Preclinic theory week 2 - oral mucous membrane and infection control

transmission of pathogenic organisms may occur as a result of

-Careless handwashing

-Unhygienic personal habits

-Inadequate sterilization and handling of sterile instruments

and materials

the ways cross-contamination can occur

- person-to-person

- person-to-inanimate object then to another person

What is the main objective of infection control in a dental office?

To protect patients, dental personnel, and others from acquiring infections.

What are the first two responsibilities of the dental team regarding infection control?

1. Organize and maintain a system for sterilization, disinfection, and care of instruments and equipment. 2. Develop and maintain work practices to prevent cross-infections.

List the six chain of events required for the spread of an infectious agent.

1. Infectious agent 2. Reservoir 3. Mode of escape 4. Mode of transmission 5. Mode of entry 6. Susceptible host.

What are the factors Influencing the Development of Infection

-Number of organisms and duration of exposure

- Virulence of the organisms

- Immune status of the host; antibody response; defense cell reaction

- General physical health and nutritional status of the host

what are types of dust borne organisms

clostridium tetani (tetanus bacillus), staphylococcus aureus, and enteric bacteria

What are sources of contamination for dust-borne organisms

dental instruments and hands of dental

personnel

_________ reduces the chances of contact with dust-borne organisms

surface disinfection

what is aerosol production

Airborne particles classified by size as either aerosols or splatter

what are aerosols

Biologic contaminants that occur in solid or liquid form, are invisible,

and remain in the air for long periods

what is splatter

heavier, larger particles; remain airborne relatively short period of time due to size and weight; drop on people, objects, and the

floor; greater than 50 in diameter; may be visible on skin, hair, clothing, or environmental surfaces

Aerosols and splatter are created during

Breathing, Speaking, Coughing, Sneezing, Other means of production: air-spray, air-water spray,

handpiece activity, and ultrasonic scaling

what are the contents of aerosols

microorganisms, particular matter

What are some ways to prevent transmission

- limitation of organisms

- preoperative oral hygiene measures

- interruption to transmission

- clean water

- protection of the clinician

how can you prevent transmission by limiting organisms

Postpone elective treatment during respiratory

illness or other communicable disease

how can preoperative oral hygiene measures prevent transmission

Toothbrushing, flossing, use of antiseptic mouthrinse to reduce bacterial numbers

how can interruption of transmission prevent transmission

-Use of rubber dams, high-volume evacuation, and manual instrumentation as often as possible.

-Adequate ventilation, filtration of air, and relative humidity in treatment area.

- Vacuum to remove dirt and microorganisms rather than regular dusting.

How can clean water prevent transmission

Flush all tubings to handpieces, ultrasonic scalers, and air-water

spray for 2 minutes at start of day, 30 seconds between patients to lower microorganism levels

how can protection of the clinician prevent transmission

use mask and protective eyewear to prevent

direct contact with splatter and aerosols

what is an autogenous infection

An infection that originates within a person when the normal defense mechanisms are modified

What are sources of autogenous infection

bacteremia, oral cavity

what is bacteremia

a condition in which bacteria or other microorganisms

are introduced into the bloodstream

how can the oral cavity be a source of autogenous infection

bacteria enter blood through a break in the mucosa;

through a gingival or periodontal pocket during scaling or other instrumentation; or through an injection site

What are factors that alter normal defenses

abnormal physical conditions, systemic diseases, drug therapy, prosthesis and transplants

susceptibility to infection is increased with systemic diseases such as

diabetes mellitus, alcoholism, leukemia, glomerulonephritis, AIDS, all other causes of immunosuppression

susceptibility to infection is increased with drug therapy such as

immunosuppressive drugs (steroids and chemotherapeutic agents), prophylactic antibiotics may be indicated to prevent infection

What are some ways to prevent autogenous infection

Antibiotic premedication, lower surface microbial count (toothbrushing, flossing, rinsing with antibacterial rinse, topical antiseptic), preparation of injection site

What is a mucous membrane

the lining of a body cavity that opens to the

outside of the body

What is the function of the oral cavity

-Place of mastication (chew)

-Contains the taste organs (tastebuds)

-Aids in digestion (start of digestion, mix w/saliva to start break down of food from enzymes in Saliva)

- Facilitates swallowing

criteria that dictates structure of mucous membrane

- Function of the area

- Forces that it must withstand

What are the layers of mucous membrane

-Epithelial layer (stratified squamous cells)

-Connective tissue layer (Lamina Propria)

-Submucosa

-Periosteum

What are the parts of the epithelial layer of the mucous membrane

- Basal cell layer (Stratum Basale): inner most layer, rest along basement membrane, cuboidal shape, where cell division takes place-then forced up to top

-Prickle cell layer (Stratum Spinosum): irregular (polyhedral shaped) Intercellular bridge: where 2 of sharp edges bridge-> holds them together

-Granular cell layer (Stratum Granulosum): cells become wider

- Keratinous layer (Stratum Corneum): outer most, not all mucous membrane is Keratinized (Keratin= protein

that protects body's tissues),

very flat cells

What is the basement membrane

Where epithelium and connective tissue meet

What makes up the connective tissue (lamina propria) of mucous membrane

-Papillary layer (above reticular)

- Reticular layer (deeper)

What are the advantages of interdigitation of the connective tissue layer

increases area of contact, tissue stability, greater fluid exchange, allows epithelium to get nourishment from C.T

what are Rete Pegs/ridges

where epithelium dips down into C.T

What are papillae (interdigitation)

where CT shoots up into epithelium

What is the function of the submucosa

attach mucous membrane to underlying structures

what does the submucosa contain

nerves, glands, blood vessels, adipose tissue

What is the periosteum

tough connective tissue membrane that covers outside surface of bone

What are the classifications of oral mucosa

Masticatory mucosa

Lining mucosa

Specialized mucosa

Where is masticatory mucosa located

gingiva, hard palate

What are the characteristics of masticatory mucosa

-epithelium (thick, keratinized)

-connective tissue (thick, dense, firm)

-attachment to bone (firmly attached to bone)

What is the gingiva does not contain

a submucosa

the hard palate contains a

submucosa

Where is lining mucosa found

- inside of lips and cheeks

- floor of mouth

- ventral of tongue (underneath)

- soft palate

- alveolar mucosa

What are the characteristics of lining mucosa

-epithelium (thin, non-keratinized)

-connective tissue (thin)

-attachment to bone (loosely attached to bone)

Where is specialized mucosa found

dorsum of the tongue (top)

What are the types of papillae

filiform papillae, fungiform papillae, foliate papillae, circumvallate papillae

Describe filiform papillae

- anterior 2/3 of tongue

- most numerous

- heavily keratinized

- conical in shape

- no tase buds

describe fungiform papillae

-scattered between filiform

- larger, less present than filiform

- darker pink

- thinner epithelium

- have taste buds

describe foliate papillae

- on posterior lateral borders of tongue

- have tastebuds

describe circumvallate papillae

- just anterior to foramen cecum

- v-shape arrangement in front of sulcus terminalis

-large

- 8-12

- upside down triangle shape

- surrounded by trough (salivary glands)

- have taste buds

where are taste buds found

fungiform papillae, foliate papillae, circumvallate papillae

What are the primary taste sensations

sweet, salty, bitter, sour

where is sweet perceived

tip of tongue by fungiform papillae

where is salty perceived

sides of dorsal surface by fungiform papillae

where is sour perceived

lateral borders of tongue by foliate papillae

where is bitter perceived

middle of tongue by circumvallate papillae