The document discusses sterilization methods in operative dentistry, emphasizing their importance in preventing microbial contamination and infection control. It covers historical backgrounds of sterilization techniques, various methods including physical, chemical, and radiation sterilization, as well as specifics on maintenance for dental tools. Key points also include OSHA regulations, levels of disinfection, and the comparative advantages and disadvantages of different sterilization techniques.

1. STERILIZATION IN OPERATIVE
DENTISTRY
PRESENTED BY :
DR.ANJALI GUPTA

2. • Introduction
• Historic background
• Terminologies
• Methods of sterilization
• Physical sterilization
• Chemical Disinfectants
• Maintaining and sterilizing hand piece
• Maintaining and sterilizing burs
• Maintaining and sterilizing endodontic files
• Maintaining and sterilizing Gutta percha cones
• Maintaining and sterilizing curing light
CONTENTS

3. • Sterilization failure
• OSHA rule on blood borne pathogen
• Conclusion
• References

4. INTRODUCTION
• Microorganism cause contamination and infection, it becomes
necessary to remove or destroy them from the materials or
from areas so, The purpose of sterilization is to prevent
contamination by the organisms, in surgery to maintain asepsis,
• Several factors changed the perception of infection control in
the dental profession. The first factor was that blood and saliva
could be vectors for viral infection. The second most potent
force for change was the AIDS pandemic.

5. • It is impossible to exclude all microbes from the clinic
environment, but they may be controlled.
• The dentist is exposed and may also expose the patients to
numerous pathogenic microorganisms to reduces the chances
of infection between patient-dentist, dentist-patient and
between patient to patient. Hence, sterilization plays a
significant role in the field of health care.

6. HISTORICAL BACKGROUND
• Louis Pasteur is a French was the first to use sterilization technique. He developed
hot air oven and autoclave. Pasteurization was also developed by him to rid bacilli
from the milk.
• Joseph lister he introduced the antiseptic technique. He is also known as father of
antiseptic surgery. He use phenol as a antiseptic solution over the wound.
• Spallanzani – he does boiling of microbes in a sealed flask.
• For most of the 20th
century, general dentistry was routinely practiced without
barriers to protect eyes, nose , mouth, and hands. Not until 1991 were dental
personnel required to wear gloves, masks, gowns, and protective eyewear while
treating patients.
• Dentistry had a dual approach to infection control. Dental procedures at this time
were divided into surgical and non-surgical procedures

7. • The federal OSHA, whose Final Rule(or The Standard) on
occupational exposure to blood borne pathogens was
published in December 1991.
• The modern infection control, prevention and sterilization
guidelines were stated by the CDC (Centre for Disease
Control) in 1973 and specific dental infection control
guidelines by the ADA and OSHA and EPA in 1978 revised in
1985 and 1988

8. Terminologies
• INFECTION - The growth of micro-organisms by any
means.
(By Seymour . S Block )
• STATIC- that refers to the property of inhibiting
microbial growth(reproduction) but not killing
microorganisms.
CIDAL-that means to kill

9. • SEPSIS – refers to presence of infection, infectious agent or
infectious material.
• ASEPSIS-freedom from infection.

10. • STERLIZATION: It is the process of destruction or removal
of all forms of microorganism weather in vegetative as well as
in spore form. Sterilization provides a method of instrument
recycling.
• DISINFECTION : According to FDI disinfection is the
process of removal of pathogenic and other forms of
microorganisms by thermal or chemical means. It is less lethal
process than sterilization as it destroys the most recognized
pathogenic microorganisms but not necessarily all the forms
such as the bacterial spores.

11. • DISINFECTANT– refers to an agent that kills most
pathogens but not necessarily spores on inanimate objects
. The efficacy can be classified in three levels
high ,intermediate and low
• ANTISEPTIC- refers to a chemical agent that is used on
or in living tissue to kill or prevent growth of
microorganisms

12. Operatory Asepsis

13. STERILISATION

14. PHYSICAL AGENT OF
STERILISATION

15. SUNLIGHT
• It possesses bactericidal activity and plays important role in
spontaneous sterilization.
• Direct sunlight has an active germicidal effect due to combined effect
of UV and heat rays.
• Semple and grieg shows that in India typhoid bacilli exposed to sun
were killed in two hours whereas controls kept in dark were alive for
6days.

16. HEAT
• Heat is the most reliable method of sterilization and should be the
method of choice unless contraindicated.
• The factors influencing sterilization by heat are:
• 1. nature of heat-dry heat or moist heat
• 2. temperature and time,
• 3. number of microorganisms present,
• 4. characteristics of the organisms, such as, species, strain, sporing
capacity
• 5. type of material from which the organisms have to be eradicated.

17. MOIST HEAT
• Temperatures below 100 °C
For pasteurization of milk: The milk is heated at either 63 °C for 30
minutes or 72 °C for 15-20 seconds followed by cooling quickly to 13
°C or lower. By these processes all nonsporing pathogens are destroyed.
Temperature at 100 °C
Boiling: Vegetative bacteria are killed almost immediately at 90-100 "C,
but sporing bacteria require prolonged periods of boiling. Boiling is not
recommended for sterilizing of instruments used for surgical procedures
and should be regarded only as a means of disinfection.
Steam at atmospheric pressure (100*C): An atmosphere of free steam is
used to sterilize culture media which may decompose if subjected to higher
temperatures.

18. STEAM PRESSURE STERILIZATION
• It is a method of sterilization temperature above 100
°C
• Steam sterilization involves heating water to generate
steam in a closed chamber producing moist heat that
rapidly kills microorganisms

19. Parameters
• Standard conditions are 1210
C at 15 psi of pressure for at
least 15 mins.
Or
• 1340
C for 7 mins at 30 psi for unwrapped instruments ,add
5mins for moderately packed.
• Instruments should be packaged in muslin
cloth,paper ,nylon,aluminium foil,steam permeable plastic.

20. Mechanism of action
The principle of the autoclave or steam sterilizer is that water
boils when its vapour pressure equals that of the surrounding
atmosphere. Hence when pressure inside a closed vessel
increases, the temperature at which water boils also increases.
Saturated steam has penetrative power. When steam comes into
contact with a cooler surface it condenses to water and gives up
its latent heat to that surface . The large reduction in volume
sucks in more steam to the area and the process continues till the
temperature of that surface is raised to that of the steam, The
condensed water ensures moist conditions for killing the
microbes present.

22. TYPES OF AUTOCLAVE
1.Gravity displacement autoclaves/ Small portable bench model
type autoclaves.
 They cause downward displacement of air as steam enters the top
of the chamber.
 There efficacy is low.
2.Pre vacuum autoclave/ Porous load autoclave.
 They are also known as rapid cycle autoclave.
 In this air is evacuated by vacuum suction before steam enters the
chamber.
 The sterilizing condition 121 degree Celsius at 20 psi for 20min.
 It is used for sterilizing suture materials,towels,cotton rolls and
rubber gloves.

23. Advantages –
• Most efficient and reliable method
• Simple to operate
• Relatively inexpensive
• Loading & Packaging is flexible.
Disadvantages
• Non stainless-steel instruments may rust .
• Low melting plastics and rubber cups cannot be sterilized.
• Items that retain moisture take time to dry and prolong
cycle.

24. STERELISATION CONTROL
For determining the efficacy of moist heat
sterilization, spores of Bacillus stearothermophilus
are used as the test organism This is a thermophilic
organism with an optimum growth temperature of
55-60 "C and its spores require an exposure of 12
minutes at 121 °C to be killed. . Chemical indicators,
autoclave tapes and thermocouples may also be used
instead.

25. DRY HEAT
• Flaming:
Inoculating loop or wire, the tip of forceps and searing spatulas are held in a
bunsen flame till they become red hot. Inoculation loops carrying infective
material may be dipped in a disinfectant before flaring to prevent spattering.
Incineration:
By this method, infective material is reduced to ashes by burning.This is an
excellent method for safely destroying materials such as contaminated cloth,
animal carcasses, and pathological materials. Plastics such as PVC and
polythene can be dealt with similarly but polystyrene materials emit clouds of
dense black smoke and hence should be autoclaved in appropriate containers.

26. Hot Air Oven
• This is the most widely used method of sterilization by dry heat.
• A holding period of 160 °C for one hour.
• It is used to sterilize forceps, scissors, scalpels, all-glass syringes,
swabs, some pharmaceutical products such as liquid paraffin, dusting
powder, fats and grease.
• The oven is usually heated by electricity, with heating elements in
the wall of the chamber.
• It must be fitted with a fan to ensure even distribution of air and
elimination of air pockets . It should not be overloaded.
• The material should be arranged so as to allow free circulation of:
air in between the objects.

27. • Packs of instruments must be kept at least 1cm apart to allow air
to circulate by gravity flow.
• Glassware should be perfectly dry before being placed in the
oven. Test tubes and flasks should be wrapped in paper.
• Rubber materials, except silicon rubber, will not withstand the
temperature.
• The oven must be allowed to cool slowly for about two hours
before the door is opened, since the glassware may crack due to
sudden or uneven cooling.

28. • ADVANTAGES OF DRY HEAT STERILIZATION:
- Carbon steel burs do not rust, corrode, or loose their temper or
cutting edges if dried well before processing .
- Large capacity at reasonable price
- Rapid cycles of sterilization are possible at high temperature.
• DISADVANTAGES OF DRY HEAT STERILIZATION:
- Heat sensitive instruments such as rubber cup, plastic goods can
not be sterilized.
- Heavy loads of instruments, crowding of packs, and heavy
wrapping easily defeat sterilization.
- Greater chances of error (lack of proper time setting inaccurate
calibration)

29. Comparison of dry heat v/s moist heat sterilization
technique
Dry heat Moist heat
Principle anti microbial
effect
Oxidizes cell proteins Denaturation of cell
proteins
Time needed for
sterilization
Long Short
Equipment and cost Low High
Tendency to dull or rust
instruments
Low High

30. RADIATION
Two types of radiation are used for sterilization
Nonionizing radiation: Infrared and ultraviolet rays are non ionizing
radiation. Infrared radiation is used for rapid mass sterilization of
prepacked items such as syringes and catheters. Ultraviolet radiation is
used for disinfecting enclosed areas such as operation theatres and
laboratories.
Ionizing radiation: They have very high penetrative power. Since there
is no appreciable increase in temperature in this method, it is referred to
as cold sterilization. Commercial plants use gamma radiation for
sterilizing items like plastics, syringes, swabs, catheters, animal feeds,
cardboard, oils, greases, fabrics and metal foils.

31. FILTERATION
• The following types of filters have been used
• Candle filters: These are manufactured in different grades of porosity and have
been used widely for purification of water for industrial and drinking purposes.
• . Asbestos filters are disposable, single-use discs. They have high adsorbing
capacity and tend to alkalinize filtered liquids. The carcinogenic potential
constituents.
• Sintered glass filters are prepared by heat- fusing finely powdered glass
particles of graded sizes. They have low absorptive property and can be cleaned
easily but are brittle and expensive.
• Membrane filters They are routinely used in water purification and analysis,
sterilization and sterility testing, and for the preparation of solutions for
parenteral use.

32. Chemical Vapor Pressure Sterilization
[Chemiclave]
Sterilization by chemical vapor under pressure is performed in a
chemiclave. Chemical vapour pressure sterilizers operate at 2700 F
(1310c) and 20 pounds of pressure. They are similar to steam sterilizers
and have a cycle time of approximately half an hour.
Instruments which are sterilized by using chemiclave are :
• Periodontal, restorative and endodontic instruments
• Carbon steel and other corrosion sensitive burs and pliers

33. • Advantages : Carbon steel and other corrosion – sensitive burs,
instruments and pliers are said to be sterilized without rust or
corrosion.
• Disadvantage:
-Heat sensitive instruments cannot be sterilized.
-Towels and heavy cloth wrapping may not be penetrated to
provide sterilization.
-frequent monitoring is needed.

34. Ethylene Oxide sterilization
• Ethylene oxide sterilization is the best method for sterilizing
complex, heat sensitive instruments and delicate materials.
• Ethylene oxide is a gas at a temperature above 10.80
c. It is highly
explosive and inflammable.
• It is highly penetrative, non-corrosive agent with a bactericidal
action.
• It is used for the sterilization of towels, metal and plastic
instruments.
• But the disadvantage it is highly explosive and inflammable.

35. GLASS BEAD STERLIZER
• The glass bead sterilizer uses a metal cup with glass
beads of 1 mm diameter in it .
• It uses table salt, which consists approximately of 1 %
sodium silico aluminate/sodium carbonate/ magnesium
carbonate.
• The instruments can be sterilized in 5 to 15 seconds
at a temperature of 437-465 F (218-246° C).
• Root canal instruments such as broaches, files and
reamers may be sterilized in 5seconds and absorbent
points and cotton pellets in 10seconds.

36. HOT SALT STERELISZER
Glass beads may be effectively substituted for the salt in a hot-
salt sterilizer because larger beads are not so effective in
transferring heat to endodontic instruments because of the
larger air spaces between the beads that reduce the efficiency
of the sterilizer.
The advantage of the hot-salt sterilizer lies in the use of
ordinary table salt, which is readily available for replacement,
instead of beads and eliminates the risk of clogging the canal.

37. CHEMICAL AGENTS OF
STERELISATION

38. Chemical Disinfectants
IDEAL REQUIREMENTS
1. Broad spectrum
2. Fast acting
3. Non toxic
4. Surface compatibility
(Should not corrode instruments and other metallic
surfaces)

39. 5. Easy to use
6. Odorless
7. Economical
8. Be stable
9. High penetrating power
10. Should not cause local irritation and sensitivity
11. High solubility
(Should be soluble in water and have a
substantial shelf life)

40. LEVELS OF DISINFECTION
High-level disinfectant Used for shorter duration and
able to kill 106 log microorganisms except spores, e.g.,
glutaraldehyde (≥2.0%), hydrogen peroxide (7.5%), and
hypochlorite (650–675 ppm).
Intermediate level disinfectant Mainly used for
noncritical items contaminated with blood/body fluids.
e.g., alcohols, chlorine-based agents etc.

41. 3. Low level disinfectants Used to remove the
vegetative form of bacteria, few fungi, and some
enveloped viruses from the noncritical items, e.g., 3%
hydrogen peroxide, quaternary ammonium
compound, diluted glutaraldehyde, and phenols.

42. SUBSTANCES MOST COMMONLY USED
ALCOHOLS
ALDEHYDES
HALOGENS
PHENOLS
GASES

43. ALCOHOL
• Ethyl alcohol (ethanol) and isopropyl alcohol are the most frequently
used.
• They are used mainly as skin antiseptics and act by denaturing bacterial
proteins. They have no action on spores.
• To be effective, they must be used at a concentration of 60-90 per cent
in water.
• . Isopropyl alcohol is preferred as it is a more bactericidal and less
volatile. It is used for the disinfection of clinical thermometers.
• Methyl alcohol is effective against fungal spores and is used for treating
cabinets and incubators affected by them
• Methyl alcohol vapour is toxic and inflammable.

44. ALDEHYDE
FORMALDEHYDE
• It is active against the amino group in the protein molecule. In
aqueous solutions, it is markedly bactericidal and sporicidal and also
has lethal effect on viruses. It is used to preserve anatomical
specimens.
• 10 % formalin containing 0.5% sodium tetraborate is used to
sterilize clean metal instruments.
• Formaldehyde gas is used for sterilizing instruments and heat
sensitive catheters and for fumigating wards, sick rooms and
laboratories.
• The gas is irritant and toxic when inhaled.

45. FUMIGATION
• Formaldehyde is used for fumigation.
• Fumigation methods There are 2 methods of fumigation. They are :
Potassium Permanganate Method
450gm of Potassium permanganate is added to 500 ml of
formaldehyde .Take about 5 to 8 bowls with equally divided parts of
formaldehyde. This will cause auto boiling and generate fumes. After the
initiation of formaldehyde vapour, immediately leave the room and seal
it for at least 48 hours. After the fumigation process, neutralize the
formaldehyde vapour with ammonia solution.

46. Electric Boiler Fumigation Method
500ml of formaldehyde is added to 1000ml of water in an electric
boiler. Switch on the boiler, leave the room and seal the door. After 45
minutes, switch off the boiler without entering in to the room (Switch
off the main from outside).

47. Glutaraldehyde
• This has an action similar to formaldehyde. It is especially
effective against tubercle bacilli, fungi and viruses.
• It is less toxic and irritant to the eyes and skin than
formaldehyde. It has no deleterious effect on the cement or
lenses of instruments such as cystoscopes and
bronchoscopes.
• It can be safely used to treat corrugated rubber anesthetic
tubes and face masks, plastic endotracheal tubes, metal
instruments .
• Glutaraldehyde will disinfect in 10 mins and will sterilize
after 6- 10 hrs immersion at room temperature.

48. HALOGEN
• These are bactericidal and are effective against sporing
bacteria and viruses.
• Chlorine and iodine are two commonly used disinfectants.
CHLORINE
Chlorine and its compounds have been used as disinfectant
used in Water supplies, swimming pools, food and dairy
industries use chlorine for disinfection. Chlorine is used
commonly as hypochlorites. Chlorine and hypochlorites are
markedly bactericidal. They have a wide spectrum of action
against viruses.

49. IODINE
lodine in aqueous and alcoholic solution has been used
widely as a skin disinfectant. It is actively bactericidal.
Compounds of iodine with nonionic wetting or surface
active agents known as iodophors are claimed to be more
active than the aqueous or alcoholic solutions of iodine.

50. PHENOLS
• Phenol (1 %) has bactericidal action.
• The lethal effect of phenols is due to cell membrane damage, thus
releasing cell contents and causing lysis.
• The derivatives of phenol include – cresol, chlorhexidine,
chloroxylenol and hexachlorophene. They are used as antiseptics.
Cresols- It is most commonly used for sterilization of infected
glassware, cleaning floors.
Chlorhexidine- is widely used in wounds, pre-operative disinfection of
skin, as bladder irrigant etc. It is bactericidal at a high dilution. They are
more active against Gram positive than Gram negative bacteria.

51. Chloroxylenol-It is an active ingredient of dettol. It is less toxic and
less irritant. It is readily inactivated by presence of organic matter.
Hexachlorophene- It is bacteriostatic at very high dilutions. It is
potentially toxic and should be used with care.

52. METHOD ACTIVITY CONDITI
ONS
LIMITAT
IONS
ADVANT
AGES
SPORE
TESTING
Steam autoclave Protein-
denaturation
20 mins at
121C,3-7
mins at 132
C
Rust and
corrosion
Time
efficient,go
od
penetration
.
Bacillus
Stearophilu
s strips
Unsaturated chemical
vapor
Protein
denaturation
and alkylation
20
mins ,132C
damage
some
plastic,
rubber
items
Time
efficient,no
rusting
Bacillus
Stearophilu
s strips
Dry Heat Oxidation 60-120
mins,160 C
damage
some
plastic,
rubber
items
No
rusting,larg
e
capacity ,lo
w cost
Bacillus
Subtills
strips
Comparison of sterilization methods

53. Ethylene oxide Alkylation 3hrs,49
C
Slow may
require up
to 24 hrs
aeration
toxic and
carcinogenic
No damage
to heat
sensitive
instruments
Bacillus
Subtilus
strips
Gluteraldehyde Alkylation 12 hrs
ambient
,6-10
hrs,20 C
Requires
rinsing,no
proof of
sterilization
No damage
to heat
sensitive
instruments,
low cost
Not possible

54. MAINTAINING AND STERELIZING
HAND PIECE
• All dental hand pieces must be cleaned and lubricated in accordance
with the manufacturer’s instructions and must be sterilized after each
patient.
• According to most of the studies, moist heat and ethylene oxide gas
have shown the best results.
• However, ethylene oxide gas is preferred over moist heat as it does
not cause corrosion

55. The following steps have been recommended for sterilizing hand piece
: 1. Clean the outside of the handpiece with detergent and water–never clean
or immerse the handpiece in disinfectant solutions or the ultrasonic cleaner.
2. Lubricate the handpiece with pressurized oil for the recommended period.
3. Clean off excess oil.
4. Sterilize in a steam sterilizer or by using other suitable sterilization method.
5. Run the handpiece briefly before use to clear excess lubricant that might be
there.

56. MAINTAINING AND STERELIZING
BURS
• It is important to note that presoaking of burs in soapy water/disinfectant is
crucial to loosen the debris that is adhering on the burs.
• Sterilization methods on the cutting efficacy and durability of burs dry heat,
‑
autoclave, microwave irradiation, and glutaraldehyde.
• It was evident that dry heat sterilization had the least deteriorating effect on
the burs. Autoclaving and chemical sterilization had corrosive effects on the bur.
• Burs protected from deteriorating during autoclaving is to submerge
them in 2% sodium nitrite solution.
The following are some of the commonly used burs in endodontics:
STAINLESS STEEL BUR
They become easily blunt and corrode after multiple uses and hence must be
discarded into the sharps waste sooner. They are also more difficult to clean as
compared to other types of burs. Hence, it is recommended to use lower cost
stainless steel burs as single use items.
‑

57. Diamond burs
They are designed for reprocessing. However, the diamond does degrade
with multiple sterilization cycles. Some brands employ chrome cobalt
alloy as a matrix for the diamond particles, which is long lasting.
Surgical burs
Are commonly used for dentoalveolar surgery and are designed for
reprocessing. They are made of materials such as tungsten carbide that
minimally degrades under steam sterilization.

58. MAINTAINING AND STERELIZING
ENDODONTIC FILES
Hand operated endodontic files
Most hand files are typically labeled as single use items. Sterilizing them is
‑
both ineffective and unsafe as it can result into sharps injury.
various studies compared different sterilization and disinfection protocols to
sterilize hand files. Through these, it can be concluded that appropriate
disinfection followed by autoclaving continues to be the most efficacious
method compared to the rest of the methods.
From studies, it is also evident that although glass bead/ salt sterilizers have
been intended for this purpose and require less time, they do not effectively
sterilize files as they are based on dry heat sterilization which has poor
penetration potential. Furthermore, the handle portion files continues to be
unsterilized.

59. Rotary NiTi files
When using rotary files, it is not economical to discard the files after a
single use.
Physical and mechanical properties of Niti instruments recover only
partially following autoclaving. Hence, it is recommended that they should
not be used for more than five cycles
A verifiable process has been described below:
1. Immediately after use remove stoppers and insert the files into a
scouring sponge soaked with chlorhexidine gluconate aqueous solution
2. Clean the files by using 10 vigorous in and out strokes in the sponge 3.
‑ ‑
Place the files in a wire mesh basket and immerse ina suitable enzymatic
cleaning solution for 30 min
4. Follow this by 15 min ultrasonification in the enzymatic cleaning
solution.
5. Drain and rinse in running water for 20s 6. Proceed to steam
sterilization.

60. Maintaining and sterilizing Gutta percha
‑
cones and resin points (root filling
materials)
• From some studies, it is evident that they require disinfection prior to use
even if they are aseptically removed from a new packet.
• Sterilization by heat would alter the cones, so autoclaving is not suggested.
• Following are some of the methods that have been tested and compared:
(1) Sodium hypochlorite in concentrations of 0.5% 5%
(2) Chlorhexidine, 2%
(3) Glutaraldehyde
(4) Alcohol[44] (5) Hydrogen peroxide, 3%
(6) MTAD
(7) Rosmarinus officinalis extract
(8) Quaternary ammonium

61. • Among all the above methods, sodium hypochlorite immersion with
concentrations ranging from 2% to 5.25% for a minimum time of 5–
10 min, continues to be the most commonly followed method. This
can be attributed to the fact that sodium hypochlorite is extremely
effective, easily available in the dental office, inexpensive and has a
quick action.
• Alternatively, chlorhexidine can be used in a concentration equal to
2% for a shorter period (1–2 min)

62. Maintaining and sterilizing Curing
lamp/light
Curing light tips are regarded as semi critical pieces of equipment.
The curing tips should be either heat sterilized or have an appropriate
barrier placed over the a tip for each patient.
However, it is not possible to heat sterilize all curing tips and hence
high level disinfectants can be used, provided a barrier was placed.

64. STERILIZATION FAILURE -
The killing of micro-organisms fails when the sterilizing agent does not
make the proper contact for the proper time.
Common causes are-
 Improper cleaning.
 Improper placement (instruments to be sterilized should not be
packed tightly or one above the other)
 Improper timing.
 Malfunctioning of the unit.(e.g. during autoclaving the
pressure/temperature display may not be correct)

65. OSHA
• The OSHA rule derives from the original Occupational Safety and
Health Act passed by the U.S. Congress in 1970.
• According to the Act, each employer must furnish employees with a
place and conditions of employment free from recognized hazards
that presently cause, or are likely to cause, death or serious harm to
employees.
• The Act covers two regulated programs of com pliance:
• (1) an OSHA Hazard Communications Program, concerning risks
from environmental and chemical hazards in the workplace.
• (2) an OSHA Bloodborne Pathogens program that addresses control
of “occupational exposure to blood and other potentially infectious
materials.”

66. OSHA Regulation
• 1. Employers must provide HBV immunization to employees without charge
within 10 days of employment.
• 2. Employers must require that standard precautions be observed to prevent
contact with blood and other potentially infectious materials. Saliva is
considered a blood-contaminated body fluid in relation to dental treatments.
• 3. Employers must implement engineering controls to reduce production of
contaminated spatter, mists, and aerosols. Examples are use of a rubber
dam, high-volume suction, rubber prophy cup.
• 4. Employers must implement work practice control precautions to minimize
splashing, spatter, or contact of bare hands with contaminated surfaces.
Telephones, switches, door handles, or faucet handles should never come in
contact with soiled gloves.

67. • 5. Employers must provide facilities and instruction for washing hands
after removing gloves and for washing other skin immediately or as
soon as feasible after contact with blood or potentially infectious
materials .
• 6. Employers must prescribe safe handling of needles and other sharp
items.
• 7. Employers must prescribe disposal of single-use needles, wires, and
sharps as close to the place of use as possible, as soon as feasible, in
hard walled, leak-proof containers that are closable, from which
needles cannot be easily spilled.
• 8. Contaminated reusable sharp instruments must not be stored or
processed in a manner that requires employees to reach hands into
containers to retrieve them.
• 9. Employers must prohibit eating, drinking, handling contact lenses,
and application of facial cosmetics in contaminated environments,
such as operatories and cleanup areas.

68. • 10. Blood and contaminated specimens (e.g.,
impressions that have not been well cleaned and well
dis infected, teeth, biopsy specimens, blood
specimens, and culture specimens) to be shipped,
transported, or stored should be placed in suitable
closed containers that prevent leakage.
• 11. At no cost to employees, employers must
provide them with necessary PPE and clear
directions for use of appropriate universal barrier
protection in treating all patients and for all other
contact with blood or other infectious materials .
PPE must not allow blood or other potentially
infectious material to pass through to contaminate
personal clothing, skin, or mucous membranes.
• 12. Employers should ensure that employees
correctly use and discard PPE or prepare it properly
for reuse. Adequate facilities should be provided to
discard gowns or laundry in the location where they
are used.

69. • 13.After treatments, one should clean
and disinfect the surface , including
floors, countertops, sinks, and other
environmental equipment that are
subject to contamination.
• 14. Employers must provide a written
schedule for cleaning and
decontaminating equipment, work
surfaces, and contaminated floors.
• 15. Contaminated equipment that
requires service first must be
decontaminated, or a biohazard label
must be used to indicate contaminated
parts.

70. Color coding system for biological
waste disposal

71. CONCLUSION
•“PREVENTION IS BETTER THAN CURE”- a proverb well
suited to sterilization
•A thorough understanding of the application of sterilization will
help ensure safety from the invisible but deadly world of microbial
pathogens
•Hence utilization of proper sterilization, disinfectants and aseptic
procedures helps us achieve the safety our profession demands

72. REFRENCES
• Sturdevant’s Art and Science of Operative Dentistry 5th
edition
• Textbook on disinfection, sterilization and prevention By Seymour S.
Block
• Textbook of microbiology By R.Anantanarayan ,CJK Paniker(7th
edition)
• Textbook of microbiology by Dr.CP Baveja (5th
edition)
• Journal of the International Clinical Dental Research Organization |
Volume 14 | Issue 2
• American journal of infection control 51 2023 A13-A21
• Asian journal of pharmaceutical technology and inovationn, 06 (27);
2018; 53-66

73. THANK YOU