Infection control In Dental Practice

ELHAWARYELHAWARY
Infection ControlInfection Control
Infection Control In DentalInfection Control In Dental
PracticePractice
Dr. Hesham El-HawaryDr. Hesham El-Hawary
Assoc Prof OMFSAssoc Prof OMFS
Cairo UniversityCairo University
hesham@elhawarydentalclinic.comhesham@elhawarydentalclinic.com

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• IntroductionIntroduction
• Stages for infection controlStages for infection control
• Aseptic surgical techniquesAseptic surgical techniques

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INTRODUCTION
IINFECTION CONTROLIINFECTION CONTROL

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Human floraHuman flora
InfectionInfection
Infective pathogensInfective pathogens
DiseaseDisease
Disease transmissionDisease transmission
HygieneHygiene
Infection controlInfection control
AsepsisAsepsis

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Human floraHuman flora
• Human flora:
Microorganisms that constantly inhabit the
human body (bacteria, fungi)
• Examples:
– Oral flora: micro-organisms present inside oral cavity as
normal habitat
– Skin-flora: micro-organisms present on the skin as normal
habitat
– GIT Flora: micro-organisms present inside the GIT as
normal habitat

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Human floraHuman flora Cont.Cont.
• These habitats are immune to its own floras
• Under certain conditions they may cause
infection

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InfectionInfection
• The colonization of a host organism by a foreign
species
• In an infection, the infecting organism seeks to
utilize the host's resources to multiply (usually
at the expense of the host)

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Infective pathogens
Bacteria &
spores
Virus Fungi
Unicellular micro-
organism
sub-microscopic
infectious agent
eukaryotic organism
opportunistic
Dependent Reproduction Independent reproduction
Dependent metabolism Independent metabolism

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DiseaseDisease
• An abnormal condition of an organism that
impairs bodily functions and can be deadly
• It is also a way of the body harming itself in an
abnormal way associated with specific
symptoms and signs

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DiseaseDisease Cont.Cont.
• Incubation period
– The time between exposure (infection) to a
pathogenic organism, or chemical or radiation,
and when symptoms and signs are first apparent
(clinical onset)
– The period may be as short as minutes to as long
as thirty years
– Depending on the disease, the person may or may
not be contagious during the incubation period

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DiseaseDisease Cont.Cont.
• Latent or Latency period
– The time from infection to infectiousness
– Depends on the disease
• A person may be a carrier of a disease,
without exhibiting any symptoms

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• Two ways of disease transmission:
– Horizontal disease transmission
– Vertical disease transmission
Passing a disease causing agent vertically from
parent to offspring
Typically the mother transmits the disease by means
of bodily fluid, and sometimes breast milk

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Patient
Dental Care
Personnel
Dentist

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• Horizontal disease transmission
– From one individual to another in the same generation
– Occur by
• Direct contact (licking, touching, biting), an infected person, including
sexual contact
– Droplet contact - coughing or sneezing on another person
– Direct physical contact – touching, sexual contact
• Indirect contact
– Vector borne transmission - carried by insects or other animals
– Soil contamination or a contaminated surface
– Airborne transmission - if the microorganism can remain in the
air for long periods
– Fecal-oral transmission - usually from contaminated food or
water sources

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HygieneHygiene
• Refers to practices associated with ensuring good
health and cleanliness
• Such practices vary widely and what is considered
acceptable in one culture may be unacceptable in
another
• In medical contexts, the term "hygiene" refers to
the maintenance of health and healthy living

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• It is the discipline concerned with preventing the
spread of infections within the health-care setting
• It concerns itself both with:
– Prevention (hand hygiene/hand washing,
cleaning/disinfection/sterilization, vaccination,
surveillance)
– Investigation and management of demonstrated
or suspected spread of infection within a
particular health-care setting (e.g. outbreak
investigation)

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AsepsisAsepsis
• It is the practice to reduce or eliminate contaminants
(such as bacteria, viruses, fungi, and parasites) from
entering the operative field in surgery or medicine to
prevent infection
• Ideally, a field is "sterile" i.e. free of all contaminants
— a situation that is difficult to attain
• However, elimination of infection is the goal of
asepsis, not sterility

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The goal of an infection control program
is
to provide a safe working environmentsafe working environment
for dental health care personnel (DHCPDHCP)
and their patients

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Control of Cross Infection InControl of Cross Infection In
Dental ClinicDental Clinic
(Clinic Asepsis)(Clinic Asepsis)
1.1.CleaningCleaning
2.2.DisinfectionDisinfection
3.3.SterilizationSterilization
reduce or eliminate
contaminants
(such as bacteria,
viruses, fungi,
parasites)
from entering the
operative field

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• Saliva and/or blood spread during:
– Dental treatment
– Dental clinic cleaning
– Instruments cleaning
• Decontamination is achieved through 3
procedures:
– Cleaning
– Disinfection
– Sterilization

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CleaningCleaning
• It is the physical removalphysical removal of debris and
reduction of the number of micro-organism
present
• It is a basic step in clinic asepsis
• AllAll items should be cleanedcleaned before
disinfection or sterilization

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How to clean your clinic?How to clean your clinic?
• Surface Cleaning:
– Surfaces to be disinfected are cleaned first
– Method of cleaning:
• Soap and water
• Foam spray containing phenol compounds
• Instruments Cleaning:
– Scrub the instruments with a heavy duty brush
under running water wearing heavy duty gloves
– Use ultra-sonic cleaners when available

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DisinfectionDisinfection
• It is the process that killskills pathogenic
organisms but notbut not necessarily all
microorganisms
• Efficiency of disinfection depends on:
– The concentration of disinfectant
– Concentration of the active ingredients
– Number and types of microorganisms killed

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SterilizationSterilization
• This is the process by which allall
microorganisms including bacterial spores are
killedkilled
• Methods of sterilization:
– Autoclaving
– Dry heat
– Chemical heat under pressure
– Cold sterilization (prolonged immersion in
chemicals)

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Universal precautions forUniversal precautions for
infection controlinfection control
1.1. Protective barriersProtective barriers
2.2. Use and disposal of needles and sharpUse and disposal of needles and sharp
instrumentsinstruments
3.3. Infection control for instrumentsInfection control for instruments
4.4. Infection control of clinicInfection control of clinic

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• Even when healthyhealthy, the mouth containscontains
hundreds of possible pathogenspathogens
• Universal precautions for infection control are
intended to prevent parentral, mucous
membrane and non-intact skin of DHCPs to
blood-and-saliva borne pathogens

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Protective barriersProtective barriers
1. Hand washing
2. Gloves
3. Masks and Eyewear
4. Attire

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Hand washingHand washing

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• It is the first step in the practice of the
universal precautions
• Wearing gloves and hand washing will notnot
provideprovide enough protection ifif there are openopen
sores or wound presentsores or wound present

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Requirements of hand washingRequirements of hand washing
• Remove rings, bracelets and watches
• Nails are cut short
• No nail polish or false fingernails

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Indications for hand washingIndications for hand washing
• Before treatment
• Between patients
• After glove removal
• Whenever contaminated with blood or other body
fluids
• Before leaving the operatory

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Types of hand washingTypes of hand washing
• OrdinaryOrdinary hand washing
– Using ordinary soap
– Using soap with anti-microbial agent
– The hands must be dried by disposable towels
• Surgical scrubSurgical scrub
– Before surgeries
– After routine hand washing
– Using surgical scrub material
– Till the elbow joint

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GlovesGloves

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• It protects the DHCWsprotects the DHCWs by providing extra barrier
against entry of micro-organism through the skin
breaks
• They protect the patientsprotect the patients from contracting micro-
organisms on the DHCWs hands

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When should we wear glovesWhen should we wear gloves
• When touching patient’s mouth
• When dealing with instruments
• When dealing with contaminated surfaces

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Types of glovesTypes of gloves
• Latex glovesLatex gloves
• Examination gloves
• Dental procedures
• Sterile disposable glovesSterile disposable gloves
• Used when sterility is needed
• Surgical or periodontal procedures
• General purpose utility glovesGeneral purpose utility gloves
• During instruments cleaning before autoclaving
• Autoclaved or cleaned with soap and water then
disinfected

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Rules during wearing glovesRules during wearing gloves
• WashWash your hands and drydry it before wearing gloves
utilizing the suitable techniquesuitable technique
• Gloves should not beshould not be worn outside the treatment
areas
• Never use the gloves that were used during patient’s
treatment when handlinghandling dental records
• Check the gloves intactnessintactness every10 minutes
• Never washNever wash the disposable gloves and re-use them

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What to do if the gloves are torn orWhat to do if the gloves are torn or
puncturedpunctured
1. Remove both gloves immediately
2. Dispose the gloves
3. Wash your hands thoroughly with soap and water
4. Disinfect your hands with a suitable hand
disinfectant

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Masks and Eye wearMasks and Eye wear
Or face shieldsOr face shields

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Indications of useIndications of use
• Patient treatment
– Cleaning of instruments
– Disposing of contaminated fluids
• Cleaning instruments
• Disposing contaminated fluids

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Recommendations for useRecommendations for use
• The mask is ineffective when become wet
• A fresh mask is used for every patient
• Wear the mask before wearing gloves
• Don’t touch the mask with the gloves
• The protective eyewear are mandatory
• Non-disposable protective eyewear should be
washed with soap and water then immersed
in glutraldehyde for 10 minutes then rinsed
with water

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AttireAttire

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• Long sleeves and high neck are essential for a clinic
coat
• Change your coat at least daily or whenever needed
(visibly contaminated)
• Don’t keep clinic coat with the street clothes in the
same locker
• Dirty clinic coats should be washed using bleach
• Disposable plastic aprons may be used for
procedures with risk of blood contamination

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For male DHCWsFor male DHCWs
• Head covers should not be wornnot be worn inside
treatment areas
• Facial hair should be completely coveredcovered
under face shields
• Slippers are not allowednot allowed
• Neckties should be tucked inside buttoned
clinic coat

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For female DHCWsFor female DHCWs
• PinPin long hair back
• Cover the hair whenever possible
• For those who wear long head covers, the cover
should be tightly tucked insidetightly tucked inside the clinic coat

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The use and disposal of needlesThe use and disposal of needles
and sharp instrumentsand sharp instruments

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PrecautionsPrecautions
• Careful handling of sharp
instruments
• Place all deposable sharp
instruments into the puncture
resistance sharp containers

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PrecautionsPrecautions

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Stages for infection controlStages for infection control

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Stages for infection controlStages for infection control
Stage I:Stage I:
Preparation of the surgery room before admitting thePreparation of the surgery room before admitting the
patientpatient
Stage II:Stage II:
Necessary procedures in the surgery roomNecessary procedures in the surgery room
Stage III:Stage III:
Management at the end of the procedureManagement at the end of the procedure

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Clinic preparationClinic preparation
1. Wear clean clinic coat
2. Wash your hands and then put on gloves (plastic gloves)
3. Disinfect all working surfaces with disinfecting solution
suing the spray-wipe-spray technique e.g.
– Dental unit light
– Bracket table
– Air-water syringe tip, handle, holder
– Saliva ejector attachement
– All hoses
– Hand piece holders
– Control switches

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1. Cover all areas that can not be sterilized with
disposable towels
2. Get sterile instruments that will be used for
the patient in sterile tray
3. Prepare disposable cup, towel, saliva ejector in
a sterile tray
4. Admit the patient

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1. Hands of the operator and assistant should be
scrubbed with soap for one minute and rinsed with
water
2. Disinfect the hands with 70% alcohol
3. Operator and assistant wear personal protective
equipments gloves, gowns, protective shields
4. Change the gloves when necessary

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5. At end dispose all
– Disposable items in special plastic bag
– Sharp instruments in special container
– Contaminated (gauze, cotton) material in another
bag
– Remove the gloves, clean then disinfect hands
– Disinfect the surfaces of the unit and cabinets with
disinfecting solution
• 1% sodium hypochlorite
• 70 % isopropanol

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1. Instruments must be cleaned with soap and water
2. Ultrasonic cleaning for removal of any depris in the
depressions of the instruments
3. Wrap the instruments
4. Autoclave
• N.B. cold sterilize instruments that can not be
autoclaved

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Aseptic surgical techniqueAseptic surgical technique

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Aseptic surgical techniqueAseptic surgical technique
Asepsis of ArmamentariumAsepsis of Armamentarium
Asepsis in the Operating RoomAsepsis in the Operating Room
Operating room Scrub techniqueOperating room Scrub technique
Sterilization of the Field of OperationSterilization of the Field of Operation
Outpatient (clinic) TechniqueOutpatient (clinic) Technique
Clinic Scrub TechniqueClinic Scrub Technique
Sterilization of the Field of OperationSterilization of the Field of Operation

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• Sterilization:
Any process that effectively kills or eliminates
transmissible agents (such as fungi, bacteria,
viruses, spore forms, etc.) from a surface,
equipment, article of food or medication, or
biological culture medium
• Means of sterilization: application of heat,
chemicals, irradiation, high pressure or
filtration

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Asepsis of ArmamentariumAsepsis of Armamentarium Cont.Cont.
• Physical sterilization : heat , irradiation
– Autoclaving
– Boiling water
– Boiling oil
– Dry heat
• Chemical sterilization / cold sterilization
– Ethylene oxide
– Ozone
– Chlorine bleach
– Glutaraldehyde
– Formaldehyde
– Hydrogen peroxide
– Peracetic acid
– Ethanol 70%

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Physical SterilizationPhysical Sterilization
AutoclavingAutoclaving

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Advantages and Disadvantages ofAdvantages and Disadvantages of
sterilization methodssterilization methods
Stem autoclave Chemical
sterilization
Dry heat
sterilization
Advantages
1. Efficient
2. Quick and easy
3. Allows package
sterilization
4. Penetrates
papers
1. Cheap
2. Can sterilize
items damaged
by heat
1. Inexpensive
2. No rusting to
metals
Disadvantages
1. Leave
instruments wet
lead to rusting
2. Requires
packaging
3. Damage plastic
4. Dull sharp items
1. Rust
instruments
2. Toxic fumes
3. Can’t use
packaged items
4. Must be rinsed
with sterile water
1. Lack of cooling
2. Long time
3. Cannot be used
with temperature
sensitive
instruments

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Status instruments How to handle
Critical
These are instruments that
invade tissues
e.g. scalpels, scalers, burs,
files
Sterilization
Semi-critical
These instruments are used
intra-orally but do not invade
tissues
e.g. amalgam condenser
Sterilization or high level of
disinfection
Non-critical
Instruments or equipments
that do not get inside the
mouth
e.g. x-ray cone
Medium or low level
disinfection

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Infection control of the dentalInfection control of the dental
unitunit

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• An autoclave is a pressurized device designed to
heat aqueous solutions above their boiling point at
normal atmospheric pressure to achieve
sterilization
• It was invented by Charles Chamberland in 1879

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• A medical autoclave is a device that uses steam to
sterilize equipment and other objects; This means
that all bacteria, viruses, fungi, and spores are
inactivated
• The most adequate method of sterilization
• Mechanism Of action:
– Steam (moist heat) under Pressure for certain
time
– Variables adjusted according to the instruments to
be sterilized

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Air removal (TYPE B)Air removal (TYPE B)
• The goal of autoclaving is to achieve sterility, it is
very important to ensure that all of the trapped air is
removed
• The reason for this is that hot air is very poor at
achieving sterility
• Steam at 134 °C can achieve in 3 minutes the same
sterility that hot air at 160 °C takes two hours to
achieve

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• Autoclaves may achieve air (pre-evacuation) removal by
various means including:
– Downward displacement (or gravity type)
• As steam enters the chamber, it fills the upper areas as
it is less dense than air
• This compresses the air to the bottom, forcing it out
through a drain. Often a temperature sensing device is
placed in the drain
– Steam pulsing
• Some autoclaves remove air by using a series of steam
pulses, in which the chamber is alternately pressurized
and then depressurized to near atmospheric pressure
Air removalAir removal Cont.Cont.

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• Autoclaves may achieve air (pre-evacuation) removal by various means
including:
– Vacuum pumps
• Some autoclaves use vacuum pumps to suck air or
air/steam mixtures from the chamber
– Superatmospheric
• This type of cycle uses a vacuum pump
• It starts with a vacuum followed by a steam pulse and
then a vacuum followed by a steam pulse
• The number of pulses depends on the particular
autoclave and cycle chosen
– Subatmospheric
• Similar to superatmospheric cycles, but chamber
pressure never exceeds atmospheric until they
pressurize up to the sterilizing temperature
Air removalAir removal Cont.Cont.

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• Materials that could be sterilized are:
– Metallic instruments
– Autoclavable plastic instruments
– Gauze and Cotton rolls
– Rubber tubing and rubber gloves
– Drapes
– Towels
• Materials to be sterilized must be wrapped in a
special packs:
– Surgical pack / wrappers
– Metallic drums

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Time Stem Temperature (SST) for effectiveTime Stem Temperature (SST) for effective
sterilizationsterilization
Steam Pressure
in pounds
/ square inch
(PSI)
Temperature
Sterilization time
(mins)
Recommended
materials to be
sterilized in
C F
15 121 250 30 Fragile objects
20 126 259 20
Instruments
Cotton
towels
30 135 273 6

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Physical SterilizationPhysical Sterilization
Boiling WaterBoiling Water

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DisadvantagesDisadvantages
• Incapable of killing heat resistant forms of bacteria and spores
• Cause rusting / corrosion of instruments
Methods to improve efficiencyMethods to improve efficiency
• Addition of 2% sodium carbonate solution to the water
AdvantagesAdvantages
• Elevate boiling temperature to 110°C
• Reduce the boiling time
• Increase bactericidal effect
• Reduce corrosion of instruments as the alkaline solution
decrease the oxygen content of water

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Physical sterilizationPhysical sterilization
Boiling OilBoiling Oil

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• For sterilization of:
– Handpieces
– Contra-angles
– Mirrors
• Not used any more since the availability of B-
type autoclaves

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Physical sterilizationPhysical sterilization
Dry HeatDry Heat
Hot air sterilizationHot air sterilization

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• Prolonged heat and excessively high
temperature in special oven
• Adequate for sterilization of certain materials
that can not be sterilized by boiling or
autoclaving
– Bone waxes
– Oils
– Talcum
– Zinc oxide powders

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Hot air sterilization time / temperatureHot air sterilization time / temperature
relationrelation
Temperature
Sterilization time
C F
121 250 18-24 hours
140 285 180 mins
150 300 150 mins
160 320 120 mins
170 340 60 mins

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• Disadvantages:
– Time consuming
– Less power of penetration
– Damages solder points of instruments
– Depends on the thermal conductivity of the material
to be sterilized

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Chemical SterilizationChemical Sterilization

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• Recommended for sterilization of instruments
that have sharp cutting edges
– Scissors
– Chisels
– Rongeurs
– Suture needles
• As successive boiling or autoclaving spoils the
cutting edges of these instruments
• Many agents are available but no one can
fulfills the requirements of sterilization

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Principles of cold sterilizationPrinciples of cold sterilization
• Instruments should be scrubbed and cleaned with detergent
soap before sterilization
• Completely immerse the instruments into the liquid
• Insert the instruments for adequate sterilization time
recommended for that chemical
• Change the solution regularly according to the manufacturer
instructions
• Instruments should be wiped and cleaned from the solution
• Never used to sterilize hypodermic needles (serum hepatitis)

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AlcoholAlcohol

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• Absolute 95%
• Alcohol mixed with formalin (formaldehyde)
– Can destroy tubercle bacilli
• Disadvantages:
– Evaporates
• Cause rusting of metals
• Needs to be stored in sealed containers
• Offensive disagreeable odour
– Cause pain and irritation to the tissues
– Expensive

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Benzalkonium ChlorideBenzalkonium Chloride
(Zephiran)(Zephiran)

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• Concentration for sterilization 1:100
• Disadvantages:
– Cause rusting to the metals
– Long sterilization time 18 hours
• Sodium nitrate is added to the solution to
decrease rusting of metals

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Mercuric BichlorideMercuric Bichloride
(Sublimate)(Sublimate)

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• Concentration for sterilization 1:500
• Sterilizing rubber objects
• Disadvantages:
– Destructive to metal instruments

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Hexachlorophane compoundsHexachlorophane compounds
(G-II)(G-II)

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• Sterilization of heat sensitive
instruments in 3 hours

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• The operating team should wear special scrubbing
suits, head caps and masks
• Wash the finger, hands and forearm up to the elbow
with soap and water using special scrubbing brushes
and clean the finger nails with special applicators
• The fingers, hands and forearm up to the elbow is
then scrubbed using surgical scrub material for 7-10
minutes
• After scrubbing the operating team proceeds into
the operating room and gets dressed in sterile
gowns and gloves

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• Aim: Rendering the oral cavity and all the parts of the face in
relation to it aseptic
• Technique:
– After administering G.A.
– Scrub the patient’s face and lips with detergent soap using folds of
sterile gauze
– Dry the using dry sterile gauze
– Scrub the oral cavity with surgical scrub material (Betadine Surgical
Scrub) using folds of sterile gauze, Sponges or towels
– Scrub the lips and the face all around the oral cavity starting from the
lips outwards
– Dry the scrubbed areas with dry sterile gauze
– Drap the patient with sterile towels and sheets just to expose the area
of interest
– Fasten the drapes with towel clamps

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The operator and assistantThe operator and assistant
1. Scrub the hands using detergent
soap and a scrubing brush for 3-5
minutes
2. Rinse with alcohol
3. Dry with a sterile towel
4. Wear sterile gloves
5. Replace sterile gowns by long
sheets covering the boy from the
neck to the knees

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The operator and assistantThe operator and assistant
1. Scrub the hands using detergent soap and a scrubing
brush for 3-5 minutes
2. Rinse with alcohol
3. Dry with a sterile towel
4. Wear sterile gloves
5. Replace sterile gowns by long sheets covering the boy
from the neck to the knees

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1. Seat the patient in the dental chair
2. Spray the oral cavity with proper antiseptic solution
3. Wipe the lips and part of the face in contact with
antiseptic (Betadine surgical scrub / Alcohol) using
folds of sterile gauze on a needle holder or hemostat
4. Dry the wiped parts with dry sterile gauze
5. Wrap the patient’s head with a sterile towel

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6. Cover the hole body and the head with sterile drape
with an opening close to its tip to expose the oral
cavity
7. Fasten the towel and drape with towel clamps
8. Proceed with the operation

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Specialized Areas GuidelinesSpecialized Areas Guidelines

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Oral And Maxillofacial SurgeryOral And Maxillofacial Surgery
Periodontal SurgeryPeriodontal Surgery
Infection Control ProtocolInfection Control Protocol

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• Physical barriers are to be worn
• Minimize trips outside the clinic as possible
and when you have to do it remove your
gloves and re-glove when entering the clinic
• Sharp instruments must be disposed in the
puncture resistant containers
• Contaminated hoses should be thoroughly
cleaned and disinfected

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Restorative Clinic CrossRestorative Clinic Cross
Infection Control ProtocolInfection Control Protocol

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• Absorbent points and cotton pellets should be
sterilized
• Root canal reamers, files, broaches and burs should
be autoclaved
• Electric pulp tester and light cure handles should be
wrapped with plastic or aluminum foil
• Electric pulp tester and light cure tips must be
disinfected between patients
• Amalgam waste must be discarded in a special
container

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Protocol For X-Ray ClinicProtocol For X-Ray Clinic

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1. Before seating the patient
– Use surface disinfectant to spray
• Control buttons
• Chair head rest
• Tube head
– Prepare the films insert it into plastic gloves finger
1. Seat the patient
2. Wash your hands, dry it and then put on gloves

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4. During the procedure use barrier techniques
5. Put on plastic over-gloves and adjust the xray
machine cone
6. Take off the over gloves
7. Take the film out of the patient mouth
8. Put the film inside a disposable cup
1. Dispose all disposable
9. Remove the gloves

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10.Put on plastic gloves and disinfect the
surfaces
11.Film processing
– Put on new latex gloves
– Dry the film cover using disposable towels
– Open the film package and drop the film into
new and clean disposable cup
– Remove your gloves and start the processing
manually or automatically

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Control of Cross Infection In TheControl of Cross Infection In The
Dental LaboratoryDental Laboratory

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Items to be disinfected after each useItems to be disinfected after each use
• Articulator
• Face-bow
• Rubber mixing bowels
• Plastic spatulas
• Impression syringes not tips
• Shade guids

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Items to be sterilized after each useItems to be sterilized after each use
• Face-bow fork
• Impression stock tray
• Waxing instruments
• Laboratory burs
• Polishing rubber points
• Impression syringes tips

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Disinfection of impressions, casts andDisinfection of impressions, casts and
denturesdentures
1. Rinsed under running water to remove debris and
saliva
2. Alginate & polyether impressions are placed on
paper towels and sprayed with sodium hypochlorite
3. Impressions are then wrapped in towel wet with
disinfectant, placed in plastic bag and sent to the
lab
4. Records such as wax rim, trial bases with tooth set
up are disinfected by sodium hypochlorite 1:10
dilution

ELHAWARYELHAWARY
Items received from the labItems received from the lab
1. Spray the cast with glutraldehyde, wait 3
minutes then spray again and rinse with
water
2. Disinfect the following prosthetic items by
sodium hypochlorite 1:10 dilution
– Trial bases with tooth set up
– Dentures
– Temporary bridges
– Porcelain teeth

ELHAWARYELHAWARY
Oral Pathology AndOral Pathology And
Microbiology SpecimensMicrobiology Specimens

ELHAWARYELHAWARY
1. Prepare pathology specimen jar before
starting the surgery (without wearing gloves)
2. Open the jar prior to the surgery and during
the instruments preparation
3. Fill the jar with the preservation fluid
4. Start the surgery and put the biopsy into the
jar
5. After finishing the surgery and removal of the
gloves close the jar and label it

ELHAWARYELHAWARY
THANK YOUTHANK YOUTHANK YOUTHANK YOU

Infection control In Dental Practice

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