The document discusses various methods for preventing the spread of infections in a dental setting. It emphasizes that standard precautions should always be followed, such as proper hand hygiene and protective equipment. It also provides guidance on preventing specific infections like Japanese encephalitis, tuberculosis, HIV, SARS, and H1N1, including recommendations around screening patients, use of masks and barriers, sterilization of instruments, and deferring treatment of infectious individuals.

2. 
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INTRODUCTION
GENERAL POLICY STATEMENT
PREVENTION OF JAPANESE ENCEPHALITIS
PREVENTION OF TUBERCULOSIS
PREVENTION OF HIV
PREVENTION OF SARS
PREVENTION OF H1N1

3. Infection
 The
invasion, adhesion, and multiplication of a
microorganism in the host.
 Infection
of a host can occur exogenously (from
outside) or endogenously (from inside)

4. Cross Infection

the transmission of infectious agents between
patients and staff within a clinical environment
either directly or indirectly via instruments,
appliances and surfaces

5. Operator
patient
TECHNICIAN
Next patient

6. 
There is always the potential for contamination and
transmission in dentistry.

Saliva is a potentially infectious fluid and has
transmitted Hepatitis B, Herpes and many other infections.

The most serious infections in dentistry are transmitted by
blood to blood contact through accidental sharps injuries.

7. 
Dentistry always has the potential to transmit
infection and hence
Standard Precautions
must always be observed.

8. 1.
Direct contact eg. blood or body fluids
2.
Indirect contact eg. with a contaminated instrument or
surface
3.
Contact of mucosa of the eyes, nose, or mouth with
droplets or spatter
4.
Inhalation of airborne microorganisms

9. Chain of Infection
Pathogen
Susceptible
host
Entry
Source
Mode

10. General policy statement

11. 
Infection control is the concept of standard precautions to
reduce the risk of bloodborne pathogen transmission

The primary principle - medical history and examination
cannot reliably identify all patients infected with bloodborne pathogens.
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All patients, therefore, must be regarded as potentially
infectious.

12. 
Based on the concept that all blood and body fluids,
secretions and excretions should be treated as infectious
when it comes into contact with non intact skin/mucous
membranes: universal precautions concept expanded by
CDC, USA:1996
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Apply to all patients

13. 
Hand Hygiene and Skin Care

Protective Clothing

Safe Handling of Sharps
(including Sharps Injury Management)

Spillage Management.

All blood and body fluids are potentially
infectious and precautions are necessary to
prevent exposure to them.
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Everyone involved in providing care in dental
practice should know and apply the standard
principles of hand decontamination

14. Transmission

JE virus is transmitted by the bite of an infected mosquito,
mainly Culex tritaeniorhynchus and C. vishnui complex,
night-time biters that breed in stagnant water such as rice
paddy fields.(1;3)

Humans can also become infected coincidentally through
proximity to JE virus-infected animals and birds.

15. 
JE virus, rarely, may also be transmitted person-toperson through blood transfusion, organ
,transplantation, intrauterine transmission and possibly
breast milk.
(Alberta Health and Wellness Public Health Disease
Under Surveillance Management Guidelines
Japanese Encephalitis,March 2011 )

17. 
Single Case/Household Cluster
Determine history of recent living in, immigration from or travel to
Asia and northern Australia including:

geographic location,

season,

duration of exposure, and
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occupational and recreational activities (while travelling).

Determine history of mosquito bites.
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Determine immunization history (i.e., recent receipt of JE vaccine).

18. 
Temperature:
Destroyed by heating for 30 minutes above 56
℃;Termal Inactivation Point(TIP) is 40℃.

pH:
Inactivated in acid environment of pH 1-3(stable in
alkaline environment ofpH7-9)

19. 
Chemicals/Disinfectants:
Inactivated by organic and lipid solvents,common
detergents,iodine,phenol iodophor
70%thanol,glutaraldehyde 3-8%,formaldegyde 1%,sodium
hypochlorite.

Survival:
Sensitive to uv light ad gamma radiation.

20. PREVENTION AND CONTROL
Sanitary prophylaxis

Housing animals in-doors in screened stabling can provide protection
from mosquitoes
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Especially during active JE outbreaks and during peak vector activity
(usually dawn to dusk)
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Insecticides, repellents and fans also provide protection
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Vector control reduces transmission
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Immunisation of swine as they are JE virus amplifier
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If practical, swine should not be raised near horses

21. Medical prophylaxis

Vaccine is available for both horses and swine; also for
humans
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Two types of vaccine:
modified live (produced in hamster or swine kidney tissue
culture or hamster lung (HmLu) cell line) or

inactivated (prepared in mouse brain, chick embryo
or cell lines, e.g. Vero cells)
(Chapter 2.1.7 Japanese encephalitis in the latest
edition of the OIE Manual of Diagnostic Tests and
Vaccines for Terrestrial Animals)

22. There are two forms of Tuberculosis..
TB Infection
 TB Disease (also called Active TB)
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It’s important to recognize the difference!

23. TB Infection
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People with a positive TB skin test have been
exposed to the TB germ.
They…
◦
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Have a TB Infection
Do not look or feel sick
Cannot infect others
May or may not develop TB Disease (Active TB)
May take medication to prevent TB Disease from
developing

24. 
May have these symptoms…
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A cough for more than two weeks
Coughing up blood
Night sweats
Fever
Loss of appetite
Weight loss

25. Most important to remember:
A person with
TB Disease (Active TB)
can infect others!

26. 
Ask history of TB disease and symptoms suggestive
of TB
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Promptly referred to a physician
 Positive history and symptoms of active TB
 Evaluation for possible infectiousness

Elective dental treatment should be postponed
 until a physician confirms, using recognized diagnostic
evaluations, that the patient does not have active
tuberculosis.

27. 
In urgent dental care TB isolation practices
 Treatment limited to relieve the patient's immediate pain.

DHCWs with persistent cough and other symptoms
suggestive of active TB
 evaluated promptly for TB
 should not return to work until a diagnosis of TB has been
excluded or on therapy and determination has been made
that the worker is not infectious.

28. 
Blood, saliva, and gingival fluid from all dental
patients should be considered infective.

All dental workers should wear surgical masks
and protective eyewear or chin-length plastic face
shields during dental procedures

Minimize generation of droplets and spatter
Rubber dams, high-speed evacuation and proper patient
positioning

29. 
Handpieces, ultrasonic scalers should be
sterilized after use with each patient.

30. 
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Blood and saliva should be thoroughly and carefully
cleaned from material that has been used in the
mouth
Contaminated materials, impressions, and intra-oral
devices
should be cleaned and disinfected

Dental equipment and surfaces that are difficult to
disinfect (e.g., light handles or X-ray-unit heads)
should be wrapped with impervious-backed paper,
aluminum foil, or clear plastic wrap

31. 1. Transmission of H1N1 influenza:
 droplet exposure of mucosal surfaces
 indirect contact –by hands and respiratory
secretions from infectious patient/contaminated
surface
 inhalation of small particle aerosols

32. 1)
Elimination of potential exposures
 e.g. deferral of ill patients
2)
Engineering controls
 reduce or eliminate exposure at the source without placing
primary responsibility of implementation on individual
employees.
3)
Administrative controls
 sick-leave policies and vaccination
4)
Personal protective equipment (PPE)
 exposures that cannot otherwise be eliminated or controlled.

33. 
Should avoid treatment of individuals who have
symptoms consistent with SARS
when these symptoms have started within 10 days of
departing from a SARS affected area.

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Dentists should ensure that the symptomatic
individuals consult their GP for medical assessment.
Dentists should avoid treating probable or confirmed
cases of SARS and contacts of SARS cases while
They are symptomatic
During the period following symptoms when the case is
advised to limit their contact with others

34. 
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ADA Guidelines for infection control 2nd Edition, 2012
Infection Control, Standard Precautions & Tuberculosis.
Washington County Health Sysytem (Effective Date: May 1,
2006)