Infection Control

Ratih Widyasari, drg., SpKGConservative DentistryPRODI GIGI FK UNJANI2012

Exposure Risks and Effect of Infection on Denstistry Clinic's Highest Standard of Care Minimize patient's anxiety of treatment Providing a supportive, informal, relaxed and non

threatening operatory environment Assuring and demonstrating to patients that they are well

protected from risks of infecious diseaseuniversal use of:- treatment gloves- masks- protective eyewear- overgarments- plastic barrier to protect equipment- proper use of disinfectants- instrument sterilization

Environment of Dental Operatory

Airborne Contamination(transmitting respiratory infections)AerosolMistsSpatter (splashing of mucosa) ---> potential route of dental infection----> Adequate air circulation

Hand-to-surface Contaminationby gloves ---> to surface of items and areasdo conscientious cleaning and disinfecting- barrier protection of personel anf equipment- instrument sterilization- avoiding direct contact w/ various surface

Environment of Dental Operatory

Cross-infections Patient Vulnerability Personnel Vulnerability

Impact of:- Hepatitis B- HIV/AIDS

Impact of Hepatitis B Transmitted through blood and body-fluid A vaccine has dramatically curtailed HB infection

among dental personnel who have been immunizedImpact of HIV and AIDS Universal Precaution (IC) IC has helped dramatically allay risks and concerns of

personnel in private dental practice

Medical History

Serve the following purposes:(1) to detect any unrecognized illness taht requires medical diagnosis

and care(2) to identify any infection or high risk that may be important to a

clinical person exposed during examination, treatment, or clean-up perocedures

(3) to assist in managing and caring for infected patients(4) to reinforce use of adequate IC procedures, bearing in mind taht

general history taking is not capable of detecting all infectious people

Only conscientious use of universal precautions provides safety

Personal barrier protection Gloves Instruction for hand washing Protective ayewear, mask and hair

protection Protective overgarments Disposal of clinical waste (in drain) Disposal of needle

Overview of Aseptic Technique

The concept of asepsis

During each appointment:- remember, whatever is touched is contaminated- directly touch only what has to be touched (anticipate

ur needs)

To prevent cross-contamination-all items that are touched with saliva coated hands

must be rendered free of contaminationBefore treating the next patient

Use one of the following to control contamination:

a. clean and stelize itb. protect surfaces and equipment that are

not sterilized with dispossible-single use covers

c. use a paper towel or plastic over gloves to briefly handle equipment

d. scrub and disinfect noncritical surface as well as possible

Procedures, materials and devices cleaning instruments before sterilization Procedures for instrument processing Ultrasonic cleaner and solutions Instrument containment

Sterilization

The four accepted methods of sterilization are: Steam pressure sterilization (autoclave)121oC at 15 minutes w/ 15 pounds pressure134oC at 7 minutes w/30 pounds pressure Chemical vapor pressure (chemiclave)131oC at 90 minutes w/ 20 pounds pressure Dry heat sterilization (dryclave)conventional 160oC for 30 minutesShort-cycle high temp 6 minutes to 12 minutes w/higher degrees (375oF) Ethylene oxide sterilizationbelow 100oC ovenightStill do but Not recomended: Boiling water or pressure cooker100oC for 10 minutes

Liquid sterilantsGlutaraldehydes 2-3% 6-10 hours

Summary

Barrier SOPs Sterilization methods Vaccines