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Hepatits B virus had the most serious risk of transmission to unvaccinated dental staff because is usually transmiteed by the introduction of infected blood into blood streams of a susceptible person.Inactivating hepatitis B virus include halogen containing disinfectants (e.g idophor and hypochlorite), formaldehyde,ethylene oxide gas.Only 105-107 virions/ml blood is reqiured
Requires direct contact between virus laden blood or secretions from the infected host organims and a mucsoal surfage 0r epithelial wound of potential host
Spore forming bacteria:anthraxbacillusclostridium
The spores of bacillus stearothermophilus is extremely resistant to heat and is therefore, used to test the stability of steriliazation.Alternative method is to place them into cassettes that are double wrapped in specifially designed paper and sterilized as se set for use on a single pateint.Three factors must be considered when using dry heat:1)warm up time for oven and the materias tp be sterilized 2)heat condcutivity of the materials.3)air flow thorugh out the oven and through the objects being sterilized.
Advantage: porous materials large equipments and material sensitive to heat or moisture.Disadvantage need for special qeuipment and the length of sterilization and aeration time necessary to reduce toxicity .
Quaternary ammonuim compund not recommended because they become inactivated by soap and anionic agents.Alocholic evaporat too rapidly that’s y not commonly used
COMMONLU USED ANTISEPTICS ARE: IDOPHORESCHLORHEXIDINEHEXACHLOROPHENE.SCCOP TECHQNIQUE FOR RESHEATING NEEDLE:
Cross infection control in oral surgery
M SHARIQ SOHAIL
3RD YEAR BDS
Infection control measures aim to ensure the protection of
those who might be vulnerable to acquiring an infection
both in the general community and while receiving care
due to health problems, in a range of setting.
NEED FOR INFECTION CONTROL PROTOCOLS??
1)First, to perform surgery, the dentist typically violates
an epithelial surface the most important barrier
2)Second, during most oral surgical procedures, the
dentist, assistants, and equipment become conta-
minated with the patient’s blood and saliva.
COMMUNICABLE PATHOGENIC ORGANISMS:
Includes bacteria ,mycobacteria , viruses and fungi.
The viral organisms that cause the most difficulty are the
hepatitis B and C viruses and human immunodefficiency
Hepatitis A is spread by contact with feces of infected
Hepatitis C virus may spread through contaminated
feces or by contaminatd blood.
Hepatits B and D viruses are spread by contact with any
HUMAN IMMUNODEFICIENCY VIRUS (HIV):
1)Because of relatively inability to survive outside the
host organisms HIV acts in a fashion similar to other
agents of sexually transmitted diseases(Requires direct
2)All patients infected with HIV infection who have C4+
T lymphocyte counts of less than 200/microL should
be treated by doctors and staff free of clinically evident
1)The only mycobacterial organism of significance to
most dentists is mycobacterium tuberculosis.
2)TB is transmitted primarily through exhaled aerosols
that carry M tuberculosis from the infected lungs of
one individual to the lungs of another individual.
As through breathing, speaking, coughing, sneezing.
3)Techniques of instrument sterilization.
a)Sterilization by Heat
b)Sterilization with gas.
4)Techniques of instruments disinfection.
6)Surgical staff preparation.
7)Post surgical Asepsis.
1)SEPSIS: Is the breakdown of living tissue by the action of
microorganims and is usually accompained by inflammation.
2)ANTISEPTIC AND DISINFECTANT: Both refer to
substance that can prevent the multiplication of organisms
capable of causing infection.The difference is that antiseptics
are applies to living tissue, whereas disinfectants are designed
only for use ininanimate object.
3)STERILITY AND SANITIZATION: Sterility is the freedom
from viable forms of microorganisms. Sanitization is the
reduction of the number of viable microorganisms to levels
judged safe by public health services.
Chemical and physical agents are the two principal means of
reduction the number of microbes on a surface.
1)Physical: Heat, Radiation and Mechanical dislodgment.
2)Chemical: Antiseptics, Disinfectants, Ethylene oxide gas
*The microbes have variable ability to resist to chemical or
physical agents. The micro organisms most resistant to
elimination are bacterial endospores.Therefore in general any
method of sterilization that kills endospoers is also capable of
eliminating bacteria viruses, mycobacteria, fungi and
The three methods available for instrument sterilization are dry heat,moist
heat, and ethylene oxide gas.
1)DRY AND MOIST HEAT:
2)STERILIZATION WIT H GAS:
1) Ehytlene oxide is a gas at room temperature, and
can readily diffuse through porous materials, such as
plastic and rubber.
2)At 50C ethylene oxide is effective for killing all
organisms,including spores,within 3 hours.
Many dental instruments cannot withstand the temperatures required for
heat sterilization.Therefore, if sterilization with gas is not available and
absolute sterility is not required,chemical disinfection can be performed.
1)LOW: Reduces overall number of vegetative microorganims but donot
destroy tubercle bacilli or bacterial spores.Agents used are phenolic
disfectants and quaternary ammonium compound. Application on
2)INTERMEDIATE: kill vegetative microorganisms including
mycobacterium tuberculosis, and inactivates most viruses.Agents used are
Alcohols, Hypochlorite, Iodine and idophor disinfectants. Application on
floor, operation tables etc
3)HIGH: Kills vegetative microorganisms and inactivates viruses, but not
necessarily high number of bacterial spores.Agents used are Hydrogen
peroxide, Gluteraldehyde, Formaldehyde. Application on on medical
Any surface that a patient or patients secretions contact
is a potential carrier of infectious organisms.
The operatory can be disinfected in two basic ways:
a)first to wipe all surfaces with a disinfectant solution.
b)second is to cover surfaces with protective shields that
are changed between each patient.
Many chemical disinfectants including chlorine
compounds and gluteraldehyde, can prevent transfer of
the hepatitis virus when used on surfaces in certain conc.
(0.2% for chlorine and 2% for gluteraldehyde)
The two basic types of personnel asepsis
1) The clean technique.
2) The sterile technique.
1)WOUND MANAGEMENT: Wound should be
inspected or dressed by hands that are covered with
2)SHARPES MANAGEMENT: During and after
surgery, contaminated materials should be disposed of
in such a way that the staff and other patients will not
Contemporary Oral and Maxillofacial surgery by
JAMES R. HUPP, EDWARD ELLIS MYRON