Presntation of infqction control in destry

Infection control procedure

1. INFECTION CONTROL IN DENTISTRY

2. Why Is Infection Control Important in Dentistry? • Both patients and dental health care personnel (DHCP) can be exposed to pathogens • Contact with blood, oral and respiratory secretions, and contaminated equipment occurs • Proper procedures can prevent transmission of infections among patients and DHCP

3. Modes of Transmission of infection  • Direct contact with blood or body fluids • Indirect contact with a contaminated instrument or surface • Contact of mucosa of the eyes, nose, or mouth with droplets or spatter • Inhalation of airborne microorganisms

4. Chain of infection Pathogen Susceptible Host Entry Mode Source

5. Standard Precautions . Hand Hygiene.   . Use of gloves, masks, eye protection, and gowns-PPE.   . Surface asepsis   . Re-processing of equipment . Sterilization Methods . Waste management.   . Injury prevention.

6. Hand Hygiene Why Is Hand Hygiene Important? Hands are the most common mode of pathogen transmission Reduce spread of antimicrobial resistance Prevent health care-associated infections

7. Hand Hygiene When to wash your hands . Visibly dirty After touching contaminated objects with bare hands Before and after patient treatment (before glove placement and after glove removal)

8. Hand Hygiene Types of hand washing . • Handwashing – Washing hands with plain soap and water • Antiseptic handwash – Washing hands with water and soap or other detergents containing an antiseptic agent • Alcohol-based handrub – Rubbing hands with an alcohol-containing preparation • Surgical antisepsis – Handwashing with an antiseptic soap or an alcohol-based handrub before operations by surgical personnel

9. Efficacy of Hand Hygiene Antimicrobial soap Alcohol- based handrub Plain Soap good better best

10. Personal Protective Equipment Masks, Protective Eyewear, Face Shields Wear a surgical mask and either eye protection with solid side shields or a face shield to protect mucous membranes of the eyes, nose, and mouth Change masks between patients Clean reusable face protection between patients; if visibly soiled, clean and disinfect

11.   Protective Clothing Wear gowns, lab coats, or uniforms that cover skin and personal clothing likely to become soiled with blood, saliva, or infectious material Change if visibly soiled Remove all barriers before leaving the work area

12. Gloving Wear gloves when contact with blood, saliva, and mucous membranes is possible Remove gloves after patient care Wear a new pair of gloves for each patient Remove gloves that are torn, cut or punctured Do not wash, disinfect or sterilize gloves for reuse

13. Surface Asepsis Use surface barriers to protect clinical contact surfaces , particularly those that are difficult to clean ( e.g. Switches on dental chair ) Light handle , countertop , bracket tray , dental chair change surface barriers between patients

14. Disinfection of Dental Equipments Clinical contact surface and dental equipments that are not covered should be cleaned and disinfected with a hospital level disinfectant after each patient . Sodium hypochlorite is an effective and economical surface disinfectant

15.  Re-processing of equipment • Critical Instruments:   Penetrate mucous membranes or contact bone, the bloodstream, or other normally sterile tissues (of the mouth) Heat sterilize between uses or use sterile single-use, disposable devices  Examples include surgical instruments, scalpel blades, periodontal scalers, and surgical dental burs

16.  Re-processing of equipment  Semi-critical Instruments:    Contact mucous membranes but do not penetrate soft tissue o Heat sterilize or high-level disinfect  Examples: Dental mouth mirrors, amalgam condensers, and dental handpieces

17.  Re-processing of equipment   Noncritical Instruments and Devices :  Contact intact skin   Clean and disinfect using a low to intermediate level disinfectant   Examples : X- ray heads , facebows , pulse oximeter , blood pressure cuff

18. Instrument Processing Area     Use a designated processing area to control quality and ensure safety   • Divide processing area into work areas Receiving , cleaning , and decontamination  ,  Preparation and packaging ,  Sterilization ,  Storage

19. METHODS OF STERILIZATION  The 4 accepted METHODS OF STERILIZATION are: • Steam pressure sterilization (autoclave) • Chemical vapor pressure sterilization- (chemiclave) • Dry heat sterilization (dryclave) • Ethylene oxide sterilization

20. METHODS OF STERILIZATION  AUTOCLAVE • Sterilization with STEAM UNDER PRESSURE • Time required at 121° C is 15 mins at 15 lbs of pressure. Advantages • Rapid and effective • Effective for sterilizing cloth surgical packs and towel packs Disadvantages • Items sensitive to heat cannot be sterilized • It tends to corrode carbon steel burs and instruments 

21. METHODS OF STERILIZATION  CHEMICLAVING Sterilization by CHEMICAL VAPOR UNDER PRESSURE • operates at 1310 C and 20 lbs of pressure. • They have a cycle time of half an hour.   • Advantages • Carbon steel and other carbon sensitive burs, instruments and pliers are sterilized without rust or corrosion • Disadvantages • Items sensitive to elevated temperature will be damaged • Instruments must be very lightly packed. • Towel and heavy clothing cannot be sterilized

22. METHODS OF STERILIZATION  Dry Heat Sterilization Conventional dry heat ovens: • Achieved at temperature above 1600 C. • Have heated chambers that allow air to circulate by gravity flow. • 6-12mins is required for sterilization   • Disadvantages • Without careful calibration, more chances sterilization failures –The most accurate way to calibrate a sterilization cycle is by using external temperature gauge (pyrometer) attached to a thermocouple wire

23. METHODS OF STERILIZATION ETHYLENE OXIDE STERILIZATION (ETO) MOBILE FUMIGATOR 71 • Advantages : Operates effectively at low temperatures Gas is extremely penetrative Can be used for sensitive equipment like handpieces. Sterilization is verifiable • Disadvantages : Potentially mutagenic and carcinogenic. . Requires aeration chamber ,cycle time lasts hours . Usually only hospital based .

24. Medical Waste   Medical Waste : Not considered infectious , thus can be discarded in regular trash Regulated Medical Waste : Poses a potential risk of infection during handling and disposal

25. Specific Precautions Before Treatment   Run water through each water system   Clean and disinfect with detergent :   Working surfaces   Dental equipment   Reduce   the number of equipment laid out ready for use to a minimum .

26.   Wherever possible , instruments should be sterilizable or disposable Cling-film should be placed across the chair buttons , light handles , ultrasonic scaler handpiece and 3-in-1 syringe . The film is changed after every patient .

27. During   Treatment During Treatment   In a small area around the patient ( includes the dental unit and extends to include the waste disposal bag ), only essential equipment , instrument , materials and personnel should be in this area of potential high contamination . The contents of the treatment should be kept to a minimum   Open cuts and fresh abrasions to the skin should be covered with a waterproof dressing

28. During Treatment Touching anything other than “ essential items ” with gloves / hands should be avoided .  A good working posture should be maintained to reduce facial contamination from the patient's mouth High volume suction should be used to reduce dental aerosols

29.   During Treatment Blood or body fluid spillage must be dealt with as soon as it happens : Hypochlorite granules can be sprinkled over the spillage . Alternatively , disposable tissues can be placed over the spillage and then strong hypochlorite poured on to paper towels which are placed over the spill and left for 30 minutes .

30. Personnel   Health   Elements   of   an   Infection   Control   Program   Education and training   Immunizations   Exposure prevention and postexposure management   Medical condition management and work-related   illnesses and restrictions Health record maintenance

31. THANK YOU