transmitted via minor glove perforations.
• Changing your gloves during long procedures reduces excess
sweating, which in turn decreases dermal infections or
inflammation.
• Remember that hands are not necessarily clean because gloves
have been worn. On removing gloves, the patient’s
microorganisms can be transmitted from the external surface of
the glove to the dentist’s hands and need to be removed by hand
hygiene.

47. Surgical masks
• Fluid repellent surgical masks act as a physical barrier
providing protection to the nose, mouth and upper respiratory
tract against sprays, splatter and droplets.
• Masks come in various shapes (e.g. moulded and non
moulded) and method of attachment (e.g. ties and ear loops).
• They are disposable and intended for single use only. When
worn correctly, the mask should cover the nose and mouth.

48. Goodpracticeguide:howtouseasurgicalmask-
• Masks are recommended for all dental procedures.
• Masks should be close fitting and cover the nose and mouth
• Avoid touching the outer filtering surface of the mask, which may be
contaminated.
• Only handle the ties/ear loops which are considered ‘clean’ and can
be touched with bare hands.
• Masks are single‐use items. They should be changed after every
patient and not reused.
• Mask should be disposed of immediately after use as hazardous
clinical infectious waste.
• Do not pull the surgical mask or respirator mask down to hang
around the neck or wear on the elbow as this will lead to cross
contamination.
• Hands should be cleaned after removing the mask in order to prevent
contamination of your face and the surgery environment.

49. Protective eyeware
• Eye protection is always required during potentially infectious
aerosol generating procedures.
• Ideally, eye protection (goggles /faceshields) should be
comfortable and allow for sufficient peripheral vision and
secure fit, and offer protection from splashes, sprays and
respiratory dropletsfrom multiple angles.

50. Good practice guide:gogglesand face shields
• Goggles with side protection or face shields should be worn
during all types of dental treatment or when manually cleaning
instruments.
• Single‐use disposable goggles and visors are preferred but
reusable goggles and visors should be decontaminated
according to the manufacturer’s instructions for
cleaning the surface with disinfectant,e.g. alcohol based ,
surface disinfectant wipe.
• Goggles should not impair the operator’s vision as this could
result in compromised patient care. If they become scratched
or cloudy following multiple use, they should be replaced.
• In the event of contamination of the eyes with blood or other
body fluids or chemicals, first remove contact lens (if worn)
and then rinse the eye with copious amounts of eye wash or
cold water.

51. • The World Health Organization (WHO) recommends that PPE
should be donned and removed in the following order to
minimize environmental and self contamination.
• Good practice guide: donning protective equipment
• Perform hand hygiene
• Plastic apron (or fluid‐repellent gown)
• Surgical mask (or respirator mask)
• Protective eyewear
• Gloves

52. • Good practice guide: removing protective equipment
• Gloves
• Plastic apron or gown
• Protective eyewear
• Mask or respirator mask
• Perform hand hygiene
• Good practice guide: wearing and cleaning of workwear
• Uniforms should be changed daily or more frequently if visibly
soiled with body fluids or obvious stains such as ink from
leaking biros, oil stains, etc.
• Protective clothing should not be worn in designated eating
and rest areas within the practice. Remove protective clothing
when eating and drinking.

53. • Tunics and uniforms should be removed before leaving the
practice and placed in an impermeable bag.
• Do not ‘greet’ friends and family with pathogens picked up in
the surgery.
• When purchasing uniforms, it makes sense to choose fabrics
and colours that can tolerate washing at the higher
temperatures required to kill microbes.
• uniforms should be washed separately from the household
wash in a washing machine set on a hot wash

54. • Plastic aprons -Plastic aprons are classified as single use items
and should be changed between patients or each procedure and
then discarded as hazardous clinical waste.
• Surgical gowns and surgical drapes -
• If there is a risk of splashing with blood or body fluids onto
skin or clothing such as during minor oral surgery,
periodontal or implant surgery then disposable,long sleeved
fluid repellent surgical gowns are advised .
• Gowns are usually the first piece of PPE to be donned after
hand hygiene has been performed.

55. • Gowns should have long sleeves with tight fitting
cuffs.Gloves are worn over the cuff of the sleeve, which
protects the wrists from contamination and helps to prevent
wetting of the cuff.
• When removing the gown, the outer, ‘contaminated’ side of
the gown is folded inwards and rolled into a bundle, and
then discarded into a hazardous waste receptacle.

56. STERILIZATIONAND DISINFECTION
OF DENTAL INSTRUMENTS
• Disinfection: This refers only to the inhibition or destruction of
pathogens. This is an adequate treatment for cleaning working
surfaces of a dental unit. Disinfectant is a chemical agent that
kills pathogenic and non-pathogenic micro-organisms but not
spores.
• Sterilization: It is the destruction or removal of all forms of
life, with particular reference o micro-organisms; in other
words destruction of bacteria, viruses, spores and fungi. The
criterion of sterility is the absence of microbial growth in
suitable media. The instrument used for sterilization is called
sterilizer and the agents capable of this are called as sterilizing
agents.

57. Classification based on risk of transmission and need of
sterilization of dental instruments
• Critical - penetrate mucous membrane or contact bone,
bloodstream,or other normally sterile tissues. Examples
surgical instruments, scalpel, blades, periodontal scalers,
curettes, surgical dental burs.
• Semi critical - contact mucous membrane but do not penetrate
soft tissue .Examples dental mouth mirrors, dental handpieces.
• Non critical - contact intact skin. Examples x-ray heads,
facebows, blood pressure cuff.

58. • STAGES FOR INSTRUMENT STERILIZATION :
• Presoaking
• Cleaning
• Corrosion control and lubrication
• Packaging
• Sterilization
• Handling sterile instruments
• Storage
• Distribution

59. • AGENTS USED IN STERILIZATION
Physical agents
• Sunlight
• Drying
• Dryheat : flaming , incineration, hot air
• Moist heat : pasteurization , boiling, steam under pressure
• Filtration ; candle asbestos pad, membranes
• Radiation
• Ultrasonic and sonic vibrations

60. Chemical agents
• Alcohols : ethyl alcohol , isopropyl, trichlorobutanol
• Aldehydes: formaldehyde, glutaraldehyde
• Dyes
• Halogens
• Phenols
• Surface active agents
• Metallic salts
• Gases : ethylene oxide, formaldehyde, beta propiolactone.

61. • The 4 accepted methods of sterilization are –
• Steam pressure sterilization(autoclave)
• Chemical vapor pressure sterilization
• Dry heat sterilization
• Ethylene oxide sterilization.
1. AUTOCLAVE
• Sterilization with steam under pressure
• Time required at 1210C is 15 mins at 15Ibs of pressure

62. • Advantages
• rapid and effective
• effective for sterilizing cloth surgical packs and towel packs
• Disadvantages
• Items sensitive to heat cannot be sterilized
• It tends to corrode carbon steel burs and instruments

63. 2. CHEMICAL VAPOR PRESSURE STERILIZATION
• Operates at 1310C and 120 Ibs of pressure
• They have a cycle time of half an hour
• Advantages
• Carbon steel and other carbon sensitive burs, instruments
and pliers are sterilized without rust or corrosion.
• Disadvantages
• Items sensitive to elevated temperature will be damaged
• Towel and heavy clothing cannot be sterilized

64. 3. DRY HEAT STERILIZATION
• Conventional dry heat ovens
• Achieved at temperature above 1600C
• Have heated chambers that allow air to circulate by gravity
flow.
• 6-12 mins is required for sterilization.
• Disadvantage
• Without careful calibration more chances of sterilization
failure

65. 4. ETHYLENE OXIDE STERILIZATION
ADVANTAGES DISADVANTAGES
 Operates effectively at low
temperature
 Gas is extremely penetrative
 Can be used for sensitive
equipment like handpieces.
 Sterilization is verifiable
 Potentially mutagenic and
carcinogenic.
 Requires aeration chamber
,cycle time lasts hours
 Usually only hospital based

66. • DISINFECTION
• Disinfection is always at least a two-step procedure
• 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.

67. • The ideal disinfectant has the following properties:
1. Broad spectrum of activity
2. Acts rapidly
3. Non corrosive
4. Environment friendly
5. Is free of volatile organic compounds
6. Nontoxic & nonstaining

68. • High-level disinfection: Disinfection process that inactivates
vegetative bacteria, mycobacteria, fungi, and viruses but not
necessarily high numbers of bacterial spores.
• Intermediate-level disinfection: Disinfection process that
inactivates vegetative bacteria, the majority of fungi,
mycobacteria, and the majority of viruses (particularly
enveloped viruses) but not bacterial spores.

69. • Low-level disinfectant: Liquid chemical germicide. OSHA
requires low-level hospital disinfectants also to have a label
claim for potency against HIV and HBV. Gigasept which
contains succindialdehyde and dimethoxytetrahydrofuran are
used for disinfection of plastic and rubber materials eg: dental
chair

70. WASTE MANAGEMENT
• Dental waste is of two types –
• Hazardous waste
• Non hazardous waste
Hazardous waste Non hazardous waste
Infectious waste
Pathological waste
Sharps
Chemical waste
Cytotoxic waste
Radioactive waste
Disposable paper towels
Paper mixing pads
Disposable covers of operating
surfaces

72. AMERICAN DENTALASSOCIATION INFECTION
CONTROLRECOMMENDATIONS FORTHE DENTAL
OFFICEAND THE DENTALLABORATORY
• Based on the recommendations of the Centres for Disease
Control and Prevention (CDC) & other publications in medical
and dental literature, have been accepted by Council on
Scientific Affairs and the Council of Dental Practice.
• These include :
• Prevention of transmission of infectious diseases
( immunization)
• Universal precautions.

73. CONCLUSION
Effective infection control must be a routine component of
professional activity. The use of universal precautions in the
management of all patients greatly minimizes occupational
exposure to microbial pathogens.When properly used,
disinfection and sterilization can ensure the safe use of invasive
and non-invasive medical devices. However, current disinfection
and sterilization guidelines must be strictly followed.

74. REFERENCES
1. Infection Control 3rd edition by Chris H Miller & Charles
John Palenik
2. Basic guide to infection prevention and control in dentistry
2nd edition by Caroline L Pankhurst & Wilson A Coulter.
3. Textbook of microbiology 4th edition by C P Baveja
4. Infection control recommendations for the dental office and
the dental laboratory. ADA Council on Scientific Affairs and
ADA Council on Dental Practice. J Am Dent Assoc . 1996
May;127(5):672-80.