1. INFECTION CONTROL IN DENTAL LAB Revised by: C. Heston Created by: ANKIT PRABHAKAR GENESIS INSTITUTE OF DENTAL SCIENCES AND RESEARCH,FEROZEPUR PUNJAB

2. CONTENTS 1 1 4 4 2 2 3 3 Introduction Scope and objectives Transmission of infection Clinical and laboratory disinfection 5 5 CDC dental guidelines for sterilization of instruments

3. INTRODUCTION A study has found that 67% of materials sent from dental office to laboratories were contaminated with bacteria of varying degree of pathogenicity.` Why do we need to know about infection control?

4. Scope of this presentation

5. Occupational Risks Direct contact Airborne infection From microbial laden aerosols spatter During lab procedures When using knives and other sharp items Infected saliva or blood

6. CHAIN OF INFECTION PathogenReservoir Direct contact Indirect contact Portal of entry Susceptible host

7. GOALS/ ACTIONS Make dental lab safe Minimize potential IC compliance  Immunization  Barrier techniques  Aseptic techniques

8. Transmission of infection IMPRESSION ARTICULATOR CASTS DENTAL PROSTHESIS OCCLUSAL RIMS IMPRESSION TRAYS

9. SOURCES OF PATHOGENS

10. Prevention of cross contamination should always be a prime consideration in the dental lab. Infection control precautions Appropriate personal protective equipment Frequent hand hygiene Organization of dental lab into separate receiving, production & shipping areas.

11. BARRIER SYSTEMS Plain or antimicrobial soap Or an alcohol based hand rub Personal Protective equipment Gloves Mask & protective eye wear Chin length face shield Labcoat Hand washing

12. Disinfection of impressions IMPRESSION COMPOUND Iodophors and sodium hypochlorite REVERSIBLE HYDROCOLLOID Iodophors and sodium hypochlorite IRREVERSIBLE HYDROCOLLOID Iodophors and sodium hypochlorite POLYETHERIodophors and sodium hypochlorite ZOE IMPRESSION PASTE Glutaraldehydes, iodophors POLYSULFIDEGlutaraldehydes, iodophors SILICONEGlutaraldehydes, iodophors

13. CHOICE OF DISINFECTANT

14. Methods of disinfection Spraying Uses less disinfectant Same disinfectant can be used again ImmersionPreferable Exposure of all surfaces METHODS OF DISINFECTION

15. DENTAL LAB PROCEDURES INCOMING ITEMS Rinse to remove blood & saliva Disinfect Again rinse to remove disinfectant Add the annotation on the form OUTGOING ITEMS Clean and disinfect Rinse, dilute with mouthwash Place in plastic bag Label the plastic bag

16. ORALLY SOILED PROSTHESIS Scrub with brush and antimicrobial soap. Place in plastic bag in ultrasonic cleaning solution. Removed Rinsed DriedAccomplished required work.

17. DENTAL PROSTHESIS Do not exceed the recommended contact time to minimize corrosion. Do not store in disinfection before insertion. Store in diluted mouthwash until insertion.

18. DISINFECTION OF CASTS Most difficult to disinfect without causing damage. In such cases, can be sprayed with an iodophor or chlorine product Rinsed, handled in aseptic manner Transfer to the production area. Dry properly, if shipping.

19. LAB EQUIPMENT  Polishing lathe requires special attention.  Should be equipped with shield  Should be equipped with ventilation to remove aerosols  Air suction motor must be able to produce an air velocity of at least 200 feet/min  A metal enclosure with hand holes is fixed to the front of the hood provides maximum containment  Pumice has been shown to pose a potential contamination risk via aerosol or direct contact. It should be discarded after every use  Rag-wheel and burs need to be sterilized between uses  All unbarriered areas need to be disinfected.

20.  Objectives - protect patients, practitioners & staff.  All blood and saliva is infectious.  Reviews scientific information & makes recommendations to protect the health of the population.  Tracks disease trends & investigates disease outbreaks. CDC DENTAL GUIDELINES

21. RESPONSIBILITY ResponsibilityPractical code Procedure kept cross infection control Universal precautions Protect exposure from blood Standard precautions Blood as well as from body fluids also.

22. GENERAL PREVENTION VACCINATIONMEDICAL HISTORY Average Risk of Transmission after Percutaneous Exposure to Blood In order to identify pathological conditions, Drug induced conditions Malformations & abnormalities

23. SPECIFIC GUIDELINES Personal hygiene Cleaning and maintenance Disposal of wastes These guidelines apply in the care of all patients.

24. SUMMARY PREVENTION OF DISEASE TRANSMISSION Aseptic techniques Wearing protective personal equipments Adhering to Standard precautions