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Infection Control

Infection Control . Disease Transmission and Sterilization. Tiffany Baggs , RDH, BASDH Joy Davis, RDH, BASDH. Objectives for DHCP Responsibility of entire dental team Work practices prevent cross-contamination.

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Infection Control

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  1. Infection Control Disease Transmission and Sterilization Tiffany Baggs, RDH, BASDH Joy Davis, RDH, BASDH

  2. Objectives for DHCP Responsibility of entire dental team Work practices prevent cross-contamination

  3. An approach to infection control in which all human blood and certain human body fluids are treated as if known to be infectious. Universal Precautions

  4. Protects the DHCP and patients from pathogens that can be spread by blood or any other body fluid, excretion, or secretion • Blood • All body fluids (except sweat) • Non-intact skin • Mucous membranes Standards of care -Level of clinical performance expected for the safe, effective and ethical practice of dental hygiene. (CODA) Standard Precautions

  5. P.P.E. • Clinical attire • Hair • Face mask • Protective eyewear • Gloves • CDC recommendations Personal Protective Equipment

  6. Introduction of microorganisms, blood or infectious material onto a surface or into tissue Cross-contamination • Person to person • Person to inanimate object • Inanimate object to another person • Brainstorm – Consider a dental appointment what all might occur that would cause cross contamination to happen? Contamination

  7. Disease Transmission

  8. Number of organisms, duration of exposure • Virulence of the organism • Immune status of host • Host general physical health and nutritional status Factors Influencing the Development of Infection

  9. Abnormal physical conditions • Systemic diseases • Drug therapy • Prostheses and transplants Factors That Alter Normal Defense

  10. Dust-borne organisms • Aerosol production • Aerosols: biologic contaminants, solid or liquid, invisible, remains suspended in air for long periods of time • Spatter : larger than aerosols, may be visible • Origin: breathing, speaking, coughing, sneezing • Contents: microorganisms, • Cavity preparation, ultrasonic scaling Air-borne Infection

  11. Pre-procedural oral hygiene measures • Tooth brushing and flossing • Antiseptic mouth rinse WHY? (chlorhexidine, Listerine) • Interruption of transmission • Rubber dam, high volume evacuation, manual scaling • Clean water • Run waterlines 2-3 minutes before first patient, 30 seconds between patients • Protection of the clinician: PPE • Protection of the patient: protective eyewear. WHY? Prevention of Transmission

  12. Use waterlines that meet EPA regulatory standards for drinking • Biofilms form in tubing and waterlines that lead to hand-pieces, air-water syringes, & ultrasonic • Human pathogens including Pseudomonas, Legionella, Non-TB, & Mycobacterium species • Source of infections immuno-compromised patient Waterlines

  13. Use enclosed water systems Flush lines Avoid heating units Educate http://www.osap.org/?page=Issues_DUWL

  14. Free from contamination of microorganisms • Chain of asepsis: a procedure that avoids transfer of infection • Includes sterile conditions • Elimination of infection is the key to Asepsis not necessarily Sterile.

  15. Sterilization Process by which all forms of life, including bacterial spores, are destroyed by physical or chemical means Disinfection An agent (chemical, x-ray, ultraviolet light) Destroys microorganisms but may not kill bacterial spores Substance applied to inanimate objects Sanitation The process by which organisms on inanimate objects is reduced to a safe level, cleaning process

  16. Cleaning procedures Instrument washer or thermal disinfectors (Miele) Ultrasonic processing- Used in most dental offices, Prior to sterilization Manual cleaning- Wet 2X2 (Nitrile gloves) Miele Instrument Cleaning

  17. To prevent contamination of sterilized instruments as soon as they are removed from sterilizer. • Provide a means of storing instruments to have them available for patient appointment use • WHY? Purpose of Packaging

  18. Process by which all forms of life, including bacterial spores, are destroyed by physical or chemical means • Approved methods • moist heat- steam under pressure; dry heat- oxidation, chemical vapor • Method selection • All items can not be sterilized by certain methods. IMPORTANT CONCEPT • Tests for sterilization • External chemical indicator • Internal chemical indicator • Both • Biologic monitor- Spore testing Sterilization

  19. Methods of sterilization

  20. Glutaraldehydes- (High) Alkaline, acidic, and neutral (Cold sterile soak) • Chlorines- dentures, water purification • Iodophors- broad spectrum, surface disinfectant • Phenolics- Synthetic (water or alcohol based) Chemical Disinfecting Agents

  21. Instrument Cleaning and Processing

  22. Steps for labeling packaged Instruments….

  23. Inanimate Objects

  24. The End!

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