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Recommended Infection-Control Practices for Dentistry Dental personnel may be exposed to a wide variety of microorganisms in the blood and saliva of patients they treat in the dental operatory.
Infections may be transmitted in dental practice by blood or saliva through direct contact, droplets, or aerosols.
Although not documented, indirect contact transmission of infection by contaminated instruments is possible. Patients and dental health-care workers DHCWs have the potential of transmitting infections to each other 1.
A common set of infection-control strategies should be effective for preventing hepatitis B, acquired immunodeficiency syndrome, and other infectious diseases caused by bloodborne viruses The ability of hepatitis B virus to survive in the environment 5 and the high titers of virus in blood 6 make this virus a good model for infection-control practices to prevent transmission of a large number of other infectious agents by blood or saliva.
Because all infected patients cannot be identified by history, physical examination, or readily available laboratory tests 3the following recommendations should be used routinely in the care of all patients in dental practices.
Include specific questions about medications, current illnesses, hepatitis, recurrent illnesses, unintentional weight loss, lymphadenopathy, oral soft tissue lesions, or other infections.
Medical consultation may be indicated when a history of active infection or systemic disease is elicited. Gloves must be worn by DHCWs when touching blood-soiled items, body fluids, or secretions, as well as surfaces contaminated with them.
Gloves must be worn when examining all oral lesions. All work must be completed on one patient, where possible, and the hands must be washed and regloved before performing procedures on another patient.
Repeated use of a single pair of gloves is not recommended, since such use is likely to produce defects in the glove material, which will diminish its value as an effective barrier. Surgical masks and protective eyewear or chin-length plastic face shields must be worn when splashing or spattering of blood or other body fluids is likely, as is common in dentistry 11, Reusable or disposable gowns, laboratory coats, or uniforms must be worn when clothing is likely to be soiled with blood or other body fluids.
If reusable gowns are worn, they may be washed, using a normal laundry cycle. Gowns should be changed at least daily or when visibly soiled with blood Impervious-backed paper, aluminum foil, or clear plastic wrap may be used to cover surfaces e. The coverings should be removed while DHCWs are gloveddiscarded, and then replaced after ungloving with clean material between patients.
All procedures and manipulations of potentially infective materials should be performed carefully to minimize the formation of droplets, spatters, and aerosols, where possible.
Use of rubber dams, where appropriate, high-speed evacuation, and proper patient positioning should facilitate this process. The rationale for handwashing after gloves have been worn is that gloves become perforated, knowingly or unknowingly, during use and allow bacteria to enter beneath the glove material and multiply rapidly.
For many routine dental procedures, such as examinations and nonsurgical techniques, handwashing with plain soap appears to be adequate, since soap and water will remove transient microorganisms acquired directly or indirectly from patient contact For surgical procedures, an antimicrobial surgical handscrub should be used Extraordinary care must be used to avoid hand injuries during procedures.
However, when gloves are torn, cut, or punctured, they must be removed immediately, hands thoroughly washed, and regloving accomplished before completion of the dental procedure. DHCWs who have exudative lesions or weeping dermatitis should refrain from all direct patient care and from handling dental patient-care equipment until the condition resolves Disposable syringes and needles, scalpel blades, and other sharp items must be placed into puncture-resistant containers located as close as practical to the area in which they were used.
To prevent needlestick injuries, disposable needles should not be recapped; purposefully bent or broken; removed from disposable syringes; or otherwise manipulated by hand after use.
Recapping of a needle increases the risk of unintentional needlestick injury. There is no evidence to suggest that reusable aspirating-type syringes used in dentistry should be handled differently from other syringes. Needles of these devices should not be recapped, bent, or broken before disposal.
Because certain dental procedures on an individual patient may require multiple injections of anesthetic or other medications from a single syringe, it would be more prudent to place the unsheathed needle into a "sterile field" between injections rather than to recap the needle between injections.
A new sterile syringe and a fresh solution should be used for each patient.
Instruments that are not intended to penetrate oral soft tissues or bone e. Cleaning may be accomplished by a thorough scrubbing with soap and water or a detergent, or by using a mechanical device e.At Thai Smile Dental Clinic, we use infection control protocol which recommend by American dental associations(ADA).
We sterile our instruments by Autoclave, Ethelene oxide gas and disinfected some instruments by chemical disinfectants. ADA Dental Assistant – American Dental Association Dental Assistant Dental assistants greatly increase the efficiency of the dentist in the delivery of quality oral health care and are valuable developing infection control protocol and preparing and sterilizing instruments and .
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