A brief pressentation about infection control measures to be followed in a dental office..

1. AHANA

2. AHANA

3. AHANA

4. • Deposition of organism in
INFECTION tissues & their growth
resulting in HOST REACTION.
INFECTIVE • Number of organism required
DOSE
AHANA to cause an INFECTION.

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6. PATHOGENS
AIR BLOOD
BORNE BORNE
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12. AIR BORNE
DIRECT
INDIRECT
CROSS CONTAMINATION
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13. AIR BORNE CONTAMINATION
Spatter
(>50mm)
Mists
Aerosols (>/= 50mm)
(50ṷm-50mm)
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14. DIRECT INDIRECT
CONTAMINATION CONTAMINATION
 Direct contact with body  Handling sterile
fluids. equipments & areas with
contaminated hands
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15. CROSS
CONTAMINATION
PATIENT DOCTOR
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16. Elimination /
reduction of
spread of infection
from their hosts
Removal of
microorganisms
from objects or
surfaces
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17. AHANA

18. STERILIZATION
IMMUNIZATION
& DISINFECTION
PERSONAL DENTAL
BARRIER EQUIPMENT
TECHNIQUE ASEPSIS
SURGICAL PROCEDURAL
ASEPSIS
AHANA BARRIERS

19. Vaccination
plays an
important role
Hepatitis B
vaccine
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20. Hand Head
washing cap
Eyewear Facemask
Protective
AHANA gown Gloves

21. AHANA

22. Primary
source of
infection
transmission
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23. HAND WASHING………..
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24. HAND WASHING………..
Mild antiseptics : 3% P-
chloro, meta- xylenol /
chlorhexidine
Control pathogens & suppress
overgrowth of skin bacteria
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25. Head Cap …………
Hair is Hair
restrained should be
away tied
from face properly
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26. Protective Eyewear……
Protection against foreign
bodies, splatter & aerosols
Protection against injury &
microbes
Do not touch with contaminated
hands
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27. Face masks……
Should be changed regularly & b/w
patients
Do not touch the mask with gloved
hands
When wet should be changed
To remove grasp only by strings
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28. GOWNS
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29. GOWNS………….
Protective over garments.
Cotton or synthetic.
Worn over dentists’ clothes.
Protection against spatter from routine work.
Only in clinic & should be laundered daily.
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30. GLOVES
Prevents
contamination of
hands & control
cross infection
Should be
changed btw
patients
Do not wash with
detergents & thr
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should be no
defects.

31. GLOVES
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32. Lowest possibility of manufacturing defects
Well fitting
Good tactile sensitivity
Do not cause hypersensitivity.
Conducive to glove powder.
Non offensive taste & odour.
Reasonable cost.
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33. LATEX
HEAVY STERILE
UTILITY GLOVES
SURGICAL
VINYL
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34. High
quality
Maximum
protection
Expensive
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35. Commonly
used in
dentistry
Adversely affected
by alcohols &
detergents
Becomes tacky / sticky when
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36. Over gloves
When intraoral
procedures are to
be interrupted
Slipped over
gloved hands.
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37. Wear resistant
NITRITE TYPE can be
washed, sterilized,
disinfected
Double gloves – Herpes, HIV, HBV
Boxes of gloves: stored away from sunlight in
tightly closed, heavy plastic bags__ minimize
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oxidation

38. Surgical staff preparation
Surgical site preparation
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Draping the patient

39. Personal barrier protection
Surgeon is helped into
sterile gown by
properly gowned &
gloved assistant
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Last step- wear gloves

40. SURGICAL SITE
PREPARATION
Reduces postoperative infections.
Lubricating oil is applied patient’s eyes &
taped shut.
Removal of hair in surgical site
Whole area is scrubbed with iodophore
solution
Skin preparation should take only about
5 min.
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41. DRAPING THE PATIENT
Isolate surgical area
Secured with towel
clips
Waterproof drapes
will be more
beneficial
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42. RUBBER DAM Prevents aerosol
formation of saliva
SALIVA
Minimize contact
EJECTOR with aerosols &
spatter
Rinsing mouth
ANTIMICROBIAL
SOLUTION reduces amount of
bacteria
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43. SALIVA RUBBER ANTIMICROBIAL
EJECTOR DAM SOLUTION
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44. Clean & disinfect
2
Approaches
Prevention of
contamination
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45. DISPOSABLE, SINGLE-USE
INFECTION CONTROL BARRIER
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46. PLASTIC
FILM Al FOIL
BAGS
TREATED
AHANA FABRIC

47. DELIVERY SYSTEM
Surfaces should be cleaned & disinfected b/w each patient
Clean the surface by vigorous wiping, reapply the agent to disinfect
& keep the surface moist for 10 min.
Simple & most cost effective method is by use of single use barrier
materials
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48. DENTAL CHAIR
Should be smooth with
minimum accessories
Upholstery should be
removable for cleaning
Plastic sheets should
cover switches
Head rests & arm slings
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should also be disinfected

49. OPERATOR STOOL
Covering the
lever with
plastic
Sheet material
should be of
vinyl plastic
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50. DENTAL
CABINETRY
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51. Materials & instruments should be
stored out of treatment room
Cabinets should be made
of materials that can be
cleaned & disinfected
regularly
Avoid organic
materials in
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construction

52. UTILITY ITEMS
Supply of water, compressed air, suction etc.
Excellent circulation of air with an exhaust to
outside
Prevent clogging of water passages by using
water sediment filter & deionizing the incoming
water
Suction pumps should have smooth flow of water
& air
Sediment trap should be disassembled & cleaned
regularly
The air compressor tank must be drained daily to avoid
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microbial contamination

53. DENTAL UNIT WATER LINES
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54. Dental unit water lines…….
Bacterial biofilm is formed
ADA - <200 CFU/ml
Dental waterlines should be flushed at
the beginning of the day.
Chemical germicides should be used to
flush the waterline
Antiretraction valves can also be used
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55. PRESOAKING CLEANING
PACKAGING RINSE & DRY
SEALING STERILIZATION
CLINICAL
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STORAGE
USE

56. Prevents debris from drying
Place instruments in a perforated
basket & then place it in holding
solution (neutral pH
detergents, water, Enzyme soln)
Do not soak for too long
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57. PRESOAKING……………
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58. Reduces the
bio burden
MANUAL
SCRUBBING
ULTRASONIC
CLEANING
MECHANICAL
INSTRUMENT
WASHER
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59. Removes debris but direct
contamination risks are high.
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60. Produces billions of tiny
bubbles which further
collapses & create high
turbulence that
dislodges debris
Safer & more effective: 4
– 16 min
Discard the solution daily
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61. Used mainly
in hospitals
Reduces
direct
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handling

62. Always keep the instruments dry.
Use hot air oven sterilization for
corrosion prone instruments
Spray rust inhibitor( sodium
nitrite)
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63. Maintains sterility of instruments
Self sealing, paper plastic & peel
pouches
Instruments will be kept wrapped
until used
Reduce the risk of contamination
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64. PACKAGING……..
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65. AHANA

66. Sunlight
Flaming
PHYSICAL
Incineration
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Hot air oven

67. Alcohols
Aldehydes
Halogens
CHEMICAL
Phenols
Metallic salt
gases
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Surface active
agents

68. • Process by which an article ,
surface or medium is freed of all
STERILIZATION microorganisms either in
vegetative or spore state
• Removal or destruction of
DISINFECTION any microorganism capable
of causing infection
• Measure used to prevent
ANTISEPSIS/ infection by inhibiting
ASEPSIS
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surfaces

69. MOIST
DRY HEAT
HEAT
METHODS
CHEMICAL
ETHYLENE
VAPOUR
OXIDE
PRESSURE
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70. AHANA

71. AUTOCLAVE………
 Most efficient & reliable method.
 3 main phases;
• Vacuum created followed by
Pretreatment induction of steam
Phase • Saturated steam affects all
instruments
• Temperature rises to peak
Sterilization
point
Phase
• Holding time
Post
• Steam removed by vacuum
treatment
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• Ensure instruments are dried
Phase

72. TEMPERATURE TIME
121˚C 15 minutes
126˚C 10 minutes
134˚C 3 minutes
15 lbs PRESSURE
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73. ADVANTAGES
Time efficient
Good penetration
Consistently good & reliable
results
Instruments can be wrapped
prior to sterilization
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74. DISADVANTAGES
Blunting & corrosion
of sharp instruments
Damage to rubber
goods
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75. AHANA

76. Hot air oven…….
Utilizes radiating heat: long periods of exposure
Packaging materials
Paper & Wrapped Nylon plastic
Al foil
plastic bags cassettes tubing
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77. TEMPERATURE TIME
141˚C 3hr
149˚C 2.5hr
160˚C 2hr
170˚C 1 hr
180˚C 30 minutes
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78. ADVANTAGES
No corrosion & blunting
Low cost of equipment
Instruments are dry after cycle
Rapid cycles are possible at
higher temperature
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79. DISADVANTAGES
Poor penetrating capacity
High temperature may damage heat
sensitive items
Inaccurate calibration & lack of attention
to proper settings lead to errors
Not suitable for hand pieces
May discolour fabrics
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80. AHANA

81. Chemical vapour sterilization……
HEATED IN
CHEMICAL HOT
CLOSED CHEMICAL
SOLUTION
CHAMBER VAPOURS
Pressure
Kill microbes
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82. ACTIVE INGREDIENTS 0.23%
Formaldehyde
OTHERS 72.38 % Ethanol +
Acetone + water +
Other Alcohols
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83. M
O
D
E
S
COAGULATION OF CELL MEMBRANE
O PROTEIN DISRUPTION
F
A
C
T
I
O REMOVAL OF FREE
SUBSTRATE
N SULFHYDRYL
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COMPETITION
GROUP

84. TEMPERATURE PRESSURE TIME
132˚C 20lb 30min
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85. Eliminates corrosion of carbon
steel instruments, burs & pliers
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86. DISADVANTAGES
Items sensitive to elevated
temperature are damaged
Sterilization of liner, textiles, fabric or
paper towels not recommended
Instruments should be dry when
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87. AHANA

88. ETOX…………..
Best method for sterilizing complex
instruments
ETOX is highly penetrative, noncorrosive
gas above 10.8˚C
Cidal action against bacteria, spores &
viruses.
Suited for electric equipments, flexible
fiber endoscopes & photographic
AHANA equipment

89. ADVANTAGES
Leaves no residue
Deodorizer
Good penetration
Suited for heat
sensitive articles
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90. DISADVANTAGES
High cost
Toxic, irritant,
mutagenic,
carcinogenic
Explosive & highly
inflammable
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91. AHANA

92. AHANA

93. BOILING WATER……………..
100˚C at normal atmospheric
pressure
10 min exposure kills almost all
bacteria & some viruses
Not suggested for tissue
penetrating instruments.
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94. AHANA

95. Glass bead sterilizer…..
Rapid , chair side method of sterilization
Usually uses table salt which consists of ~ 1 %
sodium silico aluminate & sodium carbonate
Salt can be replaced by glass beads if < 1 mm in
diameter because , larger beads are not efficient
in transferring heat to endodontic instruments
5- 15 sec at 260° C
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96. AHANA

97. IRRADIATION….
2 TYPES
IONIZING
NON IONIZING
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98. X rays, Gamma rays, High
speed electrons
Effective- heat labile
items; needles, syringes,
culture tray, cannula…
High energy gamma rays
from Cobalt 60
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99. UV LIGHT
• Absorbed by proteins & nucleic
acids & kill microbes
• Purification of air
INFRA RED
• To sterilize large number of
syringes sealed in metal container.
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• Has no penetrating ability

100. AUTOCLAVE TAPE THERMOCOUPLE
CHEMICAL
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MICROBIAL TESTS
INDICATORS

101. CRITICAL SEMI- CRITICAL NON CRITICAL
Curettes, burs, Amalgam Light switches,
files, scalpels condensers, counter tops,
mouth mirror, drawer pulls or
saliva ejectors cabinets
•Touch sterile • Touch mucous •Do not come in
areas of body / membrane contact with oral
penetrate tissues without mucosa
& enter vascular penetrating •Touched hands
system tissues. contaminated
•Sterilized & •Should be with saliva/ blood
stored in
AHANA sterilized /
packages disinfected.

102. INSTRUMENT STERILIZATION
CATEGORY METHOD
CRITICAL HEAT STERILIZED & Stored
in packages
SEMI CRITICAL HEAT STERILIZED / Treated
with high level disinfectants
after cleaning
NON CRITICAL Treated with intermediate to
low disinfectant after
cleaning
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103. Constant contact with oral fluids result in
formation of biofilm within the handpiece.
This holds potential to infect a healthy patient.
Tween 80 & Ponceau 4R
3% hydrogen peroxide
But cannot replace autoclaving.
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104. Handpiece sterilization……
Autoclave sterilization
Proper cleaning & lubricating
procedures should be done
Cleaning with disinfectants
Chemical vapour pressure & ETOX
sterilization can be done
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105. STERILIZATION
OF BURS
Critical item
Autoclaving can be done but may
result in rusting.
ETOX sterilization.
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106. INFECTION CONTROL
FOR IMPRESSIONS
Thoroughly wash under running
water
2% gluteraldehyde for 10 min
Alginate impressions – Spray an
iodophor
Store items in separate sealed bags.
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107. DISINFECTION
LEVEL COMPOUND
LOW ETHANOL & • Antibacterial activity
ISOPROPYL • Denature proteins
ALCOHOLS • Maximum 10 min
contact
INTERMEDIATE PHENOLS • In high concentration
protoplasmic poison
• Precipitate proteins &
destroy cell wall
HIGH FORMALDEHYDE & • Toxic & irritant
GLUTERALDEHYDE • Active against most
vegetative forms &
spores
• 2 % soln requires
20min for disinfection &
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6 to 10 hrs for
sterilization.

108. AHANA

109. 1. Employers must provide HB immunization to employees
without charge within 10 days of employment.
2. Universal precautions should be observed to prevent contact
with blood & other potentially infectious materials.
3. Employers must implement control systems to reduce
production of contaminated spatter, aerosols etc.
4. Safe handling of needles & other sharps.
5. Disposal of single use needles, wires , sharps etc. in hard
walled, leak proof containers from which needles cant be
easily spilled.
6. Proper hand washing
7. Providing proper personal protective barriers to employees.
8. Proper sterilization & disinfection system
9. Regular laundry services should be arranged.
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110. BIO
HAZARDOUS
WASTE
BIOMEDICAL
WASTE
MEDICAL
SOLID
WASTE
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111. BIO HAZARDOUS
WASTE
Laboratory waste
Fluid blood elements
Sharps
Human body parts, tissues etc.
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112. Empty specimen containers
Bandages & dressings
Surgical gloves
Decontaminated bio hazardous
wastes.
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113. DISPOSAL BAGS
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114. DISPOSAL METHODS
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