Dental Terminology Ch 5

Infection Control

Disease

Pathological condition of the body, abnormal condition

Types of symptoms

Objective and subjective

Objective symptoms

Signs, evidence observed by someone other than the patient, ex: swelling

Subjective symptoms

Evidence of a disease as reported by the patient, ex: toothache

Syndrome

An assortment of signs and symptoms grouped together that characterize a disease

Pathology

The study of disease

Etiology

Cause of the disease

Diagnosis

Denoting name of disease

Prognosis

Prediction about the course of the disease

Acute

Sharp, severe, describes immediate symptoms such as high fever and pain or distress

Chronic

Not acute, drawn out, describes a condition present over a long time, often without an endpoint, such as a chronic fatigue and anemia

Remission

Lessening or abating, temporary or permanent cessation of a severe condition, such as a case of sinusitis or some stage of cancer

Epidemic

Among people or widespread, a condition prevalent over a wide population, such as many cases of flu or typhoid in an area

Pandemic

All people involved, a disease that is more widespread than an epidemic, occurring over a large geographical area and populace, sometimes worldwide

Endemic

In people, diseases occurring continuously in the same population or locality

Exogenous

Produced outside, refers to causes outside the body, such as illnesses arising from trauma, radiation, hypothermia, and so on

Endogenous

Arising from within the cell or organism, refers to causes arising from within the body, such as infections, tumors, and congenital or metabolic abnormalities

Congenital

Present from birth, refers to condition inherited from parents, such as cystic fibrosis

Degenerative

Breaking down, refers to conditions resulting from natural aging of the body, such as arthritis

Opportunistic

Taking advantage of, refers to disease or infection occurring when the body resistance is lowered, such as with fungal, bacterial, and viral infections.

Nosocomial

Disease in caregiving, refers to diseases passed on from patient to patient in a health-care setting, such as staphylococcal bacterial infections, MRSA, and others. Has been replaced by the terminology hospital-acquired infections in recent years

Monococci

Single form, oval/round form of bacteria

Diplococci

Paired form, oval/round form of bacteria

Staphylococci

Cluster form, oval/round form of bacteria

Streptococci

Chain form, oval/round form of bacteria

Sarcinae

Group of eight, oval/round form of bacteria

Bacilli

Rod-shaped, if oval in shape, coccobacilli, form of bacteria

Sprilla

Rigid, spiral form of bacteria

Spirochetes

Flexible, spiral form of bacteria

Vibrios

Curved rod, spiral form of bacteria

Bacteria

One-celled, plant-like microorganisms lacking chlorophyll

3 forms of bacteria

oval/rounded, rod-shaped, and spiral

Aerobic

Designated bacteria that require oxygen to live

Facultative aerobes

Bacteria that can live in the presence of oxygen but do not require it

Obligate or strict aerobes

Bacteria that cannot survive without oxygen, such as diphtheria

Anaerobic

Bacteria that do not need oxygen for survival

Facultative anaerobes

Bacteria that grow best without oxygen but can survive in its presence, for example, bacterium fusiform

Obligate or strict anaerobes

Bacteria that cannot live in the presence of oxygen

Flagella

Whips, small, whip-like hairs that provide movement for some bacteria

Spore

Thick-walled reproductive cell, this covering is hard to destroy

Viruses

Tiny parasitic organisms that cause diseases such as polio, hepatitis, colds etc, viruses require living matter to reproduce and grow

Rickettsia

Microbes smaller than bacteria but larger than viruses; usually transmitted by vectors such as fleas or ticks, causes diseases such as Lyme or Rocky Mountain spotted fever

Fungi

A division of plants that include mold, yeasts, and slimes, some fungi are beneficial, and others are pathogenic, the latter of which cause thrush, athlete’s foot, or ringworm

Two forms of fungi

Filamentous (molds) and unicellular (yeasts)

Protozoa

Small animal parasites or organisms, must live upon another organism called the host, protozoan organisms cause malaria, dysentery, and encephalitis, for example

Saprophytes

Organisms living on decaying or dead organic matter, such as tetanus bacillus (lockjaw)

Nematodes

Small parasitic worms such as threadworms and roundworms

Commensal

Living together, microbes that live together on a host without harming it, such as mouth flora

Blood-borne pathogens

Disease-producing microbes that are present in human blood

Droplet infection

Airborne infection in which pathogens discharged from the mouth or nose by coughing or sneezing are carried through the air and settle on objects

Indirect infection

Infection resulting from improper handling of materials, contamination or articles, or fomes, poor sterilization methods permit passage of microbes from one person to another

Contact infection

Infection that is passed directly through intimate relationship-contact with saliva, blood or mucous membranes

Parenteral entry

Refers to piercing of the skin or mucous membrane; also called “needle stick”

Carrier infection

Exchange of diseases by direct or indirect contact with an infected human or animal

Vector-borne infections

An infection that is transmitted by an organism such as a fly or mosquito

Food, soil, or water infection

Infection passed along by microbes present in these media, in the dental office, water lines may harbor a biofilm containing bacterial cells that adhere to moist surfaces and form a protective slime that can carry pathogens or nematodes

Chain of Infection

Causative Agent Pathogens, Reservoir Body Conditions, Port of Exit: cough, urine, feces, blood, Mode of Transmission: droplet, contamination, injection, Port of Entry: droplet, contamination, injection, Susceptible Host: human/animal/plant

Immunity

Resistance to organisms due to previous exposure, may be affected by the virulence of a disease, and classified either natural, artificial, active or passive

Natural Immunity

Inherited and permanent

Natural Acquired Immunity

Obtained when a person is infected by a disease, produced antibodies, and then recovers from that disease

Artificial acquired immunity

Obtained from inoculation or vaccination against a disease

Passive acquired immunity

Results from receiving antibodies from another source, such as breast milk, or from injections of gamma globulin, antitoxins, or immune serums

Passive natural immunity

Passes from mother to fetus, congenitally or through antibodies in breast milk

Immunocompromised

Having a weakened immune system, resulting from drugs, irradiations, disease such as AIDS, or malnutrition

Inoculation

Injection of microorganisms, serum, or toxin into the body

Vaccination

Inoculation with weakened or dead microbes

Antigen

Substance that induces the body to form antibodies

Antibody

Protein substance produced by the body in response to an antigen

Vaccine

Solution of killed or weakened infectious agents injected to produce immunity

Autogenous vaccine

Vaccine produced from a culture, or bacteria taken from the patient who will receive the vaccine

Attenuated

Diluted or reduced virulence of pathogenic microbes

Asepsis

Free from germs

Sanitation

Application of methods to promote a favorable germ-free state

Disinfection

Application of chemicals to kill, reduce, or eliminate germs

Sterilization

The process of destroying all microorganisms

Universal precautions

Assuming all patients are infectious and applying every method of combating disease and infection

Critical

Instruments used to penetrate soft tissue or bone, or enter into the bloodstream such as forceps, scalpels or chisels, steam under pressure, dry heat, or heat/chemical vapor sterilization are suggested

Semi-critical

Instruments that do not penetrate soft tissues or bone but contact the mucous membrane or non-intact skin, high levels disinfection is appropriate if heat/pressure/chemical is not feasible

Noncritical

Instruments that come into contact with intact skin, such as blood pressure cuffs X-ray heads, and so on, EPA-registered “hospital disinfectant” such as phenols and iodophors are acceptable

Sterilization

Total killing of all microbes

Disinfection

Obtaining a germ-free area as much as possible

After use, instruments should ber

Cleaned of debris with enzymatic solutions and then rinsed, dried, packed, and wrapped in cassettes/trays, or prepared as recommended by their manufacturer

Autoclave

Apparatus fore sterilization by steam pressure, temperature (121C, 250F), pressure (15 psi) and time (20 min) are regulated, liquids with lids ajar and linen-wrapped packs require longer exposure, liquids need cooling down and depressurizing periods before removal from units

“Flash” autoclave

Smaller autoclave with higher temperature setting (132C, 270F) will lessen exposure time (3-5 min) required to obtain sterilization

Dry heat sterilization

Oven apparatus used for a hot air bake at high temperature (170C, 340F) for a longer period of time (2 hours), this method is not useful for plastic materials or some paper objects

Molten metal or glass bead heat

Devices holding superheated (234C, 450F) molten metal or small glass beads; used mainly in endodontic practice (no longer recommended by the CDC)

Chemical vapor sterilization

Use of chemicals and heat of 132C or 270C unit for 20 minutes, noncorrosive method that is used on loose or unwrapped articles, particularly metals, proper ventilation and manufacturer’s directions must be followed

Ethylene oxide

Sterilizing unit used at room temperature and required prolonged exposure and devaporization time (10-12 hours), heated units (49C or 120F) require less time (2-3 hours), useful for plastics and materials that do not tolerate heat, not popular in dental office because of size, cost, and toxic devaporing requirements

VPH (vaporized hydrogen peroxide)

Gas plasma sterilization using hydrogen peroxide that is ionized to release vaporized gas molecules capable of killing microorganisms and endospores in a short period ( < 1 hour) with no vapor clear-off time concerns’ compatible with most materials, except liquids, powders, and absorbents, plasma is the fourth stage of matter, because of the size and expense of these machines, they are found in hospital, institutions, and larger dental clinics

Chemical agents

Liquids containing chemicals that kill microbes and spores and require longer immersion time, some chemicals may be disinfectants and/or sterilizers, chemicals classified as sterilants require long (6-10 hours) soaking to kill spores

Indicator strips or commercial spore vials

Placed in or on wrapped items during the sterilization cycle to indicate effectiveness of the sterilizing processj

Two types of indication

Biological and process

Biological indication

Monitoring of sterilization cycle by office spore strips, culture tubes, and vials with encased germs spore indicators that are routinely sent out for laboratory testing to assure that the sterilization process has been achieved

Process indication

Tapes or marked autoclave sleeves indicate that heat conditions have been obtained but do not guarantee that pressure and time have completed the sterilization, the markings on the autoclave bag or sleeve tape change color when exposed to the proper sterilizing conditions, the wrapping or sleeving of the articles provide protection from contamination in handling after sterilization

Cassette Trays

Used to contain instrument setups that travel from operatory use to the ultrasonic cleaning, rinsing, and wrapping for sterilizing and storage until the next use, marked and dated; they may be color-coded to signify which operatory, procedure, operator, or any designation desired for organization

Expensive equipment handling (handpieces, probes, etc)

Should be lubricated and sterilized according to the manufacturer’s directions

Disinfection control

Application of chemicals to kill, reduce, or eliminate germs through soaking, spraying foams, sponges, or wipes

Disinfectant

Chemical or agent that kills many microbes, choice of type, concentration and use is necessary for each item

Antiseptic

Usually, a diluted disinfectant that prevents the growth or inhibits the development of microbes

Bacteriostatic

Inhibiting or retarding bacterial growth