Infection Control Procedures in Dentistry Part II Asma’a Al-Ekrish

Aseptic Technique Clean, sterile, and disinfected materials should not contact contaminated material and vice versa.

Processing of Instruments

Instruments must be cleaned well before sterilization

Instruments Clean gross deposits of materials or tissues with gauze soaked in holding solution. Soak instruments in holding solution & Burs, Barbed Broaches and Files

Holding Solution 1.Prevents tissues, fluids, and debris from drying. 2.Reduces the amount of viable micro-organisms during cleaning. Instruments & Burs, Barbed Broaches and Files

BiB Forte should be prepared fresh daily by diluting 50 ml / 1 litre Instruments & Burs, Barbed Broaches and Files Holding Solution

1.Alcohol alone not effective for biological debris. 2.Gluteraldehyde effective but toxic. 3.Sodiumhypocloride (Clorox © ) corrosive. Instruments & Burs, Barbed Broaches and Files Holding Solution

Scrub with brush under running water. Washing instrumentsWashing hands Two sinks Heavy duty gloves to protect from sharp injury Instruments & Burs, Barbed Broaches and Files

Ultrasonic cleaners 1.Reduce chances of hand injury. 2.Reduce splatter in environment 3.More effective in cleaning small crevices Instruments & Burs, Barbed Broaches and Files

 Rinse disinfectants from instruments well before packaging.  Residue of disinfectant on instruments may cause damage upon autoclaving. Instruments & Burs, Barbed Broaches and Files

Hand-pieces 1- Flush hand-piece into container for 30 seconds 2- Lubricate hand-piece 3- Reattach hand- piece and spray excess oil out by air only 4- Wipe clean 5- place in envelope

Hand-pieces IMPORTANT To prevent damage to the hand-pieces: Always keep bur inside hand-piece when flushing it.

DO NOT PLACE HAND-PIECES IN WATER Hand-pieces

Heat sealingAuto-sealingSealing tape Packaging & sealing

Double fold then tape along the edge Packaging & sealing

Chemical indicator Changes color after entering the autoclave Packaging & sealing

Infection Control in Prosthodontics

The ADA recommends chemical disinfection of all impressions and dental prostheses. An acceptable disinfectant is sodium hypochlorite (Clorox © ) in a 1:10 dilution.

Rinse thoroughly Rinse under water 15 seconds Immerse in disinfectant 10 minutes ( keep covered or place inside bag) Impressions

dipped or sprayed When working with alginate, if accuracy is extremely important… covered with damp paper towel for ten minutes Rinse Impressions Rinse-spray-rinse Rinse

Most fixed and removable prostheses may be processed by rinse- spray-rinse. Unglazed porcelain should not be disinfected. The glazing process will sterilize it. Prostheses

Prostheses which have been worn by the patient and have gross deposits must be cleaned well before disinfection. Acrylic has tiny porosities which may harbor bacteria. Prostheses

Bite registration Wax rims Custom trays Rinse-spray-rinse Other Items

Casts If disinfection of a cast is indicated, immerse for 10 minutes or spray until wet and leave for 10 minutes. Cast should be fully set (at least 24 hours) before disinfection.

Other Prosthodontic Items Autoclave Articulators Face-bows Wooden-handled spatulas Torches Rubber mixing bowls Shade-guides Face-bow forks Metal impression trays All-metal spatulas s.s. bowls Heat Stable Items Clean and Disinfect Non-Heat Stable Items

Disposable plastic impression trays which cannot be autoclaved should not be reused between patients.

Infection Control During Radiograph Making

Spread of Contamination

Protect Film Packet Remove film packet avoiding contamination of the film. Cover film with plastic barrier Handle clean film with new gloves.

Infection Control During Radiograph Making  Barrier Protection  Regloving  Two- Person Technique

Barrier Protection Cover all surfaces which will be touched with plastic barrier. Barrier should be changed between each patients

6- discard dirty gloves and outer film wrapping. 5- Remove film from wrapper. Re-gloving Technique 1- Position film in patient’s mouth 2- Change gloves 3- adjust x-ray tube and controls with clean gloves 4- Remove the film from the mouth

Two- Person Technique One person placing film in patient’s mouth Another person wearing clean gloves adjusting x-ray tube and control The person with the dirty gloves then removes the film from the packet without contaminating the film

Digital Radiography Sensor (placed in patient’s mouth) Keyboard X-ray tube head Control

Caution: If disinfection of x-ray equipment is required due to unintended contamination, care must be taken to avoid spraying x-ray head and electrical controls

Thank You Any questions ?