DNTL 14: Ch.5 Infection Control Transmissible Diseases (Week 1 Into to Clinic)

DHCP meaning?

Dental Healthcare Personnel

Who are we protecting

- Self

- Patients: they are trusting that you wash your hands and that the operator has been disinfected

- Subsequent Patients: if patient has something contagious, if you don't properly disinfect, the next patient can get that form of disease from previous patient.

- Coworkers:

- Family :be cautious of bringing anything contagious to the home, which is why we wear PPE

Infectious Agent

- Bacteria

- Viruses

- Fungi

- Protozoa (parasites)

- Helminths(parasites)

- Prions

Produce infection or disease.

Immunity and Vaccinations (3)

- Passive Immunity

- Active Immunity

- Vaccines

Passive Immunity

- protection from one person to another.

- When a person is given antibodies rather than making them.

Active Immunity

- Protection from having disease and recovering. ( naturally acquired due to infection immune system produces antibodies)

- Protection from vaccination. ( artificially acquired via vaccines stimulates immune system to produce antibodies.

Vaccines

Provide immunity by stimulating the immune system to produce antibodies

Cross contamination

Spreading microorganisms from one source to another.

- Careless hand hygiene

- Inappropriate use of PPE

- Inadequate sterilization and disinfection

Standard Precautions

- Minimum standard of care to protect DHCP and patients

- Applies to all patients

- Applies to contact with blood, saliva, all body fluids, broken skin, mucous membranes

Transmission Based

- Droplets (sneezing, coughing, talking)- pertussis, influenza, SARS-CoV-2

- Contact (direct or indirect contact)- MRSA

- Airborne (remain in the air)- Mycobacterium tuberculosis, SARS-CoV-2, measles

- Sharps (needlestick, other sharp instruments)-HBV, HIV

Virulence

the amount of pathogenicity in infectious agent

Vector

a carrier of infectious agent

Fomite

inanimate object (non living thing) containing infectious agent. Ex: the chair, countertop,

Parenteral

infection by other means than alimentary. Occurring elsewhere in the body other than the mouth.

Percutaneous

through the skin

Prodrome

symptom indicating onset of disease

Reservoirs

Where infectious agents are found in their essential environment

-People

- Equipment

- Instruments

- Dental Unit Waterlines

Port of exit

Definition: mode of escape from the reservoir

- Body fluids

- Skin and mucous membranes

- Aerosols, droplets, spatter

Port of Entry

Definition: mode of entry into the new host

- Body fluid

- Skin and mucous membrane

- Droplets,spatter

- Needlestick

- Inhalation

- Eyes

Susceptible Host

Definition: host that does not have the immunity or defense to the infectious agent

- Immunocompromised

- Elderly

- Medically compromised

- Preexisting transmissible disease

- Nonvaccinated

Transmission

Definition: how infectious agent travels

- Direct/indirect contact

- Cough

- Sneeze

- Speak

- Breathe

Aerosols, Droplets and Spatter

- Solid or liquid particle suspended in air

- Spatter is bigger and suspended in air less time ( drops down, quicker than an aerosol)

- Aerosols can contain: Staph, strep, M. tuberculosis, and viruses

- Can travel room to room ( Ex:Being in an airplane, everything is contained)

- Droplets can be the same as aerosols, spatter is bigger

- Can settle in dust

- Tetanus and enteric bacteria that travel in dust around treatment area

Control of airborne transmission

- Medical History Review

- High volume suction with high-speed handpieces

- Releaf evacuation with ultrasonic

- Pre-procedural rinse (Chlorehexidine CHX- oral mouth rinse proven to decrease microbes) 30 seconds- 2 minutes, swish, spit into cup, suction rinse in cup

Blood Born pathogens

- 20 bloodborne pathogens..3 DHCP dangers

- Three are most dangerous to dental:

HBV

HCV: No vaccine

HIV: No vaccine

Control of Bloodborne Pathogens

- Safe Sharp handling protocol

- Immediate Sharps disposal

- Puncture resistant gloves when handling instruments

Mode of transmission HAV (Hepatitis A Virus)

- Fecal Oral

- ingestion of contaminated food or water

- close contact

- sexual contact

Mode of transmission HBV (Hepatitis B Virus)

- Percutaneous, mucosal, nonintact skin exposure to blood and body fluids.

- Sexual contact

- Perinatal

- Shared injection drug equipment

- Contaminated sharps exposure

- Remains infectious on inanimate objects for 7 days

Mode of transmission HCV (Hepatitis C Virus)

- Percutaneous, mucosal, nonintact skin exposure to blood and body fluids.

- Sexual contact

- Perinatal

- Shared injection drug equipment

- Contaminated sharps exposure

- Tattooing needles

Mode of transmission HDV (Hepatitis D Virus)

- HDV only occurs as coinfection or superinfection with HBV

- Percutaneous, mucosal, nonintact skin exposure to blood and body fluids.

- Sexual contact

- Perinatal

- Shared injection drug equipment

- Contaminated sharps exposure

Mode of transmission HEV (Hepatitis E Virus)

- Fecal oral

- Ingestion of contaminated food or water

More diseases of concern in dental office

• Tuberculosis

• Herpes-HHV1 (Herpetic whitlow (fingers))

• Varicella-zoster virus-HHV3 (chicken pox, shingles)

• Epstein-Barr virus- HHV4 (mono)

All HHV viruses are transmitted

saliva, mucosa and skin

Varicella - zoster virus- HHV3 ( chicken pox, shingles) mode of transmission

Transmit through contact of skin, direct contact, indirect contact, airborne droplet is an aerosol.

Epstein barr virus-HHV4 (mono) mode of transmission

Direct contact saliva: kissing, saliva, sharing drinks

Herpes- HHV1 ( Herpetic Whitlow (fingers) mode of transmission

- saliva, mucosa, skin

- direct contact : lip, hand

- indirect contact : on objects, limited survival

- sexual contact

Mycobacterium tuberculosis mode of transmission

- Droplet nuclei

- sputum ( saliva and mucus)

- saliva