Management for Infectious Disease Patients Dr Khairi Izhar -O-O-

Dentistry before and now

Dentistry before and now

Dentistry before and now

Why precaution is necessary?

Infectious Disease to be aware HIV, AIDS Hepatitis Tuberculosis STI (sexual transmitted infection) or STD (sexual transmitted disease)

HIV and AIDS Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome Lentivirus (subgroup Retrovirus) attack CD4 T cells (Helper T cells) Transmitted by: Blood Vaginal secretion Semen Breastfeed Pregnancy

Hepatitis Cause by 5 type: Transmitted by: Primary : viral infection Secondary : drug, medication, toxin, alcohol, autoimmune 5 type: Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Transmitted by: Ingestion Blood Vaginal secretion Semen Develop on active or carrier patient

Tuberculosis Caused by Mycobacterium Tuberculosis 2 types Latent TB Active TB Transmitted by Airborne (coughs, sneezes, spits, laughs, or talks)

STI or STD Sexual transmitted Infections or Sexual transmitted disease Type of virus: Hepatitis B Hepatitis C HIV HPV Herpes Simplex Virus (HSV) Type of bacteria: Chancroid (Haemophilus ducreyi) Chlamydia (Chlamydia trachomatis) Gonorrhea (Neisseria gonorrhoeae) Granuloma inguinale or (Klebsiella granulomatis) Mycoplasma genitalium Mycoplasma hominis Syphilis (Treponema pallidum) Parasite Fungal

Precaution as Health worker Immunization All dental health worker MUST to be immunized against HBV by vaccination

Management of Infectious Disease Patient Schedule the patient at the end of the list. Number of staff to perform the procedure have to be limited All operator handling surfaces should place barrier plastic including head rest Operator and assistant use standard precaution At least 2 pair of gloves At least 2 pair of face mask Disposable gown or apron Face shield During procedure Minimize formation of droplet and aerosol Using high volume suction together with normal suction If possible, use rubber dam

Management of Infectious Disease Patient After procedure Gown, glove, face mask, saliva ejector and barrier plastics should be thrown away into different clinical waste plastic, seal and label it All exposed surface must be disinfect and leave it at least 10-15 minutes If there is visible blood or pus, clean and disinfect with 0.5% sodium hypochlorite or 2% glutaraldehyde, rinse All instrument including must be clean, immerse in disinfectant, seal it and autoclaved Immerse in disinfectant according to manufacturer Immerse overnight still debatable

Management of Infectious Disease Patient Handpiece must be disinfect and leave it at least 3 minute before oiling and autoclaved Needle and scalpel blade dispose into sharp bin Denture: Immerse in 0.1% sodium hypochlorite for 10 minutes and rinse Impression: Rinse, get rid of excess water, spray with 0.1% sodium hypochlorite, put in closed container for 10 minutes. X-ray film: Dispose the cover, drop the film without touching it Change gloves after processing

Management of Infectious Disease Patient For patient Tuberculosis Same procedure as explained before Addition by opening the nearby window to increase air circulation in the surgery room during procedure After procedure, leave it open at least 20-30 minutes

Needle Prick Injury If any of the staffs have needle prick injury incident, report to any OSH (occupational safety and health) team medical member.

Thank You