Infection Control 4.

Mucous membrane

Why important ? HEPATITIS B

1. DHCP ad patients both expose to pathogen
2. Contact blood,oral and respiratory Blood-Borne Pathogen
secretions, and contaminated equipments - Hepatitis B (Highest)
3. Proper procedures can prevent - Hapatitis C
transmission of infection - HIV (lowest)
Goals HBV
- Provide safe working environment High Moderate Low
1. Blood 1. Semen 1. Urine
Program Evaluation 2. Serum 2. Vaginal 2. Feces
“Systematic way to improve (infection control) 3. Wound Fluid 3. Sweat
procedures so they are useful, feasible, ethical, exudates 3. Saliva 4. Tears
and accurate” 5. Breastmilk
 Develop standard operating procedures
 Evaluate infection control practices Prevention: Hepatitis B Vaccine
 Document adverse outcomes
 Document work-related illnesses HEPATITIS C (low risk)
 Monitor health care-associated infections Modes
How? 1. Blood splash to eye
- Periodic observational assessments
- Checklists to document procedures HIV
- Routine review of occupational exposures Risk Factor
to bloodborne pathogens 1. Deep Injury
2. Visible blood on device
Modes 3. Needle place in artery and vein
1. Direct contact : blood or body fluids 4. Terminal Illness in patients
2. Indirect contact : instrument
3. Contact mucosa of eyes, nose, mouth with Percutaneous Injury
droplets or spatter ( sneeze) 1. Burs, syringe, needles
4. Inhalation of airborne 2. Outside patient mouth
3. Small amount vlood
Standard Precaution (Applies to all patient)
1. Handwashing
2. Use of gloves( prevnt micro & Prevention
contamination , mask, eye protection ,
gowns Engineering Control
3. Patient care equipment - Isolate and remove hazard (sharp
4. Environmental surfaces container)
5. Injury prevention Work Practice Control
- Change maner ( use instrument instead
Universal Precaution finger)
- Prevent transmission of blood bourne Adminstrative Control
pathogen - Policy, procedure and enforcement
- Blood and certain body fluid should be
treated as infectious – may have
bloodbourne virus POST-EXPOSURE MANAGEMENT PROGRAM
1. Blood 1. Clear Policies and procedures
2. All body Fluids, secretions, excretions 2. Education
except sweat 3. Rapid access to clnical care, post-exposure
3. Non-intact skin prophylaxis , testing source patient
 4. Wound Management 3. Latex-free kits
5. Exposure eporting
6. Assessment of infection risk
- Type and severity STERILIZATION & DISINFECTION OF PATIENT CARE
- Bloodborne status of a person ITEMS
- Susceptibility of edxposed person CRITICAL SEMI- NON-CRITICAL
- Penetrates CRITICAL - Contact intact
(heat sterilize)- Contact skin
HAND HYGIENE (single-use) mucus (Low
membrane intermediate
Indications only Level
 Hands are the most common mode of (Heat Sterile) Disinfect)
pathogen transmission (high-Level
 Reduce spread of antimicrobial resistance Disinfect)
 Prevent health care-associated infections 1. Bur 5. Mirror 1. X-ray head
2. Scalpel 6. Amalgam 2. Facebows
1. Handwashing 3. Scaler Condenser 3. Pulse
2. Antiseptic Handwash 4. 7. Handpiece oximeter
3. Alcohol-based Handrub 4. Blood
4. Surgical Antisepsis pressure cuff
- Antiseptic soap
- Alcohol-based Handrub
INSTRUMENT PROCESSING AREA
Special Hygiene Considerations
1. Lotion to prevnt dryness 4 Areas
2. Fingernails short 1. Receiving, Cleaning, decontamination
3. Avoid jwellery - Automated Claening
Alcohol-based  Ultrasonic Cleaner
Advantage Limitations  Instrument Washer
1. Rapid and 1. If hand soiled,  Washer-Disinfector
effective cant use - Manual Cleaning
antimicrobial 2. Store from high
action temo
2. Improve skin 3. May have glove 2. Preparation and Packaging
condition powders - ......
3. Skin more 3. Sterilization
accesible HEAT-BASED STERILIZATION
- Steam under pressure(autoclaving)
GLOVES PROBLEM o Gravity Displacement
Latex Allergy o Pre-vacuum
1. Type 1 Hypersensitivity - Dry Heat
- Due to natural rubber latex protein - Unsaturated Chemical Vapour
- May cause nose, eye, skin reaction LIQUID CHEMICAL STERILANT
- Respiratory Distress - Heat-sensitive/ critical ans semicritical
devices
2. Contact Dermatitis - Powerful toxic
( Type 4 Delayed Hypersensitivity)
- May due to chemicals Type of Indicators
1. Mechanical : measure time, tempt,
Recommendation: pressure
1. Screen 2. Chemical : chnage in color when phyical
2. Educate parameter reached
 3. Biological( spore test) : 2. Dental Radiology
3. Aseptic technique for parenteral
4. Storage medications
- .... 4. Single use (disposable) devices
5. Preprocedural mouth rinse: reduce no
ENVIRONMENTAL micro in aerosol
Categories 6. Oral surgical procedurea
1. Clinical Contact surface 7. Handling biopsy specimens: leakproof
- Spray container,label biohazard symbol
Cleaning 8. Handling extracted teeth
 Dont use High-level Disinfectants - Remove visible blood and debris
 Use EPA-registered low hospital - Maintain hydration
disinfectant (HIV/ HBV claim) - Autoclave (teeth with no amalgam)
 Intermediate level Hospital Disinfectant - Use standard precaution
(TB) 9. Laser/electrosurgery plumes / surgical
 Use barrier precaution : gloves, mask, smoke
eyewear - Infectious materials (HSV, HPV) may
contact mucous membranes of nose
2. Housekeeping Surface - No evidence HIV trnasmission
- Not contact patient device 10. Myocbacterium TB
Cleaning - Droplet
 Soap and water - Alive in lung may years (latent TB Infection)
 EPA-registered detergent/ hospital - Risk: rare
disinfectant - Preventon:
o Assess patients for history of TB
MEDICAL WASTE o DHCP should wear face mask
Regulated Medical Waste Management o Separate patient from
1. Label to prevent injury others/mask/tissue
2. Autoclaving o Refer to facility with proper TB
3. Incineration infection control precautions
11. Creutzfeldt-Jacob Disesase (CJD)
- a fatal degenerative disease of central
DENTAL UNIT WATERLINE AND BIOFILM
nervous system
- <500 CFU/ML OF heterotrophic water
- Cause: abnormal “prion” protein
- Long incubation period
* Available Duwl Technology
* Variant CJD (vCJD) is the human version
1. Independent Reservoir
of Bovine Spongiform Encephalopathy
2. Chemical Tretment
(BSE)
3. Filtrations
Infection control for CJD
4. Combinations
a) Use single-use disposable items
5. Sterile water Delivery systems
b) Consider items difficult to clean (e.g.,
endodontic files, broaches) as single-use
Monitoring Option
disposable
1. Water Testing Laboratory
c) Keep instruments moist until cleaned
2. Office: test with self-contained kits
d) Clean and autoclave at 134°C for 18
minutes
Sterile Irrigating Solutions
e) Do not use flash sterilization
- Sterile saline / sterile water as
cooleant/irrigator

Special Considerations
1. Dental handpiece attached to air and
waterlines