This document discusses infectious disease transmission and infection control methods in dental settings. It covers the chain of infection, modes of transmission, risk factors for infection, personal protective equipment, sterilization and disinfection procedures, dental waterline maintenance, portable dental kits for community outreach, and the importance of immunization and training healthcare workers to prevent occupational transmission. The overall goal of infection control is to control disease transmission between patients and healthcare workers.

2.  INTRODUCTION
 CHAIN OF INFECTION PROCESS
 TRANSMISSION OF DISEASE
 INFECTION CONTROL METHODS
 IMPLICATION IN COMMUNITY SETTING
 CONCLUSION
 ARTICLES
 REFERENCES

3.  Infectious diseases have spread throughout
the world.
 A set of infection-control strategies common
to all health-care delivery settings should
reduce the risk of transmission of infectious
diseases.

4.  Pathogenic
(causing disease)
 Potentially
Pathogenic
 Non-Pathogenic

5.  Infection requires a “chain” of events to
produce disease.
 The role of the hospital
epidemiologist/infection control is to
understand this chain and the most efficient
means of interrupting transmission

6. Susceptible
host
Port of Entry
Transmission
Port of Exit
Reservoir
Infectious agent

7.  The number of microorganisms and
duration of exposure (how many and for how
long?)
 Virulence of organisms (ability to cause
disease; pathogenic properties)
 Immune status of the host (body defenses)

8.  Systemic Diseases (diabetes, HIV infection,
etc)
 Drug Therapy (chemotherapy, steroids, etc.)
 Stress
 Prosthesis and Transplants (joint or organ
replacements)
 Poor nutrition

9.  Category 1:
Tasks that involve exposure to blood, body fluid
or tissues.
 Category 2:
Tasks that do not involve routine exposure to
blood, body fluids or tissues.
 Category 3:
Tasks that involve no exposure to blood, body
fluids or tissues.

10.  From the patient to the dental worker
 From the dental worker to the patient
 From one patient to another
 From the dental office to the community

11.  Direct- from an infected person to another
person who is not immune,
 Indirect- from contact with objects that are
contaminated, like surfaces or instruments,
 Droplet-from spray or splatter contact with
mucous membranes, or contact with
aerosols (stay suspended in the air for
longer periods of time)

13.  Immunization
 General Precaution
 Use & Care of sharp instruments
 Sterilisation & Disinfection
 Waste disposal

14.  According to OSHA(Occupational saftey and
health act) immunization against blood borne
disease and hepatitis B vaccination should
be given without cost
 In addition CDC(Centres for disease control
& prevention) recommended that all dental
health care workers should be vaccinated
for HBV, measles, mumps, Influenza,
rubella, tetanus is appropriate for DHCWs.

15.  Hand hygiene: Before and after each patient
contact & after gloves removed

16.  Gloves: When touching contaminated items
(blood, body fluids, secretions, excretions).
 Appropriate use of Rubber dam & high
velocity air evacuation

17.  Mask, eye protection, face shield: whenever
splashes or sprays of body fluids possible
 Gown: Whenever splashes or sprays of body
fluids possible

18.  Sharp items contaminated with patient blood
and saliva are potentially infective in nature
 Used needle should be placed in
approproiate puncher restitant containers

19. 1)Sterilization - Destruction of all
microorganisms including bacterial spores
Should be used for all instruments which
come in contact with blood or saliva
2) Disinfection - Destroys most microorganisms
but not bacterial spores
Used for surfaces and impressions

20.  Critical – Instrument that penetrate soft tissue
and bones. Ex scalpel , bone chisel ,
scalers , burs
 Semi critical – Instruments that don’t penetrate
in soft tissue and bones but contact oral fluids
and tissues. Ex amalgam condensor,mouth
mirrors etc.
 Non- critical – Instruments that contact only with
intact skin. Ex dental chair,x-ray head

21.  Autoclave
 Unsaturated chemical vapor sterilizer
 Dry heat

22.  It destroys all living organisms rapidly at
121c and 15 lbs pressure and for 15 mins
 Advantage – most economical
 Disadvantage – may corrode carbon steel
instruments
 Unsuitable for oils or powders that are
impervious to heat.

23.  Standard type - It kills micro organisms at
160 °c(320° F) temperature for 2 hrs.
 second type – (rapidly heat transfers type)
instruments warm faster as 375° F for 6 mins
for unwrapped instruments and 12 mins for
wrapped instruments.
 Advantage – doesn't corrode instruments
 Disadvantage – uneven & slow penetration.

24.  Complicated mixture of alcohol , water ,
formaldehydes & acetone under pressure
produces gases that is effective anti microbial
agents.
 Sterilization time 20 mins at 127°c to 132° c
with 20 to 40 pound recommended
 Advantage – rust free operation
 Disadvantage – cant use material which altered
with chemicals.
Proper ventilation is needed.

25.  Iodophors are intermediate-level hospital
disinfectants with tuberculocidal action.
Because iodophors contain iodine, they may
corrode or discolor certain metals and may
temporarily cause reddish or yellow stains on
clothing and other surfaces.

26.  Synthetic phenol compounds are
intermediate-level hospital disinfectants with
broad-spectrum disinfecting action. Phenols
can be used on metal, glass, rubber, or
plastic. However, phenols leave a residual
film on treated surfaces. Synthetic phenol
compound is prepared daily.

27.  Its is single use disposable instruments like
needles , saliva ejectors , water syringe ,
high speed air evacuators should be use for
1 patient only and then discarded
appropriately.

28.  Use surface barriers to protect clinical contact
surfaces, particularly those that are difficult to clean
(e.g., switches on dental chairs) and change
surface barriers between patients
 Clean and disinfect clinical contact surfaces that
are not barrier-protected, by using an EPA-
registered hospital disinfectant with a low- (i.e., HIV
and HBV label claims) to intermediate-level (i.e.,
tuberculocidal claim) activity after each patient. Use
an intermediate-level disinfectant if visibly
contaminated with blood.

29.  The primary source of microorganisms in
dental waterlines is the public water supply.
 It is possible that saliva may be retracted
back into the waterlines during treatment.
This process is also called “suck back.”

30.  It is not yet possible to totally eliminate bio-
film, but it can be minimized by:
• Self-contained water reservoirs
• Chemical treatment regimens
• Micro-filtration
• Daily draining and drying of lines

32. • The quantity and weight of instrument should be
minimum.
• The following instrument are required:
• Plane mouth mirror.
• Periodontal probe.
• Several pairs of tweezer
• Wash basin
• Containers(one for used instruments & one for
sterilizing instruments) & concentrated sterilizing
solution.
• Cloth or paper hand towel.
• Gauze.

33.  Sufficient number of instrument should be
available.
 Minimum of 30 mouth mirrors & 30
periodontal probes per examiner should be
provided, as this will permit instruments to be
sterilized while the others are being used.
 Used instruments should be placed in
disinfectant solution, then washed & drained
well before sterilization.

34.  The aim of infection control is to control
iatrogenic, nasocromial infection and blood
borne infection among patient & potential
occupational exposure of health care
workers.

35. Annals of Medical and Health Sciences Research Medknow Publications
Attitudes and Awareness Regarding Hepatitis B and Hepatitis C Amongst
Health-care Workers of a Tertiary Hospital in India
S Setia, RS Gambhir (OCT-DEC 2013)
Aim: The aim of this study was to assess the knowledge and attitude toward
hepatitis B and C infection among the health-care interns and correlate the
level of awareness to the attitude they behold toward the disease.
Subjects and Methods: A closed ended questionnaire consisting of questions to
evaluate the knowledge regarding hepatitis B and C infection and attitude of
the (HCWs/interns) was duly filled by 255 participants including, 100 dental,
100 medical, and 55 nursing interns. Statistical analysis was carried out using
the Chi-square test, ANOVA test, post-hoc test and Pearson's correlation.
Results: Although most of the interns were aware of the existence of hepatitis B
and C infection, the level of awareness regarding the modes of transmission
and vaccination was found to be dissatisfactory.
Conclusion: There is an urgent need to increase the level and quality of training
among HCWs to prevent the spread of hepatitis B virus and hepatitis C virus.

36.  ESSENTIAL OF PUBLIC HEALTH DENTISTRY 5TH EDITION
BY SOBEN PETER
 PREVENTIVE & COMMUNITY DENTISTRY 2ND EDITION
BY JOSEPH JOHN
 PARK’S TEXTBOOK OF PREVENTIVE & SOCIAL
MEDICINE 21TH EDITION
 Guidelines for Infection Control in Dental Health-Care
Settings—2003 CDC. MMWR 2003;52(No. RR-17)
(http://www.cdc.gov/oralhealth/infectioncontrol/guideline
s/index.htm)
 ORAL HEALTH SURVEYS 4TH EDITION BY WHO.

37. “I don't see the glass as half-
empty or half-full.
I see it as a glass somebody else
has already put
their lousy germs on.”
Maxine