What film procedure is considered to be the most effective method for reducing microbial contamination?
Using barrier film/envelopes!
what must be done when the patient arrives?
-escort patient into operatory
-update medical history
-adjust chair for patient and operator
- position patient so occlusal plain is parallel to floor
-put patient at elbow height
-remove patients partial, glasses, dentures, chewing gum, and piercings wh
in radiography the arch you are working on needs to be?
parallel to the floor
what must be done when radiographs are ready to be taken?
-make sure to wash hands in front of patient and then let them see you put gloves on
-(dont have to wear mask/eyeware because no splash or areosol spray) although our clinic requires the eyeware
-
Dose our clinic require eyeware/gloves while taking x-rays?
Yes! our clinic does! just not a mask because no splash/spatter
----means every patient should be treated in the same manner whether infectious or not. there are no exceptions and therefore no suprises.
Universal precautions
with universal precautions are there exceptions?
No
though if a patient exhibits a known compromised medical history should gloves, eyeglasses and a mask be worn?
Yes same thing as if we have a cold etc to protect patient
must a lab coat be worn in dental radiography?
no not always due to lack of spatter
must pre-bagged film-holding devices and instruments be opened in front of the patient?
yes to prove they are clean! so they know something unclean is not going into their mouth!
what must be during the taking of radiographs?
-touch as few surfaces as possible
-film dipped in cavicide must be dried with a paper towel
-paperwork and chart must be place on counter away from sink
-use only sterilizable or disposible film holders
-Dry receptor bag before place receptor back into m
what must be after the taking of radiographs?
-gloves are removed and hands are washed
-make patient comfortable
-return glasses
-reposition chair if needed
-offer bathroom break magazines etc
-remove the lead apron and hang it up (do not fold)
is the lead apron removed with gloved hands?
No it is removed after gloves are removed and hands are washed
when should the lead apron be removed and hung up?
after gloves are removed and hands are washed
are all infection control techniques for processing the same?
No! variations exist
the sctcc infection control techniques for processing fits our needs with?
the assigned operators and processors
how does a 2 person removal of film from the contaminated packet work?
one person can open the contaminated packet and the other can remove the film
using daylight loaders for an infection control point of view in dental radiography are?
not recommended due to cross contamination
using daylight loaders for an infection control point of view in dental radiography are not recommended due to?
cross contamination
Are masks optional for dental radiographic procedures?
Yes!
are developer and fixing solutions sterilizing agents?
No!
what is the advantage of using barrier film?
Most effective in reducing cross contamination
What is the primary purpose of infection control procedures?
To prevent the transmission of infectious diseases
Does disease transmission involve pathogens?
Yes!
What is a pathogen?
A microorganism capable of causing disease
A microorganism capable of causing disease is called a?
pathogen
List common pathogens to be worried about being exposed too in the dental office if infection control procedures were not in place?
-Cold and Flu viruses and bacteria
-Cytomegalovirus (CMV)
-Hepatitis B Virus (HBV)
-Hepatitis C Virus (HCV)
-Herpes Simplex Virus (HSV-1, HSV-2)
-Human Immunodeficiency Virus (HIV)
-Mycobacterium tuberculosis
What are the general routes of disease transmission in the dental office?
- Direct contact with pathogens in saliva, blood, respiratory secretions, or lesions
-Indirect contact with contaminated objects or instruments
-Direct contact with airborne contaminants present in spatter or aerosols of oral and respiratory fluids
what three conditions must be present in the dental office for infection to occur?
-A susceptible host
-A pathogen with sufficient infectivity and numbers to cause infection
-A portal through which the pathogen may enter the host
----- is a substance that inhibits the growth of bacteria ?
Antiseptic
What are examples of a antiseptic?
Procedures that prevent infection like handwashing and wound cleaning procedures
------is the absence of pathogens ,or disease causing microorganisms.
Asepsis
This term is often used to describe procedures that prevent infection?
aseptic technique
----Is pathogens present in blood that cause diseases in humans
Bloodborne pathogens
-----Is a chemical or physical procedure to inhibit or destroy pathogens.
Disinfect
What are not killed during disinfecting procedures?
Mycotic (fungal) spores
-----Is the act of disinfecting
Disinfection
-----Is a specific incident that involves contact with blood or other potentially infectious materials and that results from procedures performed by the dental professional
Exposure incident
------Is waste that consists of blood, blood products, contaminated sharps or other microbiologic products.
Infectious wastes
-----Contact with blood or other infectious materials that involves the skin, eye, or mucous membranes and that results from procedures preformed by the dental professional
Occupational exposure
-----Exposure to blood or other infectious materials that results from piercing or puncturing the skin barrier.
Parenteral exposure
-----is a name for protective attire, gloves, mask, and eyeware.
Personal Protective Equipment (PPE)
List what PPE we have?
protective attire, gloves, mask, and eyeware.
what does PPE mean?
Personal Protective Equipment
-----Is any objects that can penetrate the skin, including but not limited to, needles and scalpels
Sharps
are scalpels considered a sharp?
Yes!
-----Measures that include a standard of care designed to protect the health care personnel and patients from pathogens that can be spread by blood or ant other body fluid, excretion or secretion.
Standard precautions
-----Is the use of a physical or chemical procedure to destroy ALL pathogens, including highly resistant bacteria and mycotic spores.
Sterilize
the act of sterilizing?
Sterilization
in what year did the CDC release a publication entitled the GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS?
In 2003
in 2003 the CDC released a publication entitled?
GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS
in 2003 what organization released a publication entitled the GUIDELINES FOR INFECTION CONTROL IN DENTAL HEALTH CARE SETTINGS?
CDC
CDC guidelines must be observed in conjunction with the practices and procedures for worker protection required by the?
Occupational Safety and Health Administration (OSHA)
What recommended infection control practices directly relate to dental radiography?
PPE, Handwashing and care of hands, Sterilization and disinfection of instruments, Cleaning and disinfection of dental unit and environmental surfaces.
must hands be washed before gloves are worn?
Yes!
When are nonsterile gloves recommended?
For examinations and nonsurgical procedures
When are sterile gloves recommended?
For all surgical procedures
List when one must wash their hands in the dental office?
-Before and after treating each patient
-After removing gloves that are torn, cut or punctured and before putting on new gloves
-After contact of bare hands with inanimate objects likely to be contaminated by blood, saliva or respiratory secretions
-Befor
List the different types of hand hygiene praticed in dental radiography?
three types:
ROUTINE HAND WASH: Water and nonantimicrobial soap (handsoap) for 15 seconds
ANTISEPTIC HANDWASH: Water and antimicrobial soap (chlorhexidine, iodine and idophers, chloroxylenol, PCMX, tricolsan) for 15 seconds
ANTISEPTIC HAND RUB: Alcohol ba
all instruments in the dental practice can be classified into one of what categories?
critical, semicritical or noncritical instruments
Instruments are classified dependind on their?
risk of transmitting infection, and the need to sterilize the instrument between uses
Instruments used to penetrate soft tissue or bone are considered?
Critical
How must critical instruments be cleaned?
They must be sterilized after each use
name examples of critical instruments?
forceps, scalpels, bone chisels, scalers, and surgical burs
What are the critical instruments used in dental radiography?
None! NO critical instruments are used in dental radiography
-----Are instruments that contact but do not penetrate soft tissue or bone?
Semicritical
How must semicritical devices must be cleaned?
sterilized after each used UNLESS the instrument can be damaged by heat then use a high level disinfectant.
what is an example of semicritical devices used in dental radiography?
Beam alignment devices
-----Are instruments ir devices that do not come in contact with mucous membranes
Noncritical
How are noncritical devices cleaned and why?
Because their is little risk of transmitting infection from noncritical devices intermediate or low level infection techniques are required
what is an example of noncritical devices used in dental radiography?
PID, dental x-ray tubehead, exposure button, x-ray control panel and lead apron
What are acceptable methods of dental sterilization?
Steam under pressure (Autoclave), Dry Heat and Chemical Vapor
How is the proper use of sterilization cycles verified?
By periodic use of a Biologic Indicator (Spore Test)
EPA registered disinfectants are classified as what in the dental field?
High-level disinfectants which can be used to disinfect heat-sensitive semicritical dental instruments
EPA registered chemical germicides labeled as both hospital disinfectants and tuberculocidals are classified as?
Intermediate level disinfectants
Intermediate level disinfectants include?
Phenolics, Iodophers, Chlorine containing compounds
What is recommended to clean all contaminated dental unit surfaces?
Intermediate level disinfectants
EPA registered chemical germicides labeled as only hospital disinfectants are classified as?
Low level disinfectants
What is recommended to clean general housekeeping surfaces such as floors and walls?
Low-Level Disinfectants
In dentistry treatment of all patients must be provided after?
Taking standard precautuions
-----Is a standard of care designed to protect health care personnel and patients from pathogens that can be spread by blood or any other body fluid, excretion or secretion.
Standard Precautions
must the same infection control procedures be used for each patient?
YES! No exceptions exist and no extra precautions should be used on any patients
What dental radiography surfaces must be covered and disinfected?
X-ray machine: tubehead, PID, and exposure button must all be covered or disinfected
Dental Chair: headrest and its control as well as chairs controls must be covered or disinfected
Work Area: the area where x-ray supplies (Film sensors) are placed during
Commercially plastic barrier envelopes must be sealed in a plastic barrier to?
protect the packets from saliva and to minimize contamination after exposure of the film
how does one clean the sensors/receptors used in digital radiography?
They cannot be heat sterilized and must be wrapped in plastic barrier envelopes to protect from saliva and contamination much like the barriers used for intraoral films MUST COVER BOTH HE SENSOR AND THE WIRE CONNECTION
before radiography exposure what should be covered or disinfected?
x-ray machine
dental chair
work area
lead apron
before radiography exposure what must be prepared before seating the patient?
image receptors
beam alignment devices
cotton rolls
paper towel
disposable container
before radiography exposure what must be prepared before putting on gloves?
adjust chair
adjust headrest
place lead apron on patient
remove metallic objects in the head and neck area of patient
right before radiography exposure what must be prepared?
wash hands
put on gloves
prepare beam alignment devices
During radiography exposure how must films be handled?
dry receptor with paper towel after exposure
place dried receptor in paper towel
During radiography exposure how must devices be handled?
transfer beam alignment device from work area to mouth and back to work area, disassemble over a protected work area, never place on uncovered countertop
after radiography exposure what should be completed before gloves are removed?
dispose of contaminated items
place beam alignment devices in area designed for contaminated instruments
after radiography exposure what should be completed after gloves are removed?
wash hands
remove lead apron
the patients head should be seated with the maxillary arch ----to the floor when seating a person for radiography?
parallel
hands must be washed before putting on gloves in the presence of?
the patient
gloves must be worn immediately after?
handwashing
why is the use of a surgical mask and protective eyewear optional in dental radiography?
because no aerosolized contaminants are created during x-rays
----Is a substance that inhibits the growth of bacteria
antiseptic
what is an example of a antiseptic procedure?
handwashing
does antiseptic mean killing?
No!
-----Is the use of a chemical or procedure to destroy pathogens?
Disinfect
does disinfect mean killing?
yes...kills but not all
what is an example of a disinfectant used in radiology?
cavicide for films
----Is the destruction of all pathogens.
sterilize
does sterilize mean killing?
yes kills all
what must be sterilized in radiology?
adjuncts: XCP, easy grip, beam alignment device, snap a ray
are all three types of infection control procedures used in dental radiography?
yes
what are types of infection control procedures used in dental radiography?
sterilization, disinfection, and antiseptic techniques
what are the instrument classifications used in radiology?
only semicritical and noncritical not critical for radiology
----instruments are used to penetrate soft tissue or bone
critical
how must critical instruments be cleaned?
sterilized after each use
name some critical instruments?
scalers, and forceps
----instruments contact but do not penetrate soft tissue or bone
semicritical
how must semicritical instruments be cleaned?
sterilize after each use unless heat/sterilization will hurt instrument then high level disinfection is required
name some semicirtical instruments used in dental radiology?
film holding devices, mirrors, cotton pliers
----instruments do not come into contact with mucous membranes
noncritical
how must non critical instruments be cleaned?
with a low level disinfectant
list some noncritical instruments used in dental radiology?
PID
Exposure button
x-ray control panel
lead apron
preparation of the operatory is basically the same as in?
our clinic
how must the x-ray machiene be prepared before the patient arrives?
cover control panel with a sticky
tube head with plastic
cover PID
what must be prepared for infection control before the patient arrives?
PREPARE OPERATORY: x-ray machiene, exposure button, dental chair, counter/work area, lead apron
PREPARE SUPPLIES: 2 trays
tray 1: outside of room: x-rays, BWX tabs etc.
tray 2: in operatory: mouth mirror, cotton pliers, cotton swabs, contaminates on here
how must the exposure button be prepared before the patient arrives?
with a sticky
why must a sticky be put over the exposure button?
because salivated hands press it
how must the dental chair be prepared before the patient arrives?
wipe same as in clinic,
cover over headrest and pillow (towels etc.)
chair in position for patient
how must the counter and or work area be prepared before the patient arrives?
prepare as we do in the clinic!
how must the lead apron be prepared before the patient arrives?
if contaminated wipe with disinfectant between patients
Where must the tray with the x-rays be placed?
Outside of the room so dosn't get exposed to radiation
where should contaminates be placed while working in radiology?
on the tray inside of the room for reuse with that patient (such as the stick and stabes used) do not place on the countertops!
why is it a good idea to double bag a digital sensor?
for more protection must protect from liquids very expensive dont want to ruin! it cannot be sterilized or get wet
how does one clean a digital sensor?
protect it using a plastic barrier envelope bag or a digital sleeve
do barrier film packets envelopes have to be opened with ungloved hands?
No! must be opened with gloved hands because the barrier is contaminated just film inside is protected
do barrier film film itself have to be opened with ungloved hands?
it should be! so the film itself is not contaminated because the barrier not the film packet was only contaminated the point of using them is so that one can do this!
what film should be used to reduce cross contamination?
barrier film
Is it a good idea to use disinfecting solutions on the dental x-ray unit?
No! solutions will get into electrical components
is it a good idea to cover the exposure button?
yes you must!
is it a good idea to autoclave a contaminated exposed or unexposed film packet?
No! Will destroy it!
How do you handle a film packet or stabe that has been dropped on the floor?
kick it to side and leave in on the floor to pick up later
what is the concern with the daylight loaders?
Not recommended due to cross-contamination
Is it a good idea to immerse a film packet in a solution for approx 10 minutes to disinfect it?
No! too long, will ruin film!
is it a good idea to wear a mask,gloves, glasses on a medically compromised patient?
yes!
is it ok to keep exposed film in the operatory?
no it will get overexposed
is it ok to keep exposed or unexposed film in the operatory?
no both will get overexposed
what is a really good way to prevent microbial contamination of a film packet?
use barrier film!
does taking a patients medical history reduce cross contamination?
No! wearing gloves, masks, glasses, using barriers does! patient may not know true medical history or may be lying
is it a good idea to wipe radiographs with paper towels, alcohol, or bleach to get rid of microbes?
yes but it is best to use barrier film so you dont have to!