Infection Control Post-Treatment Period

By Amin Abusallamah

Outlines

1. Sterilization & disinfection of instruments .

2. Processing area of instruments .

3. Cleaning & Disinfection of Environmental Surfaces

4. Waste management

5. Contaminated sharp management .

Sterilization & disinfection

• Sterilization: killing all bacteria and spores.

• Disinfection: killing of infectious agents outside the body by direct exposure to agents.

• high-level disinfection may be kill all microorganism with numbers of bacterial spores.

Sterilization & disinfection of instruments

• Dental instruments are classified into three categories ( critical, semi-critical, or noncritical ) depending on their risk of transmitting infection and on the need to sterilize them between uses.

Critical instruments

• Surgical and other instruments that touch bone or penetrate soft tissue are classified as critical and should be sterilized after each use.

EXAMPLES :• surgical instruments• Periodontal scalers• Scalpel blades• Forceps• burs

Semi-critical instruments

• Instruments that touch mucous membranes, but do not touch bone or penetrate tissue .

• If sterilization is not feasible because the instrument will be damaged by heat, use high-level disinfection.

EXAMPLES :• Mirrors. • Amalgam condensers.• Dental handpieces .

Non-critical instruments

• Contact intact skin and use intermediate-level or low-level disinfection for them.

EXAMPLES :• x-ray heads.• Face-bows• Blood pressure cuff.

Processing area of instruments

Cleaning

SterilizationPreparation

&Packaging

Storage

Receiving

1

2

34

5

Receiving

• After collected the instruments that used in treatment in disinfection solution tray, send them to the clean and sterilization room receive them and clean up.

1

A) Manual cleaning.1. Wear mask & gown.

2. Wear heavy-duty gloves to avoid risk of hand injuries.

3. Clean one by one.

4. Use a long handled brush.

Cleaning 2

Cont…

B) Ultrasonic cleaner.1. More effective in cleaning than manual.

2. Reduce spatter in environment

3. Reduce chances of hand injury

Cont…

C) Automated cleaning.• It`s a combination of very hot water with a detergent to

remove the organic material & kills most microorganism at level of heat.

Preparation and packaging

• Before sterilization the instrument must be packaged to protect them from contaminated after sterilization.

Place chemical indictors inside the pack

• Types of packaging & sealing:

Heat sealing tape sealing Auto sealing

3

Sterilization

1. Steam autoclave

2. Flush sterilization

3. Dry heat

4. Chemical sterilization

5. Hand pieces Sterilization

6. Types of indicators of monitoring sterilization

4

Steam autoclave

• Suitable for sterilization of most reusable items and instruments, including dental hand pieces.

• 121 °C (30min) under 15 psi

Flush sterilization

• Involves sterilizing unpackaged instruments using short exposure times.

• Flush sterilization should be used only for instruments that are to be used quickly.

Dry heat

• Dry heat indicated for carbon steel & stainless steel dental instruments.

• Heat to 160 -170 ° C for 2 hours• is not recommended for most dental hand pieces

Chemical sterilization

• Chemical vapor sterilization is very similar to autoclaving ,except a combination of chemical and water.

CHEMCLAV

Hand pieces Sterilization

• High speed , straight and contra angle hand pieces should be cleaned and sterilized at the end of each treatment session.

• Hand pieces Sterilization can sterilized by autoclave or special hand pieces device sterilization.

Monitoring sterilization Types of indicators

• Biological Monitoring

• Chemical Monitoring

• Mechanical Monitoring

Storage

Storage the clean items in shelves or drawers must be:

Dry

Clean

Close

5

Cleaning and Disinfection of Environmental Surfaces

Clinical contact surfaces

Housekeeping surfaces

Clinical contact surfaces

Housekeeping surfaces

Waste management

Regulated wasteA. Contaminated waste: waste that contacts blood or

other body fluids like, barriers ,patient napkins and PPE.

B. Hazardous waste: it poses a risk to human ,the environment. Like, amalgam fixer solution and tooth with amalgam and lead foil from x-ray film pockets.

C. Biohazard waste: contaminated waste that transmitting infectious disease. Like, sharp tools, extracted tooth and tissue with blood.

Cont…

Unregulated waste

General waste include : Disposable paper towels Paper mixing pads Used patintbibs Surface barriers

Contaminated sharp management

• Contaminated sharps are classify as infectious waste.

• Contaminated needles and other disposable sharps, such as scalpel blades orthodontic wires and broken glass must be placed into a sharps container and must be puncture resistant , closable & color coded with biohazard symbol.

Thank you

Reference :

Office Safety & Asepsis Procedures (OSAP). Infection control in dentistry guidelines. Annapolis, MD, USA:OSAP Research