1. Chapter 10 Infection Control

2. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Define the key words. State the purpose of infection control. Describe the possible routes of disease transmission. Identify conditions for the chain of infection and methods of breaking the chain.

3. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives  Identify agencies responsible for recommending and regulating infection control guidelines.  List the personal protective equipment recommended for the dental radiographer.  Explain disinfection and sterilization.  Differentiate between semicritical and noncritical objects used during radiographic procedures.

4. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Demonstrate competency in following infection control protocol prior to radiographic procedures. Demonstrate competency in following infection control protocol during radiographic procedures. Demonstrate competency in following infection control protocol after radiographic procedures.

5. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Objectives Demonstrate competency in following infection control protocol for handling and processing intraoral image receptors. Demonstrate competency in following the infection control protocol when using an automatic processor with a daylight loader attachment.

6. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Key Words Acquired immunodeficiency syndrome (AIDS) Antiseptic Asepsis Barrier envelope Contamination Cross-contamination

7. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Key Words Disinfect Hepatitis B Human immunodeficiency virus (HIV) Immunization Infection control Intraoral dental film

8. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Key Words  Microbial aerosol  Pathogen  Personal protective equipment (PPE)  Protective barrier  Sepsis  Standard precautions  Sterilize  Universal precautions

9. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Introduction  The purpose of infection control procedures used in oral health care is to prevent the transmission of disease among patients and between patients and oral health care practitioners.

10. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson

11. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Introduction  The radiographer must possess a thorough understanding of the recommended infection control protocols that should be followed before, during, and after radiographic exposures.

12. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Introduction  The specific steps of the recommended infection control protocols require practice to achieve competency in skilled handling of contaminated radiographic equipment and supplies.

13. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Purpose of Infection Control  Routes of infection transmission  Direct contact with pathogens in open lesions, blood, saliva, or respiratory secretions  Direct contact with airborne contaminants present in aerosols of oral and respiratory fluids  Indirect contact with contaminated objects or instruments

14. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-1 Chain of infection.

15. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Purpose of Infection Control  Breaking the chain of infection  Immunization  Removing the pathogen  Reducing sufficient numbers of pathogens  Blocking the portal of entry

16. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Table 10-1 Terminology

17. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Guidelines for Infection Control Standard precaution  “Treat everyone as if known to be infectious”  All body fluids (except sweat) of all patients, whether known to be infected or not, are assumed to be infected and the necessary infection control procedures must be applied to all.

18. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson BOX 10-1 The Centers for Disease Control and Prevention (CDC) Recommended Infection-Control Practices for Oral Radiography

19. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Guidelines for Infection Control  Government agencies are responsible for developing, recommending, and/or regulating infection control guidelines:  Centers for Disease Control and Prevention (CDC)  Occupational Safety and Health Administration(OHSA)  Food and Drug Administration (FDA)  Environmental Protection Agency (EPA)

20. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Personal Protective Equipment (PPE)  Protective clothing  Masks  Protective eyeware  Gloves

21. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-2 Radiographer preparing x-ray equipment. Wearing PPE (barrier gown, protective eyewear, mask, gloves) to place barriers to cover the x-ray tube head and PID. In the background, note that image receptor holders have been assembled and placed on a plastic barrier on the countertop.

22. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-1 Procedure for Handwashing for Radiographic Procedures

23. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Disinfection and Sterilization of Instruments and Equipment  Disinfection  Sterilization  Classification of objects used in radiographic procedures

24. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Disinfection and Sterilization of Instruments and Equipment  EPA-registered sterilants-disinfectants are classified as:  High-level disinfectant  Intermediate-level disinfectant  Low-level disinfectant

25. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Table 10-2 Risk of T`ransmitting Disease Classification of Objects Used in Radiographic Procedures

26. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Infection Control Protocol for Radiographic Procedure  Protocol prior to the radiographic procedure  Protocol during the radiographic procedure  Protocol after the radiographic procedure

27. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-2 Infection control prior to the radiographic procedure.

28. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-2 (continued) Infection control prior to the radiographic procedure

29. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-2 Infection control prior to the radiographic procedure.

30. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-4 Barrier envelope. (left) Film available from manufacturer sealed in barrier packet ready for use. (right) Barrier envelopes may be purchased separately.

31. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-5 Opening the barrier envelope. A steady pull is used, allowing the film packet to drop into a clean cup.

32. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-6 Barrier envelopes for phosphor plates. (Courtesy of Air Techniques, Inc.)

33. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-7 Using a disinfectant wipe to prepare a digital sensor prior to placing plastic barrier.

34. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson

35. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-3 (continued) Infection Control during the Radiographic Procedure

36. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-8 Remove saliva. Radiographer is swiping the film packet across a disinfectant-soaked paper towel prior to dropping the film into the containment cup.

37. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson

38. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-9 Removing the plastic barrier from a digital sensor. Removal of sticky-backed biteblocks is easier if the image receptor holder remains in place attached to the barrier. (A) Grasping the holder in the palm of one hand, press on the sensor with the thumb.

39. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-9 (continued) Removing the plastic barrier from a digital sensor. Removal of sticky-backed biteblocks is easier if the image receptor holder remains in place attached to the barrier. (B) As the sensor begins to move, guide it out of the plastic sheath with the other hand.

40. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Infection Control Protocol for Radiographic Processing  Film handling without the use of barrier envelopes  Film handling with the use of barrier envelopes

41. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson

42. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-5 (continued) Infection control for processing radiographic films without barrier envelopes

43. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-10 Steps for removing film from packet without touching film with contaminated gloves. (A) Open the film packet by lifting the plastic tab. (B) Locate the folded tab of black paper and grasp with finger and thumb. (C) Gently pull on the black paper tab sliding the film out of the packet. (D) Allow the film to drop out onto the plastic or paper towel barrier placed on the counter. Separate the lead foil from the rest of the packet and dispose of all materials appropriately.

44. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson

45. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Procedure 10-6 (continued) Infection control for an automatic processor with the daylight loader attachment.

46. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Figure 10-11 Daylight loader with cover opened. The operator placed clean, dry hands through the baffles. Note that gloves will be put on once the hands are inside the unit.

47. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary The purpose of infection control is to prevent the transmission of disease between patients and operators and between patients. Standard precautions treat every patient as if known to be infectious.

48. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary The chain of infection involves a susceptible host, pathogens in sufficient numbers to initiate infection, and an appropriate route for the pathogen to enter the host.

49. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary The Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OHSA), the U.S. Food and Drug Administration (FDA), and the U.S. Environmental Protection Agency (EPA) each play a role in developing, recommending, and/or enforcing guidelines for infection control.

50. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary Personal protective equipment (PPE) is used to prevent the transmission of infective microorganisms. Disinfection and sterilization breaks the chain of infection to prevent the transmission of infective microorganisms.

51. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Review: Chapter Summary Specific step-by-step infection control procedures must be performed prior to, during, and after the radiographic procedure. Strict infection control protocol must be followed when using an automatic processor with a daylight loader.

52. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Recall: Study Questions General Chapter Review

53. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Reflect: Case Study While exposing a full mouth series of radiographs on your patient, you accidentally drop the film-holding device on the floor. Since you still have additional exposures to complete, you need the use of this device. Explain in detail what infection control protocol you would follow to deal with this dilemma.

54. Copyright ©2012 by Pearson Education, Inc. All rights reserved. Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Evelyn M. Thomson Orlen N. Johnson Relate: Laboratory Application Proceed to Chapter 10, Laboratory Application, to complete this activity.