Infection Control for Dental Assisting

What are the main causes of disease?

Germs

What happens when germs multiply?

Germs become diseases

The chain of infection contains four links:

1.) Virluence
2.) Number of microogranisms
3.) Susceptible host
4.) Portal of Entry

What is the virluence of an organism?

It's strength or ability to cause disease

Number of Microorganisms

Describes the amount of pathogens present

What is a susceptible host?

Someone who has a compromised immune system

What is the portal of entry?

The way in thich an infection enters the body

What is an infectious disease?

A disease that is contagious an can be transmitted from host to host via the chain of infection.

Direct Transmission

This route of transmission occurs when there is direct contact with infected blood, saliva, or OPIMs

What does OPIM stand for?

Other Potentially Infectious Materials

Indirect Transmission

This route of transmission occurs when the dental healthcare professional come in contact with a contaminated surface without the protection of PPE.

PPE

Personal Protective Equipment

Airborne Transmission

This route of transmission occurs through methods of inhalation.
-Aerosol, Spray, or Spatter

Blood-Borne Transmission

This route of transmission only occurs from blood-to-blood contact with an infected individual.

Cross-Contamination

Refers to germs within or from the dental setting being transmitted to other areas of the dental office or carried out of the dental setting.

Disease Transmission in the Dental Office:

-Patient to Patient
-Healthcare Worker to Patient
-Patient to Healthcare Worker
-Healthcare Worker to Community

What does OSHA stand for?

Occupational Safety and Health Administration

What does CDC stand for?

Centers for Disease Control and Prevention

OSHA's Blood-Borne Pathogens (BBP) Standard

Discusses how the dental office deals with, and its plan for, exposure to blood-borne pathogens.

Universal Precautions

Mandates that all patients be treated as if they have a deadly disease, regardless or their health history

Standard Precautions

An expansion of universal precautions.
- The infection control protocol for each patient will be the same, no matter what.

What are OSHA's categories of employees based on?

His/Her exposure risk to blood, saliva, or bodily fluids. (Category 1 is the highest risk category)

What vaccination does OSHA require that every dentist offer and pay for their employees?

Hepatitis B vaccination

Management of Sharps Waste:

Sharps must be disposed of in a biohazard, non-permeable, red plastic container.

What PPE is required for a dental assistant?

Proper PPE includes:
-Scrubs
-Leather Shoes
-Lab Coat
-Mask
-Safety glasses/face sheild
-Gloves

PPE should be removed in the following manner:

1.) Gloves
2.) Wash hands
3.) Safety glasses
4.) Mask
5.) Lab Coat
6.) Second hand washing

Classification of Waste:

1.) General Waste
2.) Contaminated Waste
3.) Hazardous Waste
4.) Infectious Waste
5.) Biohazardous Waste

Disinfection

The process of killing some microorganisms, but not all

Examination Gloves

Latex, vinyl, or nitrile materials that are most often worn by members of the dental team

Utility Gloves

Gloves used to break down a contaminated treatment room and to handle contaminated instruments. (Can be disinfected and/or sterilized in the autoclave)

Overgloves

Gloves used when an assistant must leave the treatment room, open a drawer during the procedure to retrieve a supply, or to make notes.

Sterile Gloves

Gloves utilized during surgical procedures

Disinfectants

Used to kill some of the microorganisms prior to sterilization (Two most popular: iodophors & gluteraldehydes)

Sterilization

The process that completely destroys microorganisms (including bacteria & spores) on instruments, equipment, and surfaces.

What are the 3 categories instruments are classified?

1.) Critical Instruments
2.) Semi-critical Instruments
3.) Non-critical Instruments

Critical Instruments

Instruments that contact of penetrate soft tissue or bone

Examples of critical instruments include:

Scalpels, burs, and scalers

Semi-critical Instruments

Instruments that come in contact with the oral cavity but do not penetrate soft tissue or bone

Examples of semi-critical instruments include:

Amalgam carriers, and condensers

Non-critical Instruments

Instruments that pose the least risk of spreading infection because they do not come in contact with soft tissue, membranes, or broken skin

Examples of non-critical instruments include:

X-ray unit position indicator device, or X-ray film holder

What are the seven steps of instrument processing?

1.) Transport
2.) Cleaning
3.) Packaging
4.) Sterilization
5.) Storage
6.) Delivery
7.) Quality Assurance

What are four of the leading methods of sterilization?

1.) Autoclave
2.) Chemiclave
3.) Flash Sterilization
4.) Cold Sterilization

How does an autoclave sterilize instruments?

By converting water to steam and pressurizing it (steam under pressure).

How long is the average cycle of an autoclave?

30 minutes: 20 minutes at 250 degrees, and 10 minutes venting time.

Under what conditions are spores killed?

High heat and pressure (Autoclaving)

Chemiclave

Converts chemical vapor into steam and pressurizes it (unpleasant odor)

Flash Sterilization

Utilized in an office when a particular instrument is needed right away (Average cycle = 3 minutes)

Three forms of Sterilization Monitoring:

1.) Physical
2.) Chemical
3.) Biological

Physical Monitoring

Involves checking the readings on the indicators to denote that a certain temperature level was reached

Chemical Monitoring

Using heat-sensitive chemicals that change color under certain conditions.

Biological Monitoring

Involves spore testing to establish whether the sterilization process was successful.

How often does OSHA mandate that you test every sterilization device utilized in the office?

Weekly

What are the only two ways to properly sterilize hand pieces?

Steam or chemical vapor sterilizers (hand pieces should be packaged before being sterilized)