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

2. Dentistry before and now

3. Dentistry before and now

4. Dentistry before and now

5. Why precaution is necessary?

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

7. 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

8. 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

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

10. 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

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

15. 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

16. 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 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

18. 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

19. 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 minutes

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

21. Thank You