Infection Control

Ratih Widyasari, drg., SpKG Conservative Dentistry

PRODI GIGI FK UNJANI 2012

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 disease

universal 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)

Aerosol Mists Spatter (splashing of mucosa) ---> potential route of dental infection ----> Adequate air circulation

Hand-to-surface Contamination

by gloves ---> to surface of items and areas do 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 immunized

Impact 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

To prevent cross-contaminationall items that are touched with saliva coated hands must be rendered free of contamination Before treating the next patient

During each appointment:

- remember, whatever is touched is contaminated - directly touch only what has to be touched (anticipate ur needs)

Use one of the following to control contamination: a. clean and stelize it b. 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 pressure 134oC at 7 minutes w/30 pounds pressure

Chemical vapor pressure (chemiclave) Dry heat sterilization (dryclave)

131oC at 90 minutes w/ 20 pounds pressure

conventional 160oC for 30 minutes Short-cycle high temp 6 minutes to 12 minutes w/higher degrees (375oF)

Ethylene oxide sterilization

below 100oC ovenight Still do but Not recomended:

Boiling water or pressure cooker

100oC for 10 minutes

Liquid sterilants Glutaraldehydes 2-3% 6-10 hours

Summary

Barrier SOPs Sterilization methods Vaccines