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Presented to:

Dr. Manzar AnwarDr. Shakeel Anwar

Dr. Shazia Makhdoom

Presented By: Jawad Ullah ShahClass # 04

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Infection Control In Dentistry

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CONTENTS:

• Definition

• Aims Of Infection Control

• Cross Infection

• Chain of Infection

• Route of Transmission

• Centre of disease control (CDC) recommendations

• Decontamination

• Spaulding’s classification of instruments

• Prevention

• Barrier technique

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What is Infection

The entry and development or multiplication of an infectious agent in the body of the host i.e. humans or animals to produce disease.

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Infection Control

Primary Objective• Elimination or reduction in spread from all

types/forms of microorganisms.

Factors involved in infection control

• Prevention and spread of microorganisms from their host (patient & clinician).

• Killing or removal of microorganisms from objects and surfaces.

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Aims of Infection Control

To control/prevent iatrogenic infections from their hosts among patients and clinicians.

To Control/prevent Occupational Exposure.

To control/prevent Cross Infection.

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Cross Infection

• Transmission of infectious agents among patients and staff within a clinical environment.

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Pathways of cross infection

Patient to patient Patient to practitioner Practitioner to patient Clinic to community Clinic to practitioner’s family Community to Patient

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Common Transmissible Infectious Diseases in Dentistry

• HIV

• HBS

• HCV

• Mycobacterium Tuberculosis

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Chain of Infection

Pathogen

Source

ModeEntry

Susceptible Host

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Chain/Process of Infection.

•An adequate number of pathogens, or disease-causing organisms, to cause disease.

•A reservoir or source that allows the pathogen to survive and multiply (e.g., blood).

•A mode of transmission from the source to the host.

•An entrance through which the pathogen may enter the host.

•A susceptible host (i.e., one who is not immune).

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• Infection through any of these routes requires that all of the following conditions be present:

•An adequate number of pathogens, or disease-causing organisms, to cause disease.

•A reservoir or source that allows the pathogen to survive and multiply (e.g., blood).

•A mode of transmission from the source to the host.

•An entrance through which the pathogen may enter the host.

•A susceptible host (i.e., one who is not immune).

• The occurrence of all these events is considered

the “chain” of infection. Effective infection

control strategies prevent disease transmission

by interrupting one or more links in the chain of

infection.

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Routes of transmission

Direct contact of tissues with infective biological fluids.

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Routes of transmission

Indirect contact with contaminated instruments

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Routes of transmission

Inhalation of infective droplets / particles

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Routes of transmission

Direct inoculation into cuts/abrasions via contaminated instruments

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Centre of Disease Control (CDC) recommends:

• “Consider each and every patient to be operated as potentially infectious and routinely take standard/universal precautions for each, to protect ourselves and to prevent cross infection”.

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Decontamination

• Sanitization—first level• Disinfection—second level• Sterilization—third level

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Decontamination

Sanitization

Reduction of viable microorganism to safe levels.

Sterilization

It is the process by which all forms of microorganism are destroyed.

Disinfection/Antisepsis

It is the process by which chemicals are used to prevent the multiplication of microorganism capable of causing infection.

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Decontamination

Antiseptic

For living tissues (animate).

Disinfectants

For Non living things (Inanimate).

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Methods of Sterilization in Dentistry

• Autoclave

• Chemiclave

• Dry Heat

Other Methods• Ethylene Gas

• Boiling water

• Ionizing Radiation

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Methods of Sterilization in Dentistry

Autoclave:

It is an efficient and reliable method by which instruments are sterilized, using steam under pressure which acts by inactivating essential cellular proteins or enzymes of microorganisms. It is ideal form of sterilization. (spore strip)

Dry heat sterilizer: These sterilizers use hot air to kill microorganisms by oxidation. They do not cause corrosion.

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Methods of Sterilization in Dentistry

• Chemical vapor sterilizer: Alcohols, Formaldehyde, ketone, water and acetone are heated under pressure produces a gas that is effective for sterilization by permeation of the heated formaldehyde and alcohol.

Time 120 min. Temp. 120º C to 132º C with 20-40 lbs pressure.

• Gaseous Sterilization: Ethylene oxide gas when mixed with CO2 or

N2 . At 50ºC, time 3 hours it kills all microorganism including spores.

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Dry-Heat

Temperature Duration of Treatment

120º C (250º F) 6-12 hours

140º C (285º F) 3 hours

160º C (320º F) 2 hours

170º C (340º F) 1 hours

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Steam Sterilization

Temperature Duration of Treatment

116º C (240º F) 60 minutes

118º C (245º F) 36 minutes

121º C (250º F) 24 min

125º C (257º F) 16 min

132º C (270º F) 4 min

138º C (280º F) 1-1/2 min

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Spaulding’s classification of instruments

1- Critical

2- Semi critical

3- Non critical

4- Environmental

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Critical

Items that are used in various specialties of

dentistry which pierce soft and hard tissues.

Burs, chisels, forceps.

DISEASE RISK High

METHOD Sterilization

EXAMPLES Surgical instruments

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Semi Critical

Items which do not pierce soft and hard

Tissues but cross vermillion border into the

oral cavity. Mouth mirrors, condensers

DISEASE RISK High

METHOD Sterilization or Disinfection

EXAMPLES Hand piece, syringes, Impression trays.

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Non Critical

Items that are used in various specialties

of dentistry which do not cross vermillion

border or penetrate soft and hard tissues.

X-ray heads

DISEASE RISK Moderate

METHOD Surface disinfection,

Sanitization & barrier

EXAMPLES Dental unit & accessories

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Environmental

Items not directly in contact with skin or

mucous membrane

DISEASE RISK Low

METHOD Cleansing

EXAMPLES Tables ,counters

Floor surfaces & door handles

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How to prevent cross infection ?

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From infected patient to other patients

How to prevent cross infection?

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1. Use of disposable materials

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2. Disinfecting surfaces with

• Halogens compounds

• Aldehydes

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3. Sterilize reusable instruments (Autoclave)

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DISINFECTION AND STERILIZATION

METHOD REDUCTION

Cleaning 90%

Disinfection 99.9%

Sterilization 99.9999%

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From infected patient to dental staff

How to prevent cross infection?

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1- To recognize carriers history of

Hepatitis/Jaundice

Venereal disease

Intravenous drug use

Hereditary bleeding disorders

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2- To recognize groups of people having high risk of exposure.

Hemodialysis patients and technician Hemophiliacs and blood bank

workers Dental Surgeons General surgeons

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3- Use of barrier technique during

Surgery

Handling of contaminated objects

Clean up

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4- Prompt disposal of sharp objects into a well-labeled protective container.

5- Use of an instrument to place a scalpel blade on or taking one of a blade handle.

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6-Disposal of needles immediately after use rather than resheathing.

7- Vaccine

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Refrences

• S S Hremeth

• Wikipedia

• http://www.cdc.gov/oralHealth/InfectionControl/

• https://www.osha.gov/SLTC/dentistry/index.html

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“He That Has accquired learning and nor practised what he has learnt,is like a man who ploughs but sows

no seed”.By Sheikh Saadi

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