We can can minimize the risks of disease transmission to our self and to the patients in the dental office through carefully following the infection control and safety guidelines,
Dr. Hesham Dameer
Infection control in dental clinic and management of sterile and contaminated...Arun Mangalathu
Sterilization , Disinfection and management of Instruments in dental clinic, Lecture delivered by Dr Arun George for indian Dental Association ,Malanadu branch during dental Assistance training programme
Infection control in dental clinic and management of sterile and contaminated...Arun Mangalathu
Sterilization , Disinfection and management of Instruments in dental clinic, Lecture delivered by Dr Arun George for indian Dental Association ,Malanadu branch during dental Assistance training programme
Rationale
Chain of infection
Routes of disease transmission
CDC and OSHA
Spauldings classification
Sterilization protocol
Methods of sterilization-physical and chemical agents
New methods of sterilization
Sterilization of scaler handpeice and inserts
Infection control
Infectious diseases commonly encounterd in dentistry
Medical history and dental safety
Immunization of personnel involved in dental care
Infection control practices
Hand hygiene
Personal protective equipments
Surface barriers
Waste management in dental practice
Cdc guidelines-special considerations
Sterilization and Disinfection in ProsthodonticsJehan Dordi
Brief explanation of sterilization and disinfection methods. In-detail explanation of procedures for sterilization and disinfection of materials and armamentarium used in Prosthodontics.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Major reason for failures in the field of medicine is infections. So its a prime duty to know and follow the protocols to infection control, in the dental field as well.
Cross infection control in dentistry (Few basic points)Sumaiya Hasan
Recently, dentistry has been one of the few reasons of the spread of some major diseases such as hepatitis etc. If proper cross infection control is maintained by taking few precautions then this transfer of diseases can be stopped. This presentation contains only some basic precautions which should be taken to prevent cross infection.
Rationale
Chain of infection
Routes of disease transmission
CDC and OSHA
Spauldings classification
Sterilization protocol
Methods of sterilization-physical and chemical agents
New methods of sterilization
Sterilization of scaler handpeice and inserts
Infection control
Infectious diseases commonly encounterd in dentistry
Medical history and dental safety
Immunization of personnel involved in dental care
Infection control practices
Hand hygiene
Personal protective equipments
Surface barriers
Waste management in dental practice
Cdc guidelines-special considerations
Sterilization and Disinfection in ProsthodonticsJehan Dordi
Brief explanation of sterilization and disinfection methods. In-detail explanation of procedures for sterilization and disinfection of materials and armamentarium used in Prosthodontics.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Major reason for failures in the field of medicine is infections. So its a prime duty to know and follow the protocols to infection control, in the dental field as well.
Cross infection control in dentistry (Few basic points)Sumaiya Hasan
Recently, dentistry has been one of the few reasons of the spread of some major diseases such as hepatitis etc. If proper cross infection control is maintained by taking few precautions then this transfer of diseases can be stopped. This presentation contains only some basic precautions which should be taken to prevent cross infection.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
STERILIZATION AND DISINFECTION IN A DENTAL CLINIC pptVineetha K
One of the basic things you need to know before starting a dental clinic. This presentation covers the basics of sterilization and disinfection in a dental setting.
The way to infection control in dental clinics
Introduction:
The unique nature of dental procedures, instrumentation and patient care settings require specific strategies directed to the prevention of transmission of diseases among dental health care workers and their patients.
Disease: impairment of normal functioning, manifested by signs and symptoms.
Infection: state produced by an infected agent in or on a suitable host, host may be or may not have signs or symptoms.
Carrier: individual harbors the agent but does not have symptoms (person can infect others).
Factors that allow or aid infection:
= The presence of pathogenic micro-organisms.
= There must be a portal of entry via which the organisms invade and colonize the susceptible host.
Medical history
A thorough medical history should be taken and up-dated at subsequent examinations. Medical history screening is essential in alerting the clinician to medical problems that could, in conjunction with dental treatment, adversely affect the patient.
Protective measures
Protection can be achieved by a combination of immunization procedures, use of barrier techniques and strict adherence to routine infection control procedures.
(a) Immunization:
All dental health care workers are advised to be immunized against HBV unless immunity from natural infection or previous immunization had been documented
(b) Protective coverings:
=Uniforms:
Uniforms should be changed regularly and whenever soiled. Gowns or aprons should be worn during procedures that are likely to cause spattering or splashing of blood.
=Hand protection:
Gloves must be worn for procedures involving contact with blood, saliva or mucous membrane. A new pair of gloves should be used for each patient.
If a gloves damaged, it must be replaced immediately. Hands should be washed thoroughly with a proprietary disinfectant liquid soap prior to and immediately after the use of gloves.
Disposable paper towels are recommended for drying of hands.
Any cuts o abrasions on the hands or wrists should be covered with adhesive waterproof dressings at all times.
=Protective glasses, masks or face shields Protective:
Glasses, masks or face shields should be worn by operators and close-support dental surgery assistants to protect the eyes against the spatter and aerosols which may occur during cavity preparation, scaling and the cleaning of instruments.
(c) Sharp instruments and needles:
Sharp instruments and needle should be handled with great care to prevent unintentional injury. Needles should never be recapped by using both hands indirect contact or by any other technique that involves moving the point of a used needle towards any part of the body. The needle can be recapped by laying the cap on the tray, placing the cap in a re-sheathing device or holding the cap with forceps before guiding the needle into the cap.
(d) First aid and inoculation injuries:
Safety precautions in the clinic and laboratory.pptxMustafa Al-Ali
Safety precautions in the clinic and laboratory.
Mustafa al-ali, 48
Safety precautions in the clinic and laboratory
Safety precautions in the dental clinic and laboratory are crucial to protect both patients and dental healthcare professionals. Here are some key safety measures to consider:
Personal Protective Equipment (PPE)
Hand Hygiene
Sterilization and Disinfection
Waste Management
Radiation Safety
Emergency Preparedness
Chemical Safety
Ergonomics
Personal Protective Equipment (PPE)
Personal protective equipment (PPE) should be selected based on risk assessment and tasks to be performed.
These items are designed to provide a protective barrier during dental procedures and through the sterilization process. PPE must also be considered for patients as they enter the facility and provided to administrative staff who may be screening them upon arrival.
Personal Protective Equipment (PPE)
Gown
Dental Hygiene Care Professionals (DHCP) should wear protective clothing (eg, gowns, jackets) to prevent contamination of scrubs and to protect the skin from exposure to blood and bodily fluids.
Sleeves should be long enough to protect the forearms.
Protective clothing should be changed after use or when it becomes visibly soiled by blood or other bodily fluids.
DHCP should remove protective clothing before leaving the work area.
Personal Protective Equipment (PPE)
Eyewear/Face Shields
Protective Eyewear
DHCP should wear protective eyewear with solid side shields or a face shield during procedures likely to generate splashes or sprays of blood or bodily fluids or the spatter of debris. Reusable protective eyewear should be cleaned with soap and water, and when visibly soiled, disinfected between patients.
Personal eyeglasses are not considered PPE.
Protective eyewear should be provided to patients.
Face Shields
Face shields provide full-face coverage.
Must be worn with a face mask.
Personal Protective Equipment (PPE)
Gloves
DHCP should wear gloves to prevent contamination of their hands when touching mucous membranes, blood, saliva, or other potentially infectious materials and to reduce the likelihood that microorganisms on their hands will be transmitted to patients during patient care.
Gloves should be used for one patient only and discarded appropriately after use.
Hand hygiene should be performed prior to donning gloves and immediately after glove removal.
Hand Hygiene
Hand hygiene is extremely important to prevent the spread of the SARS CoV-2 virus. It also interrupts the transmission of other viruses and bacteria, thus reducing the overall burden of disease, Dental healthcare facilities should ensure that hand hygiene supplies are readily available in every patient care location.
Pre-washing considerations
Remove jewelry, ring, watches, or bracelets
Remove artificial nails if present.
Cover skin cuts, abrasions, breaks or cracks with waterproof adhesive dressings.
Use running water; avoid dipping or washing hands in a basin of standing water
Standard precautions are meant to reduce the risk of transmission of blood borne and other pathogens from both recognized and unrecognized sources.
They are the basic level of infection control precautions which are to be used, as a minimum, in the care of all patients.
Standard safety precautions are the basic infection prevention and control measures necessary to reduce the risk of transmission of infectious agent from both unrecognized and unrecognized sources of infection.
The elements of Standard Precautions include:
Hand hygiene.
Use of gloves and other barriers (e.g., mask, eye protection, face shield, gown).
Handling of patient care equipment and linen.
Environmental control.
Prevention of injury from sharps devices, and patient placement.
Respiratory hygiene and cough etiquette
Standard Precautions for Infection Control in Hospitals.pptxanjalatchi
Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
MARUTI SUZUKI- A Successful Joint Venture in India.pptx
Infection control in the dental clinic
1.
2. As a matter of fact, the dentist, dental assistant, dental
hygienist and dental technician are at risk of exposure
to disease agents through contact with blood or other
potentially infectious materials. So by studying and by
carefully following the infection control and safety
guidelines, all the team work can minimize the risks of
disease transmission to himself and to the patients in
the dental office.
All practitioners should incorporate recommended CDC
, ADA and OSHA infection control guidelines into their
daily practice .
3. CHAIN OF INFECTION
• All links must be connected for infection to take
place
Pathogen
Source
(sufficient virulence
& adequate numbers)
Susceptible Host
(i.e., one that is not immune)
Entry Mode
(allows pathogen to
survive & multiply)
(of transmission
(portal that the from source to host)
pathogen can
enter the host)
4. Definitions:
CDC:
Center of Disease Control and Prevention .
ADA:
American Dental Association.
ADAA:
American Dental Assistants Association.
OSHA:
Occupational Safety and Health Administration.
OSAP:
Organization for Safety and Asepsis Procedures.
EPA:
Environmental Protection Agency.
FDA :
Food and Drug Administration.
NIOSH:
National Institute for Occupational Safety and Health.
5. Why , Who and what
Why is infection control necessary in dentistry ?
Dental staff and patients may be exposed to a wide variety of pathogenic
microorganisms .
Who is responsible for infection control in the dental office ?
Each member of the dental team must follow the recommended guidelines .
What should be done to prevent the transmission of disease in the dental
office ?
The most effective ways to prevent the transmission of diseases includes :
1) Hand washing
2) Gloves
3) Face masks
4) Protective eye wear
5) protective clothing
6) instrument sterilization and disinfection
6. Diseases Transmission in Dental Office
Diseases Transmission in Dental Office
The dental office should have an infection control program to prevent the
transmission of disease from the following :
Patient to dental team
Dental team to patient
Patient to patient
Dental office to community ( include dental team’s family )
Community to dental office to patient
To prevent such infections, following is a list of all those procedures and
precautions that together constitute infection control. These guidelines
should be followed each time treatment is performed because we are never
certain of the patient's status, either because they themselves do not know
or because they have chosen not to inform their healthcare providers of their
condition. Following these guidelines for every patient is called "Standard
Precautions".
8. Modes of Diseases Transmission
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
9. A) Infection Control during the Pretreatment
Period
• It is the period of protective equipment :
An essential pretreatment procedure is the preparation
of all personnel involved in patient care. This includes
the utilization of personal protective equipment (gown,
eyewear, mask and gloves) and hand hygiene.
10. Infection Control During the Pretreatment Period
The process of infection control begins during the period of
preparation for clinical treatment. Paying attention to infection
control at this time has several payoffs. In addition to reducing the
risk of transmission of infectious agents during patient care,
thinking ahead will make the treatment session more efficient and
will also make the post treatment infection control process easier
and more effective.
1. Remove unnecessary items from the dental procedure area :
The dental procedure area should be arranged to facilitate a
thorough cleaning following each patient.
2. Preplan the materials needed during treatment.
Set out all instruments, medications, impression materials,
and other items that are needed for a procedure. Thinking
ahead minimizes the need to search for additional items or to
enter cabinets and drawers once gloves have become
contaminated.
11. 3. Utilize disposable items whenever possible :
The use of disposable items saves time during cleanup
and decontamination and solves the problem of proper
reprocessing.
4. Use prearranged tray set-ups for routine or frequently
performed procedures.
Helps to eliminate the need to go into cabinets once you have
started a procedure.
5. Use individualized, sterilized bur blocks for each procedure
. Using individualized bur blocks containing only the burs required
for that procedure helps to eliminate the contamination of other,
unneeded burs and to make clean-up easier.
12.
13. 6. If indicated, have the rubber dam setup on the tray.
When a rubber dam will be used during a clinical procedure, it
also should be included on the tray setup. In addition, include
those items needed for high-velocity evacuation.
14. 7. Identify those items that will become contaminated during
treatment.
While preparing the dental procedure area prior to beginning a
clinical procedure, consider which items will become
contaminated during treatment. Examples of such surfaces include
countertops, light handles, X-ray unit heads, tray tables etc. Decide
whether to use a barrier, e.g., plastic wrap to prevent
contamination of these surfaces and items or to disinfect them
when the procedure is complete.
8. Review patient records before initiating treatment and place
radiographs on the view box.
Do not leave the record on the countertop or handle it after
beginning treatment. Place the record in a drawer or out of the
dental procedure area, so that it doesn’t become contaminated.
Entries into the record should be done before and after the
procedure.
15.
16. 9. Prepare personnel involved in patient care.
An essential pretreatment procedure is the preparation of all
personnel involved in patient care. This includes the utilization of
personal protective equipment (gown, eyewear, mask and gloves)
and hand hygiene.
17. A .Handwashing and hand care :
According to the U.S. Centers for Disease
Control (CDC) , hand washing is the single most
important procedure for preventing the spread of
infection. So , you must wash your hands each time
before you put on gloves and immediately after you
remove gloves . Handwashing is also required if you
touch contaminated instruments or surfaces during
working .
We should always use liquid soap during handwashing
. Bar soap should never be used because it may
transmit contamination .
18. Hands Need to be Cleaned When
• Visibly dirty
• After touching
contaminated objects with
bare hands
• Before and after patient
treatment (before glove
placement and after glove
removal)
19.
20. Personal protective equipment ( PPE )
OSHA requires the employer to provide employees
with appropriate personal protective equipment .
Examples of PPE :
1- Protective clothing
2- Surgical masks
3- Face shields
4- Protective eyewear
5- Disposable patient treatment gloves , and
6- Heavy-duty utility gloves .
21. These PPE must be used whenever
you :
• Performing tasks that could produce
splash or spatter .
• Any contact with body fluids
• Perform other clinical activities that
require handling contaminated items e.g.
radiographs , impressions , dentures or
contaminated equipment and surfaces .
22. We will study 4 aspects of each
one of these equipments :
• The purpose of using .
• Types .
• Guidelines for the use .
• Requirements .
23. 1) Protective clothing :
Purpose : to protect the skin
and underclothing from the
exposure to saliva , blood ,
aerosol , and other
contaminated materials .
Types
1) Laboratory coats
26. Guidelines for the use of protective clothing
1) It should not be worn out of the office for any reason .
2) Change these work clothes at least daily, or more often
if soiled, especially if they become visibly contaminated
with blood.
3) It must not be worn during eating or in resting rooms .
4) It should be washed and laundered separately .
Protective clothing requirements :
1) Should be made of fluid-resistant material ( cotton ,
cotton/polyester, or disposable jackets or gowns .
2) Clothing should have long sleeves and a high neckline
to minimize the amount of uncovered skin .
3) Must cover dental personnel at least to the knees
when seated
27. 2) Protective masks :
Purpose the mask worn over the nose and mouth to
protect the person from inhaling infectious organisms
spread by the aerosol spray of the handpiece or air-water
syringe .
Types the two most common types of masks are the
dome-shaped and flat types .
The dome-shaped Flat types
28. Guidelines for the use of protective masks :
• Masks should be changed for every patient or more
often, particularly if heavy spatter is generated during the
treatment or if the mask becomes damp.
•Masks should be handled by touching only the side edges
to avoid contact with the more heavily contaminated body
of the mask.
•Masks should conform to the shape of the face .
•Masks should not contact the mouth when being worn
because the moisture generated will decrease the mask
filtration efficiency .
Requirements : masks should be at least with 95% filtration
efficiency to remove particles 3 – 5 microns in diameter .
29. 3) Protective eyewear :
Purpose eyewear is worn to protect the eyes against
damage from :
• Aerosolized pathogens .
• Flying sharp debris such as scrap amalgam and tooth
fragments .
• Splattered solutions
• Caustic chemicals
Guidelines for the use of protective eyewear :
1) OSHA requires the use of eyewear with both front and
side protection ( solid side shields ) .
2) Members who wear correction glasses or contact lenses
must wear protective eyewear with a side shields or a face
shield .
30. 3) It must be cleaned and
decontaminated after each
treatment or patient visit
according to the manufacture’s
instructions .
Types :
Two types of protective
eyewear used during patient
care :
1) Glasses with protective side
shield , and
2) Clear face shields .
31. Face shields :
a chin-length plastic face shield
that protects your eyes, nose, and
mouth from spatter may be worn
and replace the protective
eyewear .However , a shield
cannot replace the mask because
it does not protect against
inhalation of contaminated aerosol
Face shield worn in addition to the mask
32.
33. Patient eyewear :
Patients should be provided with protective eyewear
because they may subjected to eye damage from :
1) Handpiece spatter
2) Splashed dental materials
3) Airborne bits of acrylic or tooth fragments
34. 4) Gloves :
Purpose :
Gloves must be worn by the dentist , dental assistant , and
dental hygienist during all dental treatment to avoid
contact with the patient’s blood , saliva , or mucous
membranes or with contaminated items or surfaces .
Types :
The type of gloves used in dental practice should
be determined by the various procedures that are
performed in the practice as follow :
1) Examination gloves usually are latex or vinyl . These are
the gloves most frequently worn by the dental team
during patient care .
35. Examination gloves are
inexpensive , available in a range
of sizes from extra small to extra
large , and are ambidextrous (
used for both right and left hands )
. These gloves are nonsterile and
serve only as a protective barrier
for the wearer .
Examination gloves
36. 2) Overgloves are made of lightweight , inexpensive ,
clear plastic . Overgloves may be worn over contaminated
treatment gloves ( overgloving ) to prevent
contamination of clean objects ( telephone , pen ,opening
drawers and cabinets ) that may be handled during
treatment . Overgloves are discarded after a single use .
To prevent contamination , an Overgloves is
worn while using a pen .
37. 3) Sterile surgical gloves are used during surgical
procedures such as oral surgery or periodontal treatment .
Sterile surgical gloves are supplied in specific sizes and
prepackaged unites to maintain sterility before use .
Sterile surgical gloves
38. 4) Utility gloves are made from a puncture-resistant , heavy
material which are not used for direct patient care . Utility
gloves may be washed , disinfected , or sterilized and
reused and must be discarded when they become old .
39. Guidelines for the use of gloves :
• All gloves used in patient care must be discarded after
a single use.
• Torn or damaged gloves must be replaced immediately .
• Do not wear jewelry under gloves because , it may tear
the gloves .
• If the procedure is long , change the gloves each hour .
• Contaminated gloves should be removed before leaving
the chair side during patient car.
• Hands must be washed after glove removal and dried
well before regloving .
40. 5) Non-latex containing gloves occasionally , the health
care providers or patients may experience serious allergic
reactions to latex . The person who is sensitive to latex can
substitute with gloves made from vinyl , nitrile
and other non-latex containing materials .
Hand dermatitis that developed
from wearing latex gloves.
41. B) Infection Control during the treatment Period
(Chairside Infection Control ) :
The infection control procedures described in
the previous period will help you to reduce
the risk of transmission of infectious agents.
During treatment there are additional
precautions that can be taken to further
reduce infection risks.
1) Use care when receiving, handling, or
passing sharp instruments.
2) Take special precautions with syringes and
needles.
3) Use a rubber dam whenever possible.
42. 4) Avoid touching unprotected switches, handles and other
equipment once gloves have been contaminated.
5) Avoid entering cabinets once gloves have been contaminated.
43.
44. c) Infection Control during the Post-Treatment Period
After patient treatment , dental unite and treatment
room surfaces are likely to become contaminated with
saliva or by aerosol containing blood . Also a primary
source of cross-contamination occurs when a member
of the dental team touches surfaces with contaminated
gloves .
The laboratory studies have proved that microorganisms
may survive on environmental surfaces for long time . For
example, Mycobacterium tuberculosis may survive for
weeks .
45. Dental treatment room surfaces :
Dental treatment room surfaces are classified as either :
• Clinical contact surfaces or
• General housekeeping surfaces .
Clinical contact surfaces are those that are touched
by contaminated hands , instruments or by spatter
during treatment . It should be cleaned and
disinfected between patients .
All the other surfaces , such as the walls and floors
, are considered general housekeeping surfaces
46. Clinical contact surfaces :
The clinical surfaces can be classified into three
categories :
A) Touch surfaces : are directly touched and
contaminated during treatment procedures . Touch
surfaces include ;
Dental light handles
Dental unite controls and
Chair switches
47.
48. B) Transfer surfaces :
are touched by contaminated instruments such as
instruments trays .
C) Splash , spatter , and droplet surfaces :
countertops are a major example .
Touch and transfer surfaces should be either barrier-protected
or cleaned and disinfected between patients . In
the same time , splash , spatter , and droplet surfaces should
be cleaned at least once daily .
49. Dealing with surface contamination
The goal of the two methods to deal with surface
contamination are :
1- To prevent the surface from becoming contaminated
by the use of a surface barrier .
2- To preclean and disinfect the surfaces between
Patients .
Each method has advantages and disadvantages , and most
dental offices use a combination of surface disinfection and
surface barriers .
50. Surface barriers :
Surface barriers are used to
prevent contamination on the
surface underneath .
All the surface barriers should
be resistant to fluids in order
to prevent microorganisms in
saliva , blood , and other
liquids from soaking through
the barrier and reach the
surface underneath .
Chair Drapes
52. Some plastic bags are specially designed to the shapes of
the dental chair , air-water syringe , and light handles .
53. Sticky tape as a plastic barrier is frequently used to
protect smooth surfaces , such as electrical switches on
chairs and x- ray unite
54.
55.
56.
57.
58.
59. Infection Control During the Post-Treatment
Period
1. Continue to wear personal protective equipment during
clean-up: After patient care is completed, begin the
cleaning and disinfection process by removing
contaminated gloves used during treatment, wash your
hands and use the utility gloves before beginning the
clean up. Continue to wear protective eyewear, mask,
and gown.
2. Remove all disposable barriers : All of the barriers
placed before treatment, including light handle covers
and countertop barriers, should be removed.
3. Clean and disinfect all items not protected by barriers.
60. Cleaning and disinfection of the dental treatment room
surfaces are important components in an effective
infection control program .
Precleaning
Precleaning means that all contaminated surfaces must be
precleaned before they can be disinfected . Precleaning
reduces the number of microbes and remove blood , saliva
, and other body fluids .
Precleaning techniques are most effective when
used on contaminated surfaces that are smooth and easily
accessible for cleaning .
61. Materials used for precleaning regular soap and water
always used for precleaning . However , a disinfectants
that can cleans as well as disinfect are present today .
Disinfection
Disinfection is directed to kill disease-causing
microorganisms that remain on the surface after
precleaning .
N.B always do not confuse disinfection with sterilization .
Sterilization is the process in which all forms of life
organisms are destroyed .
The term disinfectant is used for chemicals that are
applied for cleaning surfaces , such as countertops and
dental equipment .
62.
63. Disinfectants
Disinfectants are chemicals that destroy or inactivate most
species of pathogenic ( disease-causing ) micro-organisms .
In dentistry , only those products that registered with the
U.S Environmental protection Agency ( EPA ) with
tuberculocidal action should be used to disinfect dental
treatment areas .
Ideal surface disinfectant
The ideal surface disinfectant must be rabidly kills a broad
spectrum of bacteria , has residual activity , minimal
toxicity , odorless , inexpensive and does not damage
surfaces to be treated .
64. Disinfectant such as :
Iodophors :
• Iodophors are EPA-registered hospital disinfectants with
tuberculocidal action .
• It is recommended for disinfecting surfaces after dental
treatment .
• Iodophors are usually effective within 5 to 10 minutes .
• Non-irritant and non-toxic .
• Unstable solution → must be changed regularly .
• Because they contain iodine , iodophors may corrode or
discolor certain metals and temporarily may cause red or
yellow stains on clothing and other surfaces .
65. Synthetic phenol compounds :
• Are EPA-registered intermediate-level hospital
disinfectants with broad-spectrum activity ( can kill a wide
rang of microbes ) that used for surface disinfection .
• Phenol can be used on metal , glass , rubber , or plastic .
• They also may be used as a holding solution for
instruments , however , phenols leave a residual film on
treated surfaces .
• Synthetic phenol compounds must be prepared daily .
• Non irritant , non-toxic and non-corrosive .
66. Sodium hypochlorite :
Sodium hypochlorite is a fast-acting , economic and broad-spectrum
intermediate-level disinfectant .
Disinfectant effect observed after 10 minutes .
The Centers for Disease Control and prevention ( CDC )
currently recommended the use of up to 1 – 100 dilution
of sodium hypochlorite for surface decontamination .
The disadvantages →
• Unstable solution need daily preparation .
• It has a strong and unpleasant odor .
• Irritant for skin and eyes .
• Corrosive for some metals .
hypochlorite is destructive to fabrics and may eventually
cause plastic chair covers to crack .
67. Alcohol :
Ethyl alcohol and isopropyl alcohol have been used over the
years as skin antiseptics and surface disinfectants . However
, alcohol are not effective in the presence of blood and
saliva droplets because of the rapid rate of evaporation will
limits the antimicrobial activity of alcohol . In addition ,
alcohols are damaging to certain materials , such as plastics
and vinyl .
The American Dental Association ( ADA ) , CDC , and OSAP
do not recommend alcohol as an environmental surface
disinfectant .
68. Chlorine dioxide :
Chlorine dioxide can be used as an effective , rapid-acting
, environmental surface disinfectant ( 3 minutes ) or as a
chemical sterilant ( 6 hours ) .
The disadvantages →
(1) it must be prepared fresh daily .
(2) it is corrosive to aluminum containers
69. Classification of instruments and equipment :
According to the Centers for Disease Control and
Prevention, dental instruments are classified into three
categories depending on the risk of transmitting infection.
1) Critical instruments are those used to penetrate soft
tissue or bone and should be sterilized after each use.
Sterilization is achieved by steam under pressure
(autoclaving), dry heat, or heat/chemical vapor .
Critical instruments include forceps, scalpels, bone chisels,
scalars, and burs .
70.
71. 2) Semicritical instruments
are those that do not penetrate soft tissues or bone but
contact oral tissues, such as amalgam condensers,
air/water syringe , tips mirrors, intraoral radiography
accessories, digital radiography sensors, and other dental
high-technology instruments . These devices should also
be sterilized after each use. In some cases, however, high-level
disinfection is appropriate. A high-level disinfectant is
registered with the U.S. Environmental Protection Agency
(EPA) as a "sterilant/disinfectant" and must be labeled as
such.
72.
73. 3) Noncritical instruments
are those that come into contact only with intact skin
such as external components of X-ray heads. Such
devices have a relatively lowrisk of transmitting
infection and, therefore, may be reprocessed
between patients by intermediate-level or low-level
disinfection.
74. Managing contaminated sharps :
Contaminated needles and other disposable sharps ,
such as scalpel blades , orthodontic wires , and broken
glass must be placed into a sharps container .
OSHA , CDC and the EPA classify sharps as infectious
waste .
According to OSHA regulations , disposable sharps
must be placed in a puncture resistant , closable , and
color-coded or labeled with the biohazard symbol
container immediately after use .
77. Proper processing of contaminated dental instruments in
a six-steps process as :
1) Transport : transport contaminated instruments to the
processing area .
2) Cleaning : clean instruments with a hand-free ,
mechanical process such as an ultrasonic cleaner or
instrument washer.
3) Packing : warp/package instruments in appropriate
materials containing an external process indicator .
4) Sterilization : place the packages in a single layers or in
racks to increase circulation of the sterilizing agent
around the instruments . Operate the sterilizer according to
the manufacture’s instructions . Allow packages to cool
before removing them from the sterilizer .
78. 5) Storage: Store instruments in a clean , dry
environment in a manner that maintains the integrity of
the package . Rotate packages so that those with the
oldest sterilization date will be used first .
6) Delivery : deliver packages to point of use in a manner
that maintains sterility of the instruments until they are
used . Inspect each package for damage .
79.
80.
81.
82.
83.
84. Holding solution :
If the instruments can't be cleaned immediately after
procedures, they should be placed in a holding solution to
prevent drying of blood and debris on the instruments .
A holding solution is a liquid disinfectant/sterilizing
solution used to soak contaminated instruments before
they are cleaned and sterilized. It has the purpose to:
• Decrease infectious microbes on instruments .
• Loosen and minimize debris before scrubbing or
ultrasonic cleaning .
• Minimize the physical handling of the instruments .
85. The holding solution must be:
Non-corrosive liquid,
Of low cost,
Non-staining and
Readily available.
The holding solution should be changed at least twice daily
It is important to use a covered container with a separate
instrument basket to ensure complete immersion.
Remember , a holding solution is necessary only when
contaminated instruments cannot be processed
immediately .
87. Precleaning and packaging instruments
Precleaning is done in three ways:
- Hand scrubbing
- Ultrasonic cleaning
-Instrument washing machine
88. Hand scrubbing
This method is unfavorable because it requires direct
hand contact with the contaminated instrument and
accidental injury from these contaminated items may
happen.
During hand scrubbing we must follow the following
precautions
1- Wear eye wear and puncture-resistant gloves (P.P.E ) .
1- Clean only one by one .
2- Use only a long-handled brush .
3- Do not immerse items in soapy water or deep basin
so you can see the sharp edges.
89.
90. Ultra-sonic cleaning
• Ultrasonic cleaning is recommended in place of hand-scrubbing
in order to reduce direct staff contact with
contaminated instruments.
• The ultrasonic cleaner works by producing sound waves
which causes formation of bubbles in liquid . The bubbles
are too small to be seen .
• The mechanical cleaning action of the bubbles
combined with the chemical action of the ultrasonic
solution removes the debris from the instruments .
• Instruments should be processed in the ultrasonic
cleaner until they are visibly clean . The time may vary
from 5 to 15 minutes .
91.
92.
93. Automated washer
It looks similar to a household
dishwasher. It uses a
combination of very hot
water together with a
detergent to remove the
organic material. It is
considered as disinfector
because it subjects the
instruments to a level of heat
that kills most vegetative
microorganisms.
94.
95.
96. Packaging instruments
Before sterilization the instruments must be packaged to
protect them from becoming contaminated after
sterilization .
They can be contaminated by aerosols in the air , dust ,
or contact with nonsterile surfaces .
An additional advantage to packaging instruments is that
they can be grouped into special setups .
97.
98.
99.
100. Sterilization monitoring
Sterilization monitoring
Because sterilization failure can occur at any time, it is
critical to determine that dental instruments are properly
sterilized or not because microorganisms can not be seen
by naked eye.
Nowadays, three forms for sterilization monitoring are
used :
PHYSICAL CHEMICAL BIOLOGICAL
101. Physical monitoring:
Physical monitoring of the
sterilization process involves
looking at the gauges and
readings on the sterilizer and
recording the temperatures,
pressure, and exposure time.
Remember that the temperature
recorded is for the chamber, not
the inside of the pack. Therefore,
problems with overloading or
improper packaging would not
be detected from the reading on
the gauges.
102. Chemical monitoring:
Chemical monitoring involves the use of heat-sensitive
chemicals that change color when exposed to certain
conditions.
The two types of chemical indicators are process
indicators and process integrators.
Process indicators
This is used externally outside the instruments packages
like autoclave tape and color change marking. Its aim is to
determine if the package is processed or not.
They simply identify instrument packs that have been
exposed to a certain temperature.
103. They do not measure the duration or the pressure. They
are useful only in distinguishing between packages that
were processed and those that were not processed. This
can prevent accidental use of unprocessed instruments.
104. Process integrators
Process integrators are placed inside instrument
packages. They respond to a combination of pressure,
temperature, and time. All sterilization factors are
integrated. Examples of process integrators include
strips, tabs, or tubes of colored liquid.
105. Biologic monitoring
This is the best way to determine if sterilization has
occurred.
Biologic monitoring , or spore testing, is the only way to
determine if sterilization has occurred. The CDC, American
Dental Association recommend at least weekly biologic
monitoring of sterilization equipment .
Biologic indicators (BIs), also known as spore tests, are
vials or strips of paper that contain harmless bacterial
spores (spores are highly resistant to heat).
Method :
Three BIs are used in testing. Two BIs are placed inside
instrument packs, and the sterilizer is operated under
normal conditions.
106. The third strip is set aside as a control. After the load has
been sterilized, all BIs are cultured. If the spores survive
the sterilization cycle (a positive culture), a sterilization
failure has occurred. If the spores are killed (a negative
culture), the sterilization cycle was successful.
107. Sterilization in the dental office :
The three most common forms of heat sterilization in the
dental office are :
Steam sterilization,
Chemical vapor sterilization, and
Dry heat sterilization.
108. 1) Steam sterilization : involves heating water to
generate steam, producing a moist heat that
rapidly kills microorganisms. As the steam
completely fills the sterilizing chamber, the
cooler air is pushed out of an escape valve,
which then closes and allows the pressure to
increase which increase the temperature
reaches up to 120 C which is higher than boiling
water . It is the heat, not the pressure that
actually kills the microorganisms.
109. A disadvantage of steam sterilization is that the moisture
may cause corrosion on some high-carbon steel
instruments. Distilled water should be used in autoclaves
instead of tap water, which often contains minerals and
impurities. Distilled water can minimize corrosion and
pitting.
0peration cycles :
Dental office steam sterilizers usually operate through four
cycles :
1) heat-up cycle 2) sterilizing cycle
3) depressurization cycle 4) drying cycle
110. Flash Sterilization
involves sterilizing unpackaged instruments using short
exposure times. The instruments are placed in the
chamber unwrapped. The sterility of the instruments is
defeated immediately when the instruments are
removed from the sterilizer.
Flash sterilization should be used only for instruments
that are to be used promptly on removal from the
sterilizer.
111. Dry-heat Sterilizers
Dry-heat sterilizers operate by heating air and transferring
that heat from the air to the instruments. This form of
sterilization requires higher temperatures than steam or
chemical vapor sterilization . temperature ranges between
(160 C to 190 C) .
The total cycle time :
placing instruments in oven, heating to 170 C, timing for 1
hour, and then cooling it from 2–2.5 hours .
The advantage of dry heat is that the instruments will not
rust if they are thoroughly dry before they are placed in
the sterilizer.
The disadvantage of dry heat is the risk of damaging
plastic and rubber instruments and also it need long time .
112. Chemical liquid sterilization
Used for some types of plastics items that can damaged
by heat such as some rubber dam frames , shade guides ,
and x-ray film-holding devices .
A liquid sterilizer such as 2% to 3.4% Glutaraldehyde
must be used for sterilizing these items .
Sterilizing in Glutaraldehyde requires a 10 hours contact
time, but if it is less than 10 hours, it is only disinfection,
not sterilization .
Glutaraldehyde must be used full strength ( not diluted (
This material is highly toxic .
113. STERILIZATION FAILURE
Several factors can cause the sterilization process to fail .
Examples of common mistakes include :
• overloading of sterilizer chamber .
• lack of separation between packs or trays in the
chamber .
• wrong packaging material for method of sterilization .
• more than two layers of wrap, inhibiting penetration .
• sterilizer timer malfunction .
• improper cleaning of items to be sterilized.
114.
115. Sterilization of hand pieces is recommended
whenever possible :
Hand pieces that are designed for steam sterilization
between uses are preferred. When a hand piece cannot
be heat or steam sterilized, chemical disinfection can be
used as an alternative.