Infection Control and The Dental Radiographer

What is the primary purpose of infection control procedures?

To prevent the transmission of infectious diseases

Does disease transmission involve pathogens?

Yes!

What is a pathogen?

A microorganism capable of causing disease

A microorganism capable of causing disease is called a?

pathogen

List common pathogens to be worried about being exposed too in the dental office if infection control procedures were not in place?

-Cold and Flu viruses and bacteria
-Cytomegalovirus (CMV)
-Hepatitis B Virus (HBV)
-Hepatitis C Virus (HCV)
-Herpes Simplex Virus (HSV-1, HSV-2)
-Human Immunodeficiency Virus (HIV)
-Mycobacterium tuberculosis

What are the general routes of disease transmission in the dental office?

- Direct contact with pathogens in saliva, blood, respiratory secretions, or lesions
-Indirect contact with contaminated objects or instruments
-Direct contact with airborne contaminants present in spatter or aerosols of oral and respiratory fluids

what three conditions must be present in the dental office for infection to occur?

-A susceptible host
-A pathogen with sufficient infectivity and numbers to cause infection
-A portal through which the pathogen may enter the host

----- is a substance that inhibits the growth of bacteria ?

Antiseptic

What are examples of a antiseptic?

Procedures that prevent infection like handwashing and wound cleaning procedures

------is the absence of pathogens ,or disease causing microorganisms.

Asepsis

This term is often used to describe procedures that prevent infection?

aseptic technique

----Is pathogens present in blood that cause diseases in humans

Bloodborne pathogens

-----Is a chemical or physical procedure to inhibit or destroy pathogens.

Disinfect

What are not killed during disinfecting procedures?

Mycotic (fungal) spores

-----Is the act of disinfecting

Disinfection

-----Is a specific incident that involves contact with blood or other potentially infectious materials and that results from procedures performed by the dental professional

Exposure incident

------Is waste that consists of blood, blood products, contaminated sharps or other microbiologic products.

Infectious wastes

-----Contact with blood or other infectious materials that involves the skin, eye, or mucous membranes and that results from procedures preformed by the dental professional

Occupational exposure

-----Exposure to blood or other infectious materials that results from piercing or puncturing the skin barrier.

Parenteral exposure

-----is a name for protective attire, gloves, mask, and eyeware.

Personal Protective Equipment (PPE)

List what PPE we have?

protective attire, gloves, mask, and eyeware.

what does PPE mean?

Personal Protective Equipment

-----Is any objects that can penetrate the skin, including but not limited to, needles and scalpels

Sharps

are scalpels considered a sharp?

Yes!

-----Measures that include a standard of care designed to protect the health care personnel and patients from pathogens that can be spread by blood or ant other body fluid, excretion or secretion.

Standard precautions

-----Is the use of a physical or chemical procedure to destroy ALL pathogens, including highly resistant bacteria and mycotic spores.

Sterilize

the act of sterilizing?

Sterilization

in what year did the CDC release a publication entitled the GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS?

In 2003

in 2003 the CDC released a publication entitled?

GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS

in 2003 what organization released a publication entitled the GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS?

CDC

CDC guidelines must be observed in conjunction with the practices and procedures for worker protection required by the?

Occupational Safety and Health Administration (OSHA)

What recommended infection control practices directly relate to dental radiography?

PPE, Handwashing and care of hands, Sterilization and disinfection of instruments, Cleaning and disinfection of dental unit and environmental surfaces.

must hands be washed before gloves are worn?

Yes!

When are nonsterile gloves recommended?

For examinations and nonsurgical procedures

When are sterile gloves recommended?

For all surgical procedures

List when one must wash their hands in the dental office?

-Before and after treating each patient
-After removing gloves that are torn, cut or punctured and before putting on new gloves
-After contact of bare hands with inanimate objects likely to be contaminated by blood, saliva or respiratory secretions
-Before leaving the dental operatory
-When hands are visibly contaminated or soiled

List the different types of hand hygiene praticed in dental radiography?

three types:
ROUTINE HAND WASH: Water and nonantimicrobial soap (handsoap) for 15 seconds
ANTISEPTIC HANDWASH: Water and antimicrobial soap (chlorhexidine, iodine and idophers, chloroxylenol, PCMX, tricolsan) for 15 seconds
ANTISEPTIC HAND RUB: Alcohol based product until the hands are dry

all instruments in the dental practice can be classified into one of what categories?

critical, semicritical or noncritical instruments

Instruments are classified dependind on their?

risk of transmitting infection, and the need to sterilize the instrument between uses

Instruments used to penetrate soft tissue or bone are considered?

Critical

How must critical instruments be cleaned?

They must be sterilized after each use

name examples of critical instruments?

forceps, scalpels, bone chisels, scalers, and surgical burs

What are the critical instruments used in dental radiography?

None! NO critical instruments are used in dental radiography

-----Are instruments that contact but do not penetrate soft tissue or bone?

Semicritical

How must semicritical devices must be cleaned?

sterilized after each used UNLESS the instrument can be damaged by heat then use a high level disinfectant.

what is an example of semicritical devices used in dental radiography?

Beam alignment devices

-----Are instruments ir devices that do not come in contact with mucous membranes

Noncritical

How are noncritical devices cleaned and why?

Because their is little risk of transmitting infection from noncritical devices intermediate or low level infection techniques are required

what is an example of noncritical devices used in dental radiography?

PID, dental x-ray tubehead, exposure button, x-ray control panel and lead apron

What are acceptable methods of dental sterilization?

Steam under pressure (Autoclave), Dry Heat and Chemical Vapor

How is the proper use of sterilization cycles verified?

By periodic use of a Biologic Indicator (Spore Test)

EPA registered disinfectants are classified as what in the dental field?

High-level disinfectants which can be used to disinfect heat-sensitive semicritical dental instruments

EPA registered chemical germicides labeled as both hospital disinfectants and tuberculocidals are classified as?

Intermediate level disinfectants

Intermediate level disinfectants include?

Phenolics, Iodophers, Chlorine containing compounds

What is recommended to clean all contaminated dental unit surfaces?

Intermediate level disinfectants

EPA registered chemical germicides labeled as only hospital disinfectants are classified as?

Low level disinfectants

What is recommended to clean general housekeeping surfaces such as floors and walls?

Low-Level Disinfectants

In dentistry treatment of all patients must be provided after?

Taking standard precautuions

-----Is a standard of care designed to protect health care personnel and patients from pathogens that can be spread by blood or any other body fluid, excretion or secretion.

Standard Precautions

must the same infection control procedures be used for each patient?

YES! No exceptions exist and no extra precautions should be used on any patients

What dental radiography surfaces must be covered and disinfected?

X-ray machine: tubehead, PID, and exposure button must all be covered or disinfected
Dental Chair: headrest and its control as well as chairs controls must be covered or disinfected
Work Area: the area where x-ray supplies (Film sensors) are placed during exposure must be covered or disinfected
Lead Apron: If contaminated the lead apron must be wiped with a disinfectant between patients

Commercially plastic barrier envelopes must be sealed in a plastic barrier to?

protect the packets from saliva and to minimize contamination after exposure of the film

how does one clean the sensors/receptors used in digital radiography?

They cannot be heat sterilized and must be wrapped in plastic barrier envelopes to protect from saliva and contamination much like the barriers used for intraoral films MUST COVER BOTH HE SENSOR AND THE WIRE CONNECTION

before radiography exposure what should be covered or disinfected?

x-ray machine
dental chair
work area
lead apron

before radiography exposure what must be prepared before seating the patient?

image receptors
beam alignment devices
cotton rolls
paper towel
disposable container

before radiography exposure what must be prepared before putting on gloves?

adjust chair
adjust headrest
place lead apron on patient
remove metallic objects in the head and neck area of patient

right before radiography exposure what must be prepared?

wash hands
put on gloves
prepare beam alignment devices

During radiography exposure how must films be handled?

dry receptor with paper towel after exposure
place dried receptor in paper towel

During radiography exposure how must devices be handled?

transfer beam alignment device from work area to mouth and back to work area, disassemble over a protected work area, never place on uncovered countertop

after radiography exposure what should be completed before gloves are removed?

dispose of contaminated items
place beam alignment devices in area designed for contaminated instruments

after radiography exposure what should be completed after gloves are removed?

wash hands
remove lead apron

the patients head should be seated with the maxillary arch ----to the floor when seating a person for radiography?

parallel

hands must be washed before putting on gloves in the presence of?

the patient

gloves must be worn immediately after?

handwashing

why is the use of a surgical mask and protective eyewear optional in dental radiography?

because no aerosolized contaminants are created during x-rays

----Is a substance that inhibits the growth of bacteria

antiseptic

what is an example of a antiseptic procedure?

handwashing

does antiseptic mean killing?

No!

-----Is the use of a chemical or procedure to destroy pathogens?

Disinfect

does disinfect mean killing?

yes...kills but not all

what is an example of a disinfectant used in radiology?

cavicide for films

----Is the destruction of all pathogens.

sterilize

does sterilize mean killing?

yes kills all

what must be sterilized in radiology?

adjuncts: XCP, easy grip, beam alignment device, snap a ray

are all three types of infection control procedures used in dental radiography?

yes

what are types of infection control procedures used in dental radiography?

sterilization, disinfection, and antiseptic techniques

what are the instrument classifications used in radiology?

only semicritical and noncritical not critical for radiology

----instruments are used to penetrate soft tissue or bone

critical

how must critical instruments be cleaned?

sterilized after each use

name some critical instruments?

scalers, and forceps

----instruments contact but do not penetrate soft tissue or bone

semicritical

how must semicritical instruments be cleaned?

sterilize after each use unless heat/sterilization will hurt instrument then high level disinfection is required

name some semicirtical instruments used in dental radiology?

film holding devices, mirrors, cotton pliers

----instruments do not come into contact with mucous membranes

noncritical

how must non critical instruments be cleaned?

with a low level disinfectant

list some noncritical instruments used in dental radiology?

PID
Exposure button
x-ray control panel
lead apron

preparation of the operatory is basically the same as in?

our clinic

how must the x-ray machiene be prepared before the patient arrives?

cover control panel with a sticky
tube head with plastic
cover PID

what must be prepared for infection control before the patient arrives?

PREPARE OPERATORY: x-ray machiene, exposure button, dental chair, counter/work area, lead apron
PREPARE SUPPLIES: 2 trays
tray 1: outside of room: x-rays, BWX tabs etc.
tray 2: in operatory: mouth mirror, cotton pliers, cotton swabs, contaminates on here NOT ON COUNTER,
-Name on cup, cavicide dip, paper towel, timer
-new film, barrier films, envelopes or digital sensors
-x-ray arm away from patient and in position
-room neat for patient

how must the exposure button be prepared before the patient arrives?

with a sticky