Infection Control in Dental Settings: Key Concepts and Protocols

What is the primary purpose of infection control in dental settings?

To prevent infectious disease to the clinician and the patient.

What are standard precautions in infection control?

A standard of care that protects dental healthcare personnel and patients from pathogens spread by blood or other body fluids, non-intact skin, mucous membranes, excretion, or secretion.

What is the only time the oral cavity is sterile?

At birth, up to one day.

What are the essential components of the chain of infection?

Causative agent, reservoir, port of exit, mode of transmission, port of entry, susceptible host.

What types of microorganisms can act as causative agents of infectious diseases?

Viruses, bacteria, protozoa, fungi.

What are bloodborne pathogens of concern in dental procedures?

HBV (Hepatitis B Virus), HCV (Hepatitis C Virus), HIV (Human Immunodeficiency Virus).

Where can pathogenic microorganisms be found in the oral cavity?

In dental biofilm (plaque), periodontal pockets, and carious lesions.

What factors contribute to the transmission of pathogens in a dental environment?

Careless hand washing, inadequate sterilization, and improper handling of sterile instruments and materials.

What is a reservoir in the context of infection control?

A reservoir is where the invading organism lives and multiplies, such as in people, dental waterlines, and instruments.

What is the role of dental professionals in managing occupational health and safety issues?

They need to be knowledgeable about the prevention and control of infectious diseases.

What are the classifications associated with dental healthcare personnel (DHCP) and patient care materials?

Classifications include sterilization methods and biological monitoring systems.

What are the differences between regulated and nonregulated medical waste?

Regulated medical waste includes infectious waste that requires special handling, while nonregulated waste does not pose a risk of infection.

What are the risks associated with occupational exposure in dental hygiene?

Potential exposure to bloodborne pathogens and other infectious materials.

What are the guidelines for caring for environmental surfaces in a dental office?

Follow procedures for cleaning and disinfecting surfaces to prevent contamination.

What is the significance of training in infection control protocols for dental professionals?

Training ensures that dental professionals are equipped to prevent the transmission of infectious diseases.

What is the importance of written policies and procedures in a dental office?

They ensure consistency, efficiency, and effective coordination of infection control activities.

How can dental professionals prevent the transmission of diseases during patient care?

By adhering to infection control protocols and standard precautions.

What is the role of biological monitoring systems in sterilization?

They verify the effectiveness of sterilization processes.

What are the legal implications for healthcare providers with Hepatitis B?

Providers must follow specific protocols as outlined by the Board of Dentistry.

What is the impact of asymptomatic carriers in the transmission of infectious diseases?

Asymptomatic carriers may spread pathogens without showing symptoms of illness.

What are the procedures involved in clinical infection-control practices?

Application of standard precautions, sterilization, disinfection, and proper waste disposal.

What is the significance of understanding the infectious disease process in dental hygiene?

It helps in identifying risks and implementing effective infection control measures.

What is the port of exit in the context of infection transmission?

The mode of escape from the reservoir, which can include blood, saliva, coughing, sneezing, and waterlines.

What are the modes of transmission for infectious agents?

Infectious agents can be transmitted through direct or indirect contact, inhalation of organisms, and airborne contaminants.

How can infectious agents be transferred from person to person?

Through body fluids with open wounds, contact with inanimate objects like dental instruments, and airborne transmission during sneezing or dental procedures.

What is the port of entry for infectious agents?

The access site for the infectious agent to enter the host, which includes eyes, respiratory tract, open skin, needle sticks, and mucous membranes.

Who is considered a susceptible host?

A person who lacks effective resistance to a pathogenic agent, influenced by factors like nutritional status, heredity, medications, therapeutic procedures, underlying diseases, and immunization status.

What are the two types of immunity?

Passive immunity, which is temporary and transferred from one person to another, and active immunity, which is acquired through disease or vaccination and can provide lifelong protection.

What are the additional transmission-based precautions?

Droplet precautions for respiratory contact, contact precautions for skin contact, and airborne precautions to reduce airborne transmission.

What is the difference between aerosols and spatter in a dental office?

Aerosols are invisible solid or liquid particles that remain suspended in air, while spatter consists of heavier particles that drop on surfaces and people.

What constitutes dental occupational exposure?

Exposure resulting from a percutaneous injury or contact of mucous membranes or non-intact skin with potentially infectious body fluids.

What are the highest risk factors for blood exposure in dental settings?

Parenteral exposure (needle stick) and contact with mucous membranes or non-intact skin.

What factors influence exposure risks in dental settings?

Route of exposure, quantity of virus transferred, and susceptibility of the exposed dental team member.

What is required for occupational exposure training in dental offices?

Training must be provided at initial employment, when new tasks affect exposure, and annually.

What should be included in post-exposure evaluation and follow-up?

Administering first aid as necessary and washing puncture wounds with soap and water.

What are the examples of diseases transmitted through droplet precautions?

Mycobacterium tuberculosis, influenza virus, and chickenpox virus.

What are some examples of diseases requiring contact precautions?

Methicillin-resistant Staphylococcus aureus (MRSA).

What are the examples of airborne diseases?

Mycobacterium tuberculosis, SARS (COVID), and measles.

What is the purpose of the Immunizations and Infection Control Program?

To establish standard precautions and manage work-related illnesses and injuries, including post-exposure treatment.

What is the role of OSHA training in dental offices?

To review preventive strategies, infection control policies, and procedures related to occupational exposure.

What should be done immediately after an occupational exposure?

Administer first aid as necessary and wash the affected area with soap and water.

What are the factors that influence a person's susceptibility to infection?

Nutritional status, heredity, medications, therapeutic procedures, underlying diseases, and immunization status.

What is the significance of the port of entry in infection control?

It is crucial for understanding how infectious agents gain access to the host and how to prevent infection.

What is the importance of understanding modes of transmission in infection control?

It helps in implementing effective strategies to reduce the risk of infection spread.

What is the primary goal of infection control training in dental settings?

To ensure that dental professionals are knowledgeable about preventing the transmission of infectious agents.

What should be done to puncture wounds and mucous membranes after exposure?

Puncture wounds should be washed with soap and water, and mucous membranes should be flushed with water.

What documentation is required after an exposure incident?

Documentation must include the name and date/time of exposure, details of the exposure, type of exposure, source of exposure, and details about counseling, post-exposure management, and follow-up.

What is the vaccination schedule for the HBV vaccine?

The HBV vaccine is given at 0, 1, and 6 month intervals.

What are some immunizations that reduce susceptibility to disease for healthcare providers?

HBV, Influenza, MMR, Tetanus, Varicella-Zoster (Chicken pox).

What types of contact are included in Standard Precautions?

Contact with blood, saliva, all body fluids and excretions, non-intact skin, and mucous membranes.

What measures are taken to prevent airborne infections?

Eliminate or interrupt transmission and protect susceptible recipients.

What are preprocedural oral hygiene measures to prevent transmission?

Biofilm removal, such as tooth brushing, flossing, and using antiseptic mouth rinse.

What are some methods to ensure clean water in dental practices?

Flush waterlines, use self-contained water systems, chemical treatment, in-line water filters, and antiretraction devices.

What are some work practice controls to prevent transmission in dental settings?

Never recap, bend, or pass sharp instruments; dispose of them in puncture-resistant containers.

What does OSHA require regarding employee medical records?

Records must be kept confidential, not disclosed without written consent, and maintained for the duration of employment plus 30 years.

What is irritant contact dermatitis?

It develops due to dry, itchy, irritated areas on the skin from frequent use of hand products, exposure to chemicals, or glove use.

What is allergic contact dermatitis?

An allergy due to exposure to accelerators and other chemicals in glove manufacturing.

What are the symptoms of a latex allergy?

Symptoms can include asthma, difficulty breathing, cardiovascular and gastrointestinal issues, and anaphylaxis.

What are common predisposing conditions for latex allergy?

A history of spina bifida, genitourinary abnormalities, and allergies to certain fruits such as avocado, kiwi, papaya, peanuts, chestnuts, or bananas.

What are the three main processes in disinfection and sterilization?

Cleaning, disinfection, and sterilization.

What is cleaning in the context of infection control?

The physical removal of debris that reduces the number of microorganisms and removes organic matter.

What are the levels of disinfection?

Low level disinfection, intermediate level disinfection, and high level disinfection.

What are the properties of an ideal disinfectant?

Broad spectrum, fast acting, unaffected by organic matter, nontoxic, compatible with surfaces, residual effect, easy to use, odorless, and economical.

What is sterilization?

A process in which all types and forms of microorganisms are destroyed.

What are the three classifications of patient-care items?

Critical, Semicritical, Noncritical.

What defines critical patient-care items?

Instruments that penetrate soft tissue, contact bone or blood, requiring sterilization after each use or disposal.

What are examples of critical patient-care items?

Scaling instruments, surgical instruments, needles, curets, explorers, and probes.

What defines semicritical patient-care items?

Instruments not intended to penetrate soft tissue but come in contact with mucous membranes and non-intact skin, requiring sterilization after each use.

What are examples of semicritical patient-care items?

Dental handpieces and mouth mirrors.

What defines noncritical patient-care items?

Items that do not touch mucous membranes and are protected by barriers.

What are examples of noncritical patient-care items?

Countertops, equipment surfaces, safety eyewear, and X-ray tube heads.

What are the three main sterilization methods?

Autoclave (steam under pressure), Dry heat, Chemical vapor.

What is the most widely used sterilization method?

Steam sterilization using an autoclave.

What is the temperature and time requirement for steam sterilization in an autoclave?

121°C (250°F) for 15-30 minutes.

What are the advantages of steam sterilization?

Destroys all life forms quickly and efficiently, treats a wide variety of materials, and is the most economical method.

What is a disadvantage of steam sterilization?

It may corrode carbon steel instruments.

What is the principle of dry heat sterilization?

Sterilization is achieved by heat conducted from the exterior surface to the interior of the object.

What are the temperature and time requirements for dry heat sterilization?

160°C (320°F) for 2 hours; 170°C (340°F) for 1 hour.

What are the advantages of dry heat sterilization?

Useful for materials that cannot be subjected to steam, and no corrosion occurs.

What is a disadvantage of dry heat sterilization?

Long exposure time is required.

What is the operation temperature and time for chemical vapor sterilization?

132°C (270°F) for 20 minutes.

What are the advantages of chemical vapor sterilization?

Corrosion- and rust-free operation for carbon steel instruments.

What is a disadvantage of chemical vapor sterilization?

Adequate ventilation is needed, and it cannot be used in a small room.

What are the tests for sterilization?

External chemical indicators, internal chemical indicators, and biological monitoring.

What is the purpose of an external chemical indicator?

To seal the package and change color to show the autoclave temperature has been reached.

What is the purpose of biological monitoring in sterilization?

To assess the effectiveness of sterilization by culturing selected test microorganisms.

How should sterile instruments be stored?

In labeled, sterilized, and sealed packages stored unopened in clean, dry cabinets or drawers.

What is the typical shelf life for sterilized instruments?

Several months to 1 year.

What are the three types of monitoring sterilization systems?

Mechanical, chemical, and biological monitoring.

What does mechanical monitoring of sterilization involve?

Assessing cycle time, temperature, and pressure by observing gauges or displays on the sterilizer.

What is the purpose of chemical monitoring in sterilization?

To detect whether the unit is malfunctioning using internal indicators placed inside packages and external indicators like bags or tape that change color.

What does biological monitoring of sterilization use?

Bacterial spores impregnated on paper strips or sealed in glass ampoules.

What surfaces should be covered with barriers in a clinical setting?

Clinical contact surfaces such as light handles, unit switches, and radiographic equipment.

What is the recommended practice for dental unit water quality?

Bleed waterlines for 2 minutes at the start of each day and for 30 seconds between each patient.

What items are considered nonregulated medical waste?

Gloves, masks, gowns, lightly soiled gauze, and barriers.

What constitutes regulated medical waste?

Infectious waste that carries a risk of causing infection during handling and disposal, such as extracted teeth and contaminated sharps.

How should extracted teeth be handled?

They should be treated as regulated waste.

What type of container is used for non-sharp regulated waste?

A leak-resistant biohazard bag.

What type of container is used for sharp regulated waste?

A puncture-resistant container identified with a biohazard label.

What is the significance of disinfection for prostheses and impressions?

To protect laboratory personnel and ensure safety during handling.