Dent 161 LO1

Direct Cintact

Physically incontact with the source

Indirect Contact

Through an intermediate object

• needle/instrument

• contaiminated surface not cleaned

Droplet Infection

Large (more than 5) particle droplet splatter

• Need close contact with airborne droplets (sneeze/cough) inhalation

Airborne Infection

Small (less than 5) that remains in the air for hours

• Ex: Measles, chickenpox, tuberculosis, COVID-19

Other

Waterborne in lines (Needs to be less than 500)

Pathwyas for Cross Contamination

PHOTO form slide 37

Bloodborne pathogen Hep B

Killed or inactivated by disinfection and sterilization

Transmitted by non-intact skin, sexual contact, or perinatal

Viable at room temp for at least 1 month (Milller 2018) and can be infectious for 7 days on inanimate surfaces

Vaccine recc

Bloodborne pathogen Hep V

Killed or inactivated by disinfection and sterilization

Transmitted by non-intact skin, sexual contact, or perinatal

Hep V contaiminated blood that dried on an inantimate surface can remain infectious up to 6 weeks at room temp.

no vaccine, higher risk if born in older years

Bloodborne pathogen HIV/AIDS

Transmitted by direct contact with infected blood and bodily fluids ( Semen/breast milk) and perinatal. Not spread through casual contact

Common modes of transmission: Sharing needles, sexual contact

Less common modes of transmission: Breaches or bad infection control

Human Herpes Viruses (HHV)

Spreads through direct contact with lesions or aerosols to the eyes or unprotected hands, then to another patient's mouth

Can lead to infection of the eyes, fingers, mucous membranes or other people

need to postpone tx if active lesion (Healing up to 10 days)

Tuberculosis

Transmitted by airborne droplets and saliva (Inhalation)

No tx until no longer infectious

No vaccine

Influenza

Transmitted by direct contact, airborne droplets

self- inoculation onto mucosal surfaces

COVID- 19

Transmitted by droplets and aerosols

can self incoulated by touching inatmited infected objects then touching mucosal surfaces

Essentials for the disease transmission chain.

1. Pathogen (Infectious agent)

2. Reservoir (Place for it to live)

3. Portal of exit

4. Mode of transmission

5. Portal of entry

6. Susceptible host

Immunizations

Introducing specific antigens to the body with the intention of producing immunity to those antigens

most effective method, but dont exist for all diseases

Exposure Prevention

1. Facility Manual

• Use current IPC standards and documents when needed

2. Education and Training

3. Routine Practices

Percutaneous injury

Piercing the skin barrier

Greatest risk of transmission

Exposure Prevention/Management

Not all exposures result in infectious diseases

3 factors influence:

1. Virulence of pathogen(can't easily change in natural environment )

2. Dose( can be managed with good IPC practices)

3. Body Resistance (keep immune system strong and immunizations

Health or Diseases = Virulence X Dose/ Resistance

Exposure Managment

1. First Aid

2. Reporting

3. Documention

4. Follow up

Best to have a serology test with clients consent (To test for HIV and HCV)

Engeineering/ Work practice contorls

Ventilation:

• 10 cycles per hr = 30 min clearance time

Aerosol Controlled Environment (ACE):

• Isolation room, follow settle time

Operatory/Clinic patient placement:

• Postiion clients 6 feet apart with physical barriers

Respiratory hygiene

Measures to contain respiratory secretions to prevent the spread

• Cover mouth, hand hygiene, screening

Hand Hygiene

Prevent the transfer of pathogens

Soap and water:

• Initial hand wash two consecutive washes for 20 sec each, after 4-5 ABHR

Alcohol Based (ABHR):

• 70% or higher

• only if hands are not visibly soiled or contaminated

PPE: Examination Gloves

Nonsterile: Latex or non-latex, Vinyl (tears easily)

Sterile: used for surgical procedures

Utility Gloved: Nitrile, puncture and chemical-resistant, provide more protection for operatory cleanup and instrument processing

Heat-resistant gloves: when unloading sterilizers

PPE: Masks

Surgical Mask:

• Worn during all dental procedures, does not provide protection against airborne infections

• Change between each patient and every hour or 20min if aerosols are heavy

• Select based on BFE:

  • Level 1: low amounts of aerosols, BFE/PFE > 95%, fluid resistance at 80mmHG

  • Level 2: Light-moderate amounts of aerosols, BFE/PFE > 98%, fluid resistance at 120mmHG

  • Level 3: Moderate - Heavy of aerosols, BFE(3 microns)/PFE(0.1 microns) >98%, fluid reisitance at 160mmHG

Irritant Contact Dermattis

Skin becomes dry, red, and itch due to irritation from chemicals in gloves or soap, inadequate rinse/drying, and sweating.

Type IV Hypersensitivity

immunological reaction(80%), delayed reaction

first must become sensitized to an allergen

Caused by chemicals used in the processing of gloves, limited to areas of contact ,can be delayed from 8hrs to 5 days

Type 1 Hypersensitivity

Immediate reaction to latex, allergic to latex

Sensitized by one or more exposures before a subsequent reaction to exposure

Can develop within 5 min to 2 hrs

Can have respiratory symptoms and Anaphlazis (life-threatening allergic reactions)