The document discusses sterilization and disinfection procedures in dentistry. It covers key terms, routes of contamination, regulations from OSHA, and methods of personal barrier protection. Various sterilization techniques are described such as heat sterilization methods like hot air oven, rapid heat, and autoclave. Moist heat sterilization methods include autoclaving, tyndallization, and chemical vapor. The document emphasizes the importance of sterilizing critical and semi-critical items using heat or chemical methods to prevent transmission of infections in dental practice.
Due to the complex morphology of the root canal system in primary teeth, the clinician must rely primarily on chemical cleansing and sterilization and secondarily on mechanical instrumentation during pulpectomy procedure.
And in order to increase the chance of success of the endodontic treatment, substances with antimicrobial properties are frequently used as root canal filling materials in deciduous teeth
Due to the complex morphology of the root canal system in primary teeth, the clinician must rely primarily on chemical cleansing and sterilization and secondarily on mechanical instrumentation during pulpectomy procedure.
And in order to increase the chance of success of the endodontic treatment, substances with antimicrobial properties are frequently used as root canal filling materials in deciduous teeth
The cast metal restoration is versatile and is especially applicable to Class II onlay preparations. The process has many steps, involves many dental materials, and requires meticulous attention to prepration.
Tooth treatment planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would not be able to sustain or bear forces.
Additionally, when decay or fracture incorporate areas of cusp or remaining tooth structure that undermines perimeter walls of a tooth, an onlay might be indicated.
This lecture explain the basic of root canal preparation in endodontic treatment. It is not meant to be a comprehensive lecture, rather an preliminary one
Iatrogenic Perforation- A guide to fixing the hole in your patient's toothTaseef Hasan Farook
An overview of the possible types of perforation that may occur during endodontic treatment with their management. This slide presentation covers multiple management possibilities of said perforation proposed by various clinicians from around the world which can aid the readers in their treatment plan for the repair of a tooth perforation
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
Apexogenesis & apexification in pediatric dentistryDr. Harsh Shah
SDDCH Parbhani
Presented by : Vipul GIratkar
Dept. of Pediatric dentitstry
Guided by . Dr. Rehan Khan
DIscussion regarding apexification and apexogenesis
Endodontic implants /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
Welcome to Indian Dental Academy
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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Techniques of direct composite restorationMrinaliniDr
Techniques of the direct composite restoration. Includes different instruments, matrix system, wedges, bevel, etching, bonding, and placement of composite along with finishing and polishing and clinical management
Cleaning and shaping of Root canal systemmustmunda
IT IS ABOUT BIOMECHANICAL PREPARATION
Main objective of root canal treatment
What Is Cleaning And Shaping ?
Objectives of biomechanical Preparation (given by Schilder]
INSTRUMENTS USED FOR RADICULAR PREPARATION
DIFFERENT MOVEMENTS OF INSTRUMENTS
Motions Of Instruments For Cleaning And Shaping
BASIC PRINCIPLES OF CANAL INSTRUMENTATION
Techniques Of Root Canal Preparations
CONVENTIONAL
STEP BACK
MODIFIED STEP BACK
PASSIVE STEP BACK
STEP DOWN CROWN DOWN HYBRID
DOUBLE FLARED
BALANCE FORCE
ENGINE DRIVEN ROTATORY INSTRUMENTS
CANAL PREPARATION USING ULTRASONIC INSTRUMENTS
ADVANTAGES AND DISADVANTAGES
THANK YOU
BIBLIOGRAPHY GOOGLE AND NISHA GARG
The cast metal restoration is versatile and is especially applicable to Class II onlay preparations. The process has many steps, involves many dental materials, and requires meticulous attention to prepration.
Tooth treatment planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would not be able to sustain or bear forces.
Additionally, when decay or fracture incorporate areas of cusp or remaining tooth structure that undermines perimeter walls of a tooth, an onlay might be indicated.
This lecture explain the basic of root canal preparation in endodontic treatment. It is not meant to be a comprehensive lecture, rather an preliminary one
Iatrogenic Perforation- A guide to fixing the hole in your patient's toothTaseef Hasan Farook
An overview of the possible types of perforation that may occur during endodontic treatment with their management. This slide presentation covers multiple management possibilities of said perforation proposed by various clinicians from around the world which can aid the readers in their treatment plan for the repair of a tooth perforation
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
Apexogenesis & apexification in pediatric dentistryDr. Harsh Shah
SDDCH Parbhani
Presented by : Vipul GIratkar
Dept. of Pediatric dentitstry
Guided by . Dr. Rehan Khan
DIscussion regarding apexification and apexogenesis
Endodontic implants /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
Welcome to Indian Dental Academy
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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Techniques of direct composite restorationMrinaliniDr
Techniques of the direct composite restoration. Includes different instruments, matrix system, wedges, bevel, etching, bonding, and placement of composite along with finishing and polishing and clinical management
Cleaning and shaping of Root canal systemmustmunda
IT IS ABOUT BIOMECHANICAL PREPARATION
Main objective of root canal treatment
What Is Cleaning And Shaping ?
Objectives of biomechanical Preparation (given by Schilder]
INSTRUMENTS USED FOR RADICULAR PREPARATION
DIFFERENT MOVEMENTS OF INSTRUMENTS
Motions Of Instruments For Cleaning And Shaping
BASIC PRINCIPLES OF CANAL INSTRUMENTATION
Techniques Of Root Canal Preparations
CONVENTIONAL
STEP BACK
MODIFIED STEP BACK
PASSIVE STEP BACK
STEP DOWN CROWN DOWN HYBRID
DOUBLE FLARED
BALANCE FORCE
ENGINE DRIVEN ROTATORY INSTRUMENTS
CANAL PREPARATION USING ULTRASONIC INSTRUMENTS
ADVANTAGES AND DISADVANTAGES
THANK YOU
BIBLIOGRAPHY GOOGLE AND NISHA GARG
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
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
by - dr. sheetal kapse, 2nd year p.g. student, dept. of oral & maxillofacial surgery, RCDSR, Bhilai, C.G. please contact for any question...email id - sheetal.kpse@yahoo.com
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
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
Sterilization /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Sterilization and disinfection of orthodontic instruments /certified fixed or...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Similar to STERILISATION AND DISINFECTION IN DENTISTRY.pptx (20)
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. CONTENTS
INTRODUCTION
TERMINOLOGIES
ROUTES OF CONTAMINATION
OSHA REGULATIONS
PERSONAL BARRIER PROTECTION IN THE DENTAL
OFFICE
OPERATORY ASEPSIS
PROCEDURES BEFORE STERILISATION
STERILISATION
MONITORING STERLIZATION
DISINFECTION
NEWER METHODS OF STERLIZATION
3. HAND-PIECE STERLIZATION
CONTROL INFECTION FROM AEROSOL
DENTAL CONTROL WATER UNIT SYSTEMS & HAND-PIECE
ASEPSIS
INFECTION CONTROL FOR IMPRESSIONS
INFECTION CONTROL FOR EXTRACTED TEETH USED FOR
RESEARCH AS PER OSHA & CDC
NEEDLE STICK INJURY
FUTURE CONSIDERATIONS
DISPOSAL OF WASTE
CONCLUSION
4. INTRODUCTION
• Infection control has become an integral part of dental
practice.
• Presently there are clearly defined techniques and protocols
for sterilization of various materials and instruments used for
restorative treatment.
• Main concern is for upper respiratory tract infections, herpes
simplex, TB, Hepatitis B, AIDS etc.
• Hence it is essential for dental team to have a clear
understanding of infection transmission & various methods to
control them.
5. • All infected patients cannot be identified by medical
history, physical examination or laboratory tests, Centers
for Disease Control & Prevention (CDC) recommends
that blood and body fluid precautions be used consistently
for all patients.
• These precautions, referred to as “ universal precautions ”
must be observed routinely of all dental patients.
6. TERMINOLOGIES
• CLEANING:
Process which removes visible contamination, but does not
necessarily destroy microorganisms.
• ASEPSIS:
Prevention of contact with pathogens.[barrier protection, sterilization,
disinfection]
• ANTISEPSIS
Procedure or application of an antiseptic which inhibits the growth of
microorganisms, while remaining in contact with them, but not
necessarily imply sterility.
7. • STERLIZATION:
Process by which an article, surface or medium is freed of all
living microorganisms either in the vegetative or spore state.
• DISINFECTION:
Destruction or removal of all pathogenic organisms, or
organisms capable of giving rise to infection.
• DISINFECTANT:
Chemical substance, which causes disinfection. It is used for
non-vital objects to kill vegetative pathogenic organisms, but
not necessarily spore forms or viruses.
8. ROUTES OF CONTAMINATION
• DIRECT TRANSMISSION:
Occurs by direct contact with body fluids through a
previously damaged skin/mucous membrane with a lesion,
organisms/debris while performing intra-oral procedures.
9. • INDIRECT CONTAMINATION:
The invisible trail of saliva left on contaminated surfaces
like handles, operatory units etc are potential sources of
contamination to personnel & patients
Cross-contamination of patients by such sources
have been documented.
10. • AIR BORN CONTAMINATION:
• High-speed hand piece capable of creating air-borne contamination…
• Aerosols consists of invisible particles ranging from
50mm to approx 5mm that remain suspended in the air & breathed for
hours…
• Mists become visible in a beam of light consists of droplets estimated to
approach or exceed 50mm.
Heavy mists tend to settle gradually from air after 5 to 15 mm…
11. • Spatter consists of particles larger than 50mm and are
even visible splashes.
Has distinct trajectory, usually falling within 3ft of
the patients mouth, having potential for coating the face
and outer garments of the attending personnel.
12.
13. OSHA REGULATIONS FOR
EMPLOYERS
• Must provide HBV immunization to employees within 10days of
employment.
• Must implement engineering control to reduce production of spatter,
mists, aerosols… rubber dam, high volume suction, etc.,
• Practice control precautions-telephone, handles, not be touched with
soiled gloves.
• Employers must require that standard precautions be observed to
prevent contact with blood and other potentially infectious materials.
14. • Must provide instructions to wash hands after removing gloves &
flush eye/mucosa of any contact with blood/saliva.
• Prescribe safe handling of needles. They should not be bend/cut.
• Prescribe disposal of single-use needles, wires, carpules, sharps in
red/biohazard labeled bags.
• Teeth must not be discarded into trash, but can be given to the
patient or discarded in sharps container
15. • Basket/cassette/puncture resistant bags used for reusable
sharp instruments.
• Prohibit eating, drinking, handling contact lenses,
application of cosmetics , use of mobiles in contaminated
areas.
• Blood/contaminated specimens stored in leak-proof
containers.
• Provide necessary PPE ( Personal Protective Equipment)
such as gloves, gowns, or masks.
• Ensure proper use & discard of PPE or prepare it properly
for reuse.
16. • Attend regularly to housekeeping requirements &
prescribe written schedules for cleaning/decontaminating
work surfaces/floors.
• Contaminated sharps are regulated waste & should be
discarded in hard-walled containers.
• Reusable sharps placed in basket in hard-walled
containers to be transported to clean up areas.
• Laundering of protective garments/soiled linens.
17.
18. PERSONAL BARRIER TECHNIQUE
1) Hand washing:
Hand cleansers such as 3% p-chlorometaxylenol or 4%
chlorhexidine gluconate can be used.
2) Gloves:
Fresh gloves must be worn for every patient.
Avoids contamination by occult blood and help to prevent painful
& transmissible herpetic infections to fingers (whitlow) & hands.
Gloves should not be washed with hand soaps [ reduces gloves
integrity, leaving personal more vulnerable].
Types- latex gloves, polyethylene gloves.
They come in 4 mil & 8 mil thickness.
19. 3) Protective Eyewear, Masks & Hair protection:
Consists of goggles or glasses with solid side shields.
Protect against aerosols.
Mask should be changed between every patient or whenever it becomes
moist or visibly soiled.
Changing time – 20min in aerosol environment and 60 min on non-aerosol
environment.
Masks should have atleast 95% filtration efficiency for particles 3 to 5 µm
diameter.
4) Overgloves:
Made of lightweight, inexpensive, clear plastic.
20. 5) Protective overgarments:
Made of cotton or synthetic fiber similar to an isolation garment
material protect the skin.
Overgarment should be changed whenever becomes moist or
visibly soiled.
Wearing contaminated garments to home or out the clinic area
should not occur.
Laundered on daily basis separately from other garments.
Hot water (70°C or 158° F) or cool water containing 50-150 ppm
of chlorine provided by liquid bleach would provide more
antimicrobial action.
21. Standard rub-in technique for hygienic hand
disinfection
• For hygienic hand disinfection, apply the hand disinfectant onto
dry palms and rub in up to the wrists for 30 seconds according to
the steps listed below.
• Perform the movements of each step five times.
• After completion of the 6th step, the individual steps are to be
repeated until the rubbing time indicated has been attained.
• Important: Make sure that the hands remain moist during the
entire rubbing time. If necessary, use more hand disinfectant.
22. Rub palm to palm.
In addition the
wrists, if required
1 2
Right palm over
the back of the
left
hand – and vice
versa
3
Rub palm to palm
with interlaced
spread fingers
Rub the backs of the
interlocked fi ngers
on the opposing
palms
4
Rub the right thumb in the
closed palm
of the left hand using a
circular motion
– and vice versa
Rub the closed fi
ngertips of the right
hand on the left
palm using a circular
motion – and vice
versa
23. HAND CARE PROTOCOL
REMOVE JEWELLERY
HAND WASH USING RECOMMENDED TECHNIQUE
RINSE HAND THOROUGHLY
DRY HANDS WITH DISPOSABLE TOWEL
DISINFECT WITH ALCOHOL HAND RUB
INVASIVE PROCEDURE NON-INVASIVE PROCEDURE
AT LEAST 2-5 ml ALCOHOL 3min EXAMINATION GLOVES
TREATMENT PATIENT
HAND NOT VISIBLY
CONTAMINATED REMOVE & DISCARD GLOVES
HAND VISIBLY NEXT PATIENT CLEAN & DISINFECT – ALCOHOL 30
CONTANMINATED sec
24. OPERATIVE ASEPSIS
• CRITICAL ITEMS:
Surgical and other instruments that cut or penetrate soft
tissues or bone are classified as critical & should be
sterlized after each use.
Includes- needles, scalpels, endodontic instruments, burs
& scalers.
25. • SEMI-CRITICAL ITEMS:
Instruments that contact oral tissues like air-water syringe
tip, suction tips, prophy angle and hand-pieces.
Other instruments are handled during treatment like lamp
handle, switches, chair control buttons etc.
Must be removed for cleaning & sterilization, unless they are
disposable plastic covers( applies especially to air-water
syringe).
They should not be disinfected only.
They should be covered, cleaned, and sterilized or discarded.
26.
27. • NON-CRITICAL ITEMS :
These are the environmental surfaces, such as chairs,
floors, walls and supporting equipments not touched
ordinarily during treatment.
Contaminated non-critical items require cleaning and
disinfection.
• Ex: pulp oximeter, stethoscope, light switches,
dental chair
28. • CDC recommends:
1. Critical and semicritical inst --- heat sterlized
2. Semicritical sensitive to heat --- high level disinfection after
cleaning
3. Non critical inst --- intermediate to low level disinfection
after cleaning
29. PROCEDURES BEFORE STERILISATION
• Pre-soaking of instruments:
1) Soaked in chemical disinfectant like gluteraldehyde or synthetic
phenol for 30min.
2) Pre-soaking the contaminated instruments keeps them wet until a
thorough cleaning can occur. This prevents the blood or saliva from
drying on instrument facilitating cleaning.
• Pre-sterilization cleaning of instruments:
1) Manual method-
Hard brush with stiff bristles and detergent soln.
2) Ultrasonic method-
Ultrasonic cleanser operating at 40 degree Celsius & 35 KHz for
2-20 min.
30. • After removal of debris, instruments which are likely to rust should
be dipped in rust inhibiter ( 2% sodium nitrate).
• The clinician should drain and dry the instruments in cassettes or
carefully spill the basket of instruments onto an absorbent towel on a
tray.
• The towels are considered as contaminated items.
• Still wearing protective gloves , the clinician properly packages the
inst. together with internal or external sterlization indicators suited to
sterlization process used.
31.
32.
33. STERILIZATION
SUNLIGHT:
• Possesses appreciable bactericidal activity.
• Spontaneous sterilization occurs under natural light if kept in
sunlight for 12 hrs.
• Action is primarily due to ultraviolet rays.
DRYING:
• Moisture is essential for growth of bacteria.
• Four-fifth of the weight of the bacterial cell is due to water. Drying
in air therefore has deleterious effect on many bacteria.
34. HEAT:
• Most reliable method of sterilization and should be the
method of choice unless contraindicated.
Mode of action:
• Dry heat protein denaturation, oxidative damage & toxic
effect of elevated levels of electrolytes.
• Moist heat denaturation & coagulation of protein.
Thermal death time: It is the minimum time required to kill a
suspension of organisms at a predetermined temperature in a
specified environment.
35. • DRY HEAT:
I) INCINERATION:
• Excellent method for destroying materials such as
contaminated cloth, animal carcasses & pathological
materials.
II) HOT AIR OVEN:
• Widely used method.
• Glassware, forceps, scissors, scalpel, all-glass syringes,
swabs, some pharmaceutical products such as liquid
paraffin, dusting powder, fats & grease can be sterilized.
37. Precautions:
Should not be overloaded.
Must be fitted with fans for distribution of hot air.
Allowed to cool for 2hrs.
Advantages:
No corrosion .
Cost effective.
Items are dry after cycle.
Disadvantages:
Longer sterlization time.
Cannot sterlize liquids.
May damage plastic & rubber items.
Not suited for heat sensitive inst like NiTi whose property changes
by increase in temperature.
39. RAPID HEAT STERLIZATION (forced air type)
• Uses internal air flow system at 374°F for 6min for unwrapped
instruments &12min for wrapped instruments.
• Advantages:
1] No corrosion.
2] Short cycle.
3] Items are dry after cycle.
4] maintains the sharpness of the instruments
• Disadvantages:
1] cannot sterilize liquids.
2] May damage plastic and rubber items.
40.
41. Glass Bead Sterilizer
• Used for small instruments like burs, endodontic instruments, absorbent
points , etc.
• Temperature range – 450°F(218°C) & 475°F(246°C) for 5-15 sec.
• Root canal inst.- 5 sec, absorbent points & cotton pellets- 10 sec.
• Usually uses table salt which consists app 1% of sodium silico-aluminate,
sodium carbonate or magnesium carbonate.
• It can be poured immediately & does not fuse under heat. Salt can be
replaced by glass beads of diameter smaller than 1mm.(larger beads are not
efficient in transferring heat due to large air spaces.)
• These sterlizers are used to consists of either hot salt or glass beads as a
medium for dry sterlization.
• Hottest part is along the outer rim.
43. MOIST HEAT
• Temperature below 100°C:
• PASTURIZATION OF MILK:
Milk is heated at either 63°C for 30 min (holder method)
or 72°C for 15-20 min (flash method) followed by cooling
quickly to 13°C or lower.
Non-sporing pathogens are destroyed.
Vaccines of non-sporing bacteria are best inactivated in
special vaccine baths at 60°C for an hour.
44. • Temperature at 100°C:
• BOILING:
• Vegetative forms of bacteria are killed almost
immediately at 90-100°C.
• Time required is 10-30min.
• Not suitable for sterilizing instruments for surgical
procedures & should be regarded as only as a means of
disinfection.
45. • TYNDALIZATION ( INTERMITTENT
STERLIZATION):
• Used for sterilization of media containing sugars or
gelatin.
• An exposure of 100°C for 20 min on 3 successive days is
used.
• Principle first exposure kills all vegetative bacteria,
and the spores, since they are in a favorable medium, will
germinate and be killed on subsequent occasions.
46. AUTOCLAVE
• Sterilization is due to latent heat of vaporization present in moist
heat.
• When steam condenses on contact with cooler surfaces, it becomes
water and gives latent heat to that surface.
• Moist heat denatures and coagulates proteins of microorganisms.
47. TEMP TIME PRESSURE
UNWRAPPED
INSTRUMENTS
1340C 3 min 30 psi
WRAPPED
INSTRUMENTS
1210C 15 - 20 min 15 psi
Advantages:
1] Good penetration
2] Time efficient
3] Sterilize water based liquids
Disadvantages:
1] May damage plastic or rubber items.
2] Rust carbon steel instruments & burs.
48. CHEMICAL VAPOUR PRESSURE
STERILIZATION
• Uses a solution of 72% ethanol & 0.23% formaldehyde in
place of water in its autoclave.
• Cycle – 132° C (270°F), 20lbs, 20min.
• ADVANTAGES-
-No corrosion of metals.
-Rapid & efficient cycle time.
-Load comes out dry.
49. • DISADVANTAGES:
-High cost.
-Ventilation or filtration is required to handle
formaldehyde fumes.
-Solution supplied by manufacturer has to be used.
-Hand-pieces cannot be sterilized.
50. ETHYLENE OXIDE STERILIZATION
• Uses automatic devices filled with ethylene oxide gas at temp
below 100° C.
• Colorless liquid with a boiling point of 10.7°C.
• Its highly inflammable & in the concentrations in air greater
than 3%, highly explosive.
• Action is due to its alkylating the amino, carboxyl, hydroxyl
& sulphahydral groups in protein molecules. Also reacts with
DNA & RNA.
51. • ADVANTAGES :-
Best method to sterilize complex instruments & delicate
materials.
Operates effectively at low temperatures.
• DISADVANTAGES :-
High cost.
prolonged time.
not practical for dental clinics.
ethylene oxide gas is potentially mutagenic & carcinogenic.
52.
53. MONITERING STERILIZATION
• Mechanical monitoring:
• Each load must be monitored to document
time/temp/pressure.
• Sterilization indicators are marked with heat-sensitive
dyes to differentiate the packs that have been in the
sterilizer from those that have not.
54. • Chemical indicator strips:
• This provides an inexpensive, qualitative monitor sterilizer
function, operation & heat penetration into packs.
• Chemicals on strip change color & breakdowns/gross
overloading can be identified.
• Biologic monitoring strips:
• Is the accepted weekly monitor of adequate time/temp
exposure.
• Pre-dried spores on absorbent paper are calibrated to be killed
when sterilization conditions are reached & maintained to kill
pathogenic organisms.
55. • Documentation notebook:
• One fixes a single, dated, initialed indicator strip to a
sheet/calendar for each work day followed by weekly
spore report.
• Dated sterilized inst packs, bags, trays provide final
evidence of the sterilization program.
56. DISINFECTION
• Ideal requirements of disinfectants:
1.Broad spectrum
2.Fast acting
3.Not affected by physical factors
4.Non toxic
5.Surface compatibility
6.Residual effect on treated surfaces
7.Easy to use
8.Odorless
9.Economical
57. • ALCOHOLS:
• Ethyl alcohol & isopropyl alcohol are frequently used as surface
disinfectant.
• Effective in concentration of 60-90% in water.
• Act by denaturing bacterial proteins.
• Mainly used as skin disinfectants.
• Isopropyl alcohol is preferred as it is better fat solvent, more
bactericidal & less volatile.
• Disadvantages:
• No action on spores.
• Protein slows action( but 1% mineral acid
or alkali enhances the action)
58. • FORMALDEHYDE:
• Formaldehyde is active against amino group in the protein
molecule.
• It is bactericidal & sporicidal & also has lethal effect on
viruses.
• USES:
• Used to preserve anatomical specimens.
• For destroying anthrax spores in hair & wool.
• 10% formalin containing 0.5% sodium tetraborate is used to
sterilize clean metal instruments.
• Formaldehyde gas is used for sterilizing instruments & heat-
sensitive catheters & for fumigating wards, sick rooms.
59. • Disadvantages:
• Gas is irritant & toxic when inhaled.
• Surfaces which have been disinfected by this agent may
give off irritant vapour for some time after disinfection.
60. GLUTERALDEHYDE
• Action similar to formaldehyde i.e., bactericidal, sporicidal & lethal to
viruses.
• Specially effective against the tubercle bacilli, fungi & viruses.
• 2% gluteraldehyde – cidex requires 20 min immersion time for disinfection
& 6-10 hrs for sterlization.
• Less toxic & irritant to the eyes & skin than formaldehyde.
• No deleterious effects on the cements or the lenses of instruments such as
cytoscopes & bronchoscopes.
• Can be safely used to treat corrugated rubber anesthetic tubes & face
masks , plastic endotracheal tubes, metal instruments & polythene tubing.
61. HALOGENS
• IODINE:
• It is an aqueous & alcoholic solution has been used as a skin
disinfectant.
• Actively bactericidal, with moderate action against spores.
• Compounds of iodine with nonionic wetting or surface-active
agents known as iodophores are claimed to be more active
than the aqueous or alcoholic solutions of iodine.
• 2% iodine in 4% potassium iodide has been used as
endodontic disinfectant.
62. • CHLORINE COMPOUNDS:
• A potent germicide acts by oxidation of bacterial proteins.
• Commonly used as hypochlorites.
• Organic chloramines are used as antiseptics for dressing
wounds.
• CDC recommended 0.05% to 0.5% NaoCl application 3
min for disinfection & 6 hours for sterilization
• NaOCl ( 0.5-5.25 %) is used as an endodontic disinfectant.
63. CHLORINE COMPOUNDS
• Advantages:
– Broad spectram
– Economical
– fast acting
– effective in dilution
• Disadvantages:
– Unstable
– Less active in the presence of organic debris
– Corrodes metal
– Degrades plastics and rubber
– Irritant to skin and mucosa
64. PHENOLS
• Obtained by distillation of coal tar between temperatures
of 170 & 270°C.
• Lister , the father of antiseptic surgery, first introduced
them in surgery (1865).
• Lethal effect is due to their capacity to cause cell
membrane damage, releasing cell contents & causing lysis
eg., carbolic acid.
• Synthetic derivatives like lysols and cresols are active
against wide range of organisms.
65. • Advantages :
– Economical
– Less toxic
– Good surface cleaner
• Disadvantages :
– Not sporicidal
– Irritant to eyes
– Epithelial toxicity
66. CHLORHEXIDINE ( HIBITANE )
• Chlorhexidine (hibitane) is a bisguanide.
• It is relatively non-toxic skin antiseptic against gram +ve & gram-ve
organisms and the aqueous solutions are used for treatment of skin
wounds.
• Gets inactivated in the presence of soaps, pus, plastics,etc.,
• Mainly used for cleaning skin & mucous membrane.
• A 0.2% aqueous solution or 1% gel used for suppression of plaque &
postoperative infection.
67. FORMALDEHYDE GAS:
• Widely employed for fumigation of operation theaters & other rooms.
• After sealing the windows & other outlets, formaldehyde gas is
generated by adding 150g of KMnO4 to 280ml of formalin for every
1000cu.ft (28.3cu.m) of room volume.
• When formaldehyde vapour is generated, the doors should be sealed &
left unopened for 48hrs.
68. BETAPROPIOLACTONE(BPL)
• This is a condensation product of ketone & formaldehyde
with a boiling point of 163°C.
• Has rapid biocidal action but unfortunately has
carcinogenic activity.
• 0.2% BPL is used for sterilization of biological products.
69. SURFACE ACTIVE AGENTS
• Substances that alter the energy relationship at interfaces, producing
a reduction of surface or interfacial tension, are referred to as surface-
active agents.
• Used as wetting agents, detergents & emulsifiers.
• Act on phosphate groups of cell membrane & also enter the cell.
• Active against gram+ve & gram-ve organisms.
• Types:
– Cationic – Ex: Quarternary ammonium compounds
– Anionic – Ex: Soaps
70. NEWER METHODS OF
STERILIZATION
Irradiation :
• Gamma rays, ultraviolet light are used.
• UV radiation may be useful for sanitization of room air to
help control tuberculosis.
• Limitations :
Poor penetration of oil & incomplete exposure of all
surfaces.
UV light is not highly effective against RNA viruses such
as HIV & is not effective against bacterial spores.
72. HAND-PIECE STERILIZATION
-Steam sterilization
-For hand-pieces with metal bearing turbines
-For hand-pieces with lubrication-free ceramic bearing turbine
-Other methods
Steam sterilization:
• Most rapid methods.
• Good utility is obtained if proper cleaning/lubricating done.
For hand-pieces with metal bearing turbines:
Scrub the metal bearings of hand-pieces at sink with water &
detergent.
Should be bagged/sheathed/autoclaved
73. For hand-pieces with lubrication- free, ceramic bearing
turbine:
• Do not use chemicals that would damage internal parts
• Consult manufacturer for directions on cleaning fibro-
optics.
• Should be bagged & autoclaved.
• Others: ETOX/Chemical vapour sterilization
74. CONTROL OF INFECTION FROM AEROSOL
• Contamination from spatter & aerosol is created by rotary
instruments.
• Aerosoization of mycobacterium tuberculosis that cause
pulmonary tuberculosis is of great concern.
• Annual tuberculin testing of personal is standard
recommendation in dentistry.
• Rubber dam & high volume evacuators are helpful methods.
• High volume evacuators are 80% effective in reducing aerosol
contamination.
• Universal use of personal barriers, drapes, effective clean up
procedures are must.
75. DENTAL CONTROL UNIT WATER SYSTEMS AND
HAND-PIECE ASEPSIS
• Oral fluid contamination problems of rotary equipment, especially
high speed, involve-
1. Contamination of hand-piece external surfaces & crevices,
2. Turbine chamber contamination that enters the mouth,
3. Water spray retraction& aspiration of oral fluids into the water lines
of older dental units.
4. Growth of environmental aquatic bacteria in water line,
5. Exposure of personnel to spatter & aerosol generated by intra oral
use rotary equipments.
76. Hand-piece surface contamination control:
Blood and saliva contaminate the surfaces of hand-piece during
various dental procedures.
Scrubbing with disinfectants- reduces no. of bacteria
Sterilization.
Turbine contamination control:
Contaminated oral fluids may be drawn back into the turbine
chamber by negative pressure created by a venturi effect during
operation or when turbine continues to spin whenever the air is
stopped.
It has been experimentally shown under extreme conditions on a
laboratory bench, but still during clinical treatments its not proved.
77. • Water retraction system correction:
• Place a one-way check valve
• Systems should be monthly checked.
• Since 1988 nearly all manufacturers produce units cut off
water supply without retraction.
78. Inherent water system contamination:
• Microbes exist in dental unit water line as free floating bacteria & as sessile
form known as biofilm.
• Microbes produce a protective polysaccharide matrix that provides
mechanisms for surface attachment & retention to water line.
• CDC has recommended dental water line should contain less than 500
cfu/mL.
• Clean water reservoir systems combined with disinfection/sterilization of
equipment downstream.
• Educating dental personnel & periodically monitoring compliance with
procedures.
79.
80. INFECTION CONTROL FOR IMPRESSIONS &
OTHER PROSTHETIC ITEMS
Precautions in making impressions & bite registrations:
Barrier protection by using PPE like gloves, masks, over
garments.
• Wipe material containers with disinfectant after use.
• Trays made of non-aqueous rubber impression materials(
use once & discard)
81. • Transporting to remote laboratory:
• Potentially infectious material in leak-proof containers.
• Labeling/color coding when specimens leave the facility.
• Mandatory to disinfect before sending it to laboratory.
82. Handling & transporting silicone/rubber based
impressions/registrations:
• Remove impression/device from mouth & rinse under tap
water 15sec.
• Place it into clear heat-sealable biohazard-labeled bag.
• Remove gloves & close bag & tape prescription.
• Attach a note to disinfect before use & communicate with
lab personnel.
83.
84. Handling & transporting items of aqueous impression
material/assoc registrations:
• Rinse under tap water 15sec.
• Disinfect with hospital based disinfectant by spraying.
• Rinse & pour cast immediately
• Carefully pack & transport.
• Add a note stating the impression/registration is
disinfected.
85. Handling impressions/assoc
registrations for an on-site laboratory:
• Wear clean uniform/jacket/coat/gown.
• masks, protective eyewear, gloves.
• Designated area to receive items
• All items labeled, disinfected with1:10 dilution 0.5% liquid
chlorine bleach for 10min.
• Rinse impressions.
• Personnel receiving them must wear disposable treatment
gloves.
86. Handling impressions/assoc registrations for an on-site
laboratory:
• All incoming items to the dental laboratory must be properly labeled with
gloved hands, disinfect the impressions by submerging (for 10 min) in 1:10
dilution(0.5%) of household bleach.
• With gloved hands, spray articulators and any related equipment.
• With clean hands, thoroughly rinse the impression under tap water
(15 sec) to remove any residual disinfectant.
• All outgoing items must be properly cleaned & placed in leak-proof
bags/containers.
• Countertops/work surfaces properly cleaned/disinfected.
87.
88. Infection control protocol for extracted teeth collected for
educational research purposes as per OSHA& CDC
• 0.5% sodium hypochlorite- initial collection & storage medium.
• Gloves, masks, protective eye wear should be worn.
• Collection jars should be opened & liquids should be poured from the
jars. Then jars be filled with 5% soluton of bleach ( NaOCl) which
occupy 20% volume of jar.
• After standing in the bleach for atleast one & half hour , collection
liquids should be poured in swear.
• Extracted teeth should be placed on thick paper towel on the desktop.
• Collection jars & their lids should be discarded in biohazard waste
receptacles.
89. • Paper towels should be discarded in biohazard waste receptacles.
Gloves should be removed & discarded.
• Desktops should be cleaned with clinical disinfectant using spray.
• As needed teeth should be removed from jars & rinse with tap
water. After soaking in container of tap water for few min, the
teeth should be rinsed again & then handle sefely with gloved
hands.
90. OUCH – NEEDLESTICK INJURY
• Most infectious diseases transmitted by needle pricks are
1. HIV- 0.3% , 2. Hepatitis C- 3%, 3.Hepatitis B- 30%
• IMMEDIATE MEASURES:
Encourage the wound to bleed freely.
Wash thoroughly in running water with 70% alcohol/ antiseptic
hand wash.
Do not scrub the injury .
Cover the wound with appropriate dressing.
91. ASSESS THE SIGNIFICANCE OF RISK:
i. TYPE OF INJURY:
- penetrating injury ( greater risk)
- splashes on any mucous membrane – eye, oral mucous membrane , etc.,
ii. DEGREE OF CONTAMINATION:
- high risk if needle has penetrated artery/ vein
iii. INFECTIVITY OF THE MATERIAL TRASFERRED
-contaminated with blood or saliva.
iv. ASK THE PATIENT FOR PRESNCE OF ANY DISEASE
- talk to pts physician regarding pts health status in terms of above
disease.
- collect pts blood to screen for infectious disease.
92. • If the patient is HIV positive:
• For maximum effectiveness postexposure prophylaxis is
recommended that is administered within 1 hr.
• It is 70% effective in reducing the risk of trasmission .
• Prophylaxis regimen- zidovudine, lamivudine, & nelfinavir is
given for no. of weeks depending on the drug protocol.
• Side effects of prophylaxis can be debilitating & therefore routine
propphylaxis foe every needle stick injury cannot be advocated.
93. • If the patient is infectious for Hep B:
• Prior vaccination.
• Antibody titre of both patient & dentist should be checked.
• If the patient is infectious for Hep C:
• No active & passive immunization available.
• No past exposure drug regimen appears effective.
94. • How can it be minimized ( needles, burs, broken plstic, hand
instruments,etc.,)
1. Always pass inst. with sharp end pointing away from any person.
2. Remove burs/ultrasonic tips from hand piesesimmediately after use.
3. Pick up inst immediately.
4. Use one hand technique to resheath the needle.
5. Dispose off sharps into a solid container.
6. Use heavy duty gloves when cleaning instruments prior to
autoclaving.
7. Keep working area well organized & uncultured, with sharps in
separate areas.
95. FUTURE CONSIDERATIONS
• A potential threat on the horizon are prions (PREE-onz).
• Prions are glycoproteins found on cell surfaces. Modified
versions of normal prions cause various sloe-moving,
often fatal disease of nervous system.
• Almost impossible to sterilize in a dental office & they
have affinity for stainless steel.
• killed by some chemical treatments, such as sodium
hydroxide.
96. • Following are the methods followed prior to routine sterlization:
Method 1: immerse contaminated instruments in a pan of 1N NaOH &
heat in a gravity displacement autoclave for normal cycle of 121°
for 30min.
Method 2: immerse in either 1N NaOH or full strength bleach ( 20,000
ppm available chlorine) for 1hr; rinse; transfer to dry, open pan;
heat in gravity displacement autoclave at 121°C for 1hr.
Method 3: immerse in either 1N NaOH or full strength bleach for 1hr;
rinse; transfer to dry open pan; autoclave at 121°C in gravity
displacement autoclave or a conventional autoclave at 134°C for 1
hr.
97. Method 4: immerse and boil in 1N NaOH for 10min.
Method 5: immerse in 1N NaOH or full stregth bleach for 1
hr, rinse and subject to routine sterlization.
Method 6: autoclave at 134°C for 18min.
98. DISPOSAL OF WASTE
• Mercury, silver or other heavy metals should not be poured
down drains.
• Needles disposed in leak-proof bags which has OSHA
biohazard label.
• Separate needles, sharps into hard-walled, leak-proof bags out
of soft trash.
• Sharp & curved ends of inst should be turned away from
recipient's hands while passing inst to other individual.
• Needle-sheath holder/safety device should be used to resheath
the needle with only 1 hand.
• Burs should be removed from hand-pieces when
finished/pointed away from hands, body.
99. BIOMEDICAL WASTE MANAGEMENT
COLOUR CODING TYPE OF
CONTAINER
WASTE
PRODUCTS
TREATMENT
OPTIONS
YELLOW PLASTIC
CONTAINER
HUMAN TISSUES, BODY PARTS,BLEEDING
PARTS,INFECTED COTTON & DRESSING,
SOILEDPLASTER,CASTS,LINES,BLEEDIND
ITEMS CONTAMINATED WITH BLOOD
INCINERATION /
BURNING
RED DISINFECTED
CONTAINER/
PLASTIC BAG
AMALGAM, ZINC OXIDE EUGENOLPASTE,
GREEN STICK COMPOUND, TOOTH OR
BONE FRAGMENTS
DISPOSE IN
SECURE LAND
FIELD
BLUE/WHITE
TRANSLUCENT
DISINFECTED
CONTAINER/
PLASTIC BAG
NEEDLESGLASS, SCALPEL, FORCEPS,
BLADES, METAL CROWNS,BRIDGES,
OTHER USED & UNUSED SHARPS
AUTOCLAVING/
MICROWAVING/
CHEMICAL
TREATMENT
BLACK PLASTIC BAG DISPOSABLE ITEMS LIKE :
SYRINGES, BASE PLATE, IMMPRESSION
MATERIALS, BROKEN DENTURES, PLASTIC
BOTTLES & OTHER CONTAMINATED
PLASTIC ITEMS
DISPOSE IN
SECURE LAND
FIELD
100. CONCLUSION
• Adequate asepsis is a highly critical step in treatment.
• Sterilization procedures should be simple, effective, of
short duration.
• Procedures should not cause any appreciable damage to
dental inst & materials