InfectionControl24-25_09a6f2c2649841699203808754ed34f1

Page 1: Infection Control - Rationale for Infection Control

Understanding Infection

  • Definition: Infection is the deposition and growth of organisms in tissues, leading to a host reaction.

  • Infective Dose: The minimal number of organisms needed to cause an infection.

Factors Affecting Infective Dose

  • Virulence of the organism: Stronger organisms require lower doses.

  • Susceptibility of the host: Affected by age, drug therapy, and pre-existing diseases.

Spread of Microorganisms

Transmission Routes

  • Direct Contact: Touching soft tissues or teeth leads to immediate infection spread.

  • Indirect Contact: Involves contaminated instruments or surfaces.

  • Droplet Infection: Transmitted through large droplets, especially during close contact in procedures.

  • Airborne Infection: Small particles (< 5 µm) can remain airborne for hours and cause infection.

Page 2: Cross-Infection

Definition of Cross-Infection

  • Cross-infection: Transmission of infectious agents among patients and staff in a clinical environment.

Sources of Infection

  • Infectious patients.

  • Patients in the prodromal stage.

  • Healthy carriers of pathogens.

Routes of Spread

  1. Patient to Dental Health Care Worker (DHCW)

  2. DHCW to Patient

  3. Patient to Patient

  4. Dental Office to Community

  5. Community to Patient

Transmission Mechanisms

Patient to DHCW

  • Direct contact via skin breaks or mucous membranes.

  • Indirect contact (sharp instruments, needle sticks).

  • Droplet infection from procedures.

DHCW to Patient

  • Direct contact via mucosal surfaces.

  • Indirect contact with contaminated instruments.

  • Droplet infection via inhalation.

Patient to Patient

  • Through contaminated instruments.

Dental Office to Community

  • Contaminated dental materials affecting lab technicians and community.

Page 3: Objective of Infection Control

Aim of Infection Control

  • Eliminate or reduce infection spread from microorganisms.

Key Factors

  • Prevent spreading microorganisms from hosts.

  • Kill or remove microorganisms from surfaces and objects.

Page 4: Universal Precautions

Introduction to Universal Precautions

  • Strategies to reduce infection risk from bloodborne pathogens.

Recommended Practices

  • Immunization: Vaccinate against hepatitis B for all dental team members.

  • Personal Protective Equipment (PPE): Gowns, masks, eyewear, gloves should be utilized.

  • Hand Hygiene: Essential for infection control.

Personal Protective Equipment Description

Protective Gowns

  • Prevents contamination and skin exposure.

  • Change when soiled.

  • Must be removed before leaving clinical areas.

Face Masks

  • Should be worn to prevent splatter contamination.

  • Change masks regularly and if wet.

  • Chin-length face shields provide extra protection.

Head Caps

  • Used to keep hair away from the face.

Protective Eyewear

  • Protects against splatter and injury during procedures.

Page 5: Gloves and Hand Hygiene

Importance of Gloves

  • Use to prevent contamination of hands during patient contact.

  • Should be good quality, sterile or non-sterile as required.

Key Points on Glove Use

  • Disposable for single patient use.

  • Change between patients and if damaged.

  • Must wash hands before and after glove use.

Hand Hygiene Significance

  • Critical measure for reducing cross-contamination.

Types of Microbial Flora

  • Transient Flora: Easily removable, associated with infections.

  • Resident Flora: More resistant, less likely associated with infections.

Page 6: Hand Hygiene Recommendations and Techniques

Hand Hygiene Recommendations

  • Perform at key moments: beginning/ending patient contact, after touching surfaces, before/after gloves.

Handwashing Techniques

  1. Remove jewelry.

  2. Cover cuts with dressings.

  3. Clean fingernails.

  4. Use good quality liquid soap.

  5. Rinse thoroughly; dry with a towel.

Page 7: Classification of Instruments

CDC Instrument Classification (Spaulding Classification)

  • Critical: Instruments that penetrate sterile tissues (e.g., surgical blades).

  • Semicritical: Instruments that contact mucous membranes (e.g., dental handpieces).

  • Noncritical: Instruments that contact intact skin (e.g., stethoscopes).

Sterilization Recommendations

  • Critical and semicritical items: Heat sterilized.

  • Noncritical items: Intermediate to low-level disinfectants.

Page 8: Definitions of Key Terms

Definitions

  • Cleaning: Physically removing contamination.

  • Disinfection: Destroys harmful microbes but not spores.

  • Antisepsis: Destroys pathogens on living tissue.

  • Sterilization: Destroys all forms of life.

  • Aseptic Technique: Prevents wound contamination.

Page 9: Instrument Processing Procedures

Steps for Instrument Processing

  1. Presoaking

  2. Cleaning

  3. Corrosion Control

  4. Packaging

  5. Sterilization

  6. Monitoring

  7. Handling processed instruments.

Page 10: Cleaning Techniques

Methods of Cleaning

  • Presoaking: Prevents debris from drying.

  • Cleaning Methods: Manual scrubbing, ultrasonic cleaning, mechanical washer.

Advantages of Ultrasonic Cleaning

  • Reduces direct handling of instruments.

  • Efficient at debris removal.

Page 11: Sterilization Methods

Overview of Sterilization

  • Types: Autoclave, chemical vapor, dry heat.

  • Manual touch should be minimized during handling.

Autoclaving Process

  • Most effective sterilization method using steam.

  • Requires specific conditions of pressure, temperature, and time.

Page 12: Autoclaving Equipment Handling

Autoclaving Instruments

  • Must be packaged properly and dried before usage.

Factors Influencing Autoclaving

  1. Pressure

  2. Temperature (at least 121°C)

  3. Time (typically 20-30 minutes).

Page 13: Dry Heat Sterilization

Dry Heat Overview

  • Utilizes high temperatures, longer exposure times.

  • Packaging must be heat resistant and allow for air circulation.

Applications

  • Ideal for materials sensitive to moisture (not for liquids).

Page 14: Chemical Vapor Sterilization

Chemical Vapor Process

  • Hot chemical vapors kill microorganisms effectively.

Precautions in Usage

  • Must be well-ventilated, protective gear essential.

Page 15: Ethylene Oxide Sterilization

Ethylene Oxide Characteristics

  • Highly effective for heat-sensitive instruments.

  • Care needed due to toxicity of gas.

Page 16: Radiation and Other Sterilization Methods

Types of Radiation

  1. Ionizing: Effective for disposable materials.

  2. Non-Ionizing: Used for air purification.

Boiling Water Method

  • Not recommended for sterilization of penetrating instruments.

Page 17: Management of Dental Equipment

Handpieces Management

  • Must be cleaned and sterilized after each use.

Dental Unit Water Systems (DUWS)

  • Can harbor microorganisms leading to biofilm formation.

Page 18: Needle Stick Injury Prevention

Handling Needle Stick Injuries

  • Immediate reporting and cleaning is crucial.

Preventive Measures

  • Use protective measures and avoid direct handling of sharp ends.

Page 19: Overview of Disinfection

Disinfection Methods

  • Cleaning: removes many pathogens.

  • Heat: Efficient for many applications.

Chemical Disinfectants Overview

  • Use caution as chemicals may cause tissue damage.

Page 20: Antiseptics and Their Uses

Common Antiseptics

  • Alcohol: Used for skin disinfection.

  • Iodophor Compounds: Effective against various microorganisms.

Chemical Disinfectants and Their Properties

  • Varying effectiveness and safety considerations.

Page 21: References

  • Textbook of Operative Dentistry. Chapter: 11 Infection Control.