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Infection Control

What do the links in the chain of infection include?

virulence, number of microorganisms, susceptible hosts, and portal of entry

What does the virulence of an organism refer to?

the degree of pathogenicity, or the strength of that organism in its ability to produce disease

How does the number of microorganisms do its part in the chain of infection?

To cause disease, a high enough number of pathogenic microorganisms must be present to overwhelm the body's defenses

What does Bioburden refer to?

organic material such as blood and saliva.

What can help minimize the amount of bioburden on surfaces?

the use of the dental dam and the high-volume evacuator

What is a susceptible hosts?

a person who is unable to resist infection by a particular pathogen.

What kind of individual is more likely to be infected?

An individual who is in poor health, is chronically fatigued, and under extreme stress, or has a weakened immune system is more likely to be infected

How does Portal Entry do its part in the chain of infection?

To cause infection, pathogens must have a portal of entry, or a means to enter the body.

Examples of portal entry for blood-borne pathogens include:

a break in the skin caused by a needle stick, a cut, or even a human bite

What are the portals of entry for airborne pathogens?

mouth and nose

What must blood-borne pathogens have to enter the body?

access to the blood supply as a means of entry into the body

What are the four types of infection?

Acute infection, Chronic infection, Latent infection, and opportunistic infection.

Describe Acute infection?

symptoms are often severe and usually appear soon after the initial infection occurs.
short duration
Ex: Common Cold

What are Chronic infections?

those in which the microorganism is present for a long duration.
may not be showing symptoms but still a carrier
EX: HIV or HCV

What is a latent infection?

a persistent infection in which symptoms come and go
EX: Cold sores (oral herpes simplex) and genital herpes

What is Opportunistic Infection?

caused by normally nonpathogenic organisms, occur in individuals whose resistance is decreased or compromised.
EX: in an individual who is recovering from influenza, pneumonia... an ear infection may develop.

What are the modes of disease transmission?

Direct contact, indirect contact, droplet infection, parental transmission

Direct contact:

touching or contact with the patient's blood or other body fluids

Indirect contact:

Touching or contact with contaminated surface or instrument

Droplet infection:

An infection that occurs through mucosal surfaces of the eyes, nose or mouth

Parenteral transmission:

Needle stick injuries, human bites, cuts, abrasions, or any break in the skin

What is an infectious disease

one that is communicable or contagious

Direct transmission occurs when:

through a person-to-person contact.
EX: Droplets that are spread through sneezing or coughing, or even spatter produced during dental treatment

What disease can come from direct transmission?

herpes infection, HIV infection, and tuberculosis are spread through direct contact

When does indirect transmission occur?

when microorganisms first are transmitted to an object or surface, and then are transferred to another person who touches those objects or surfaces
EX: a dental chart is handled by a dental assistant while wearing contaminated gloves that is then handled by the receptionist with bare hands.

What does airborne transmission refer to?

the spread of disease through droplets of moisture that contain bacteria or viruses

When do aerosols, sprays, and spatters occur?

they are generated during dental treatment and can contain blood, saliva, and nasopharyngeal secretions.

What are aerosols created by?

by the use of high-speed handpiece and the ultrasonic scaler during dental procedures

How are sprays and spattered created?

created by the use of the handpiece and the ultrasonic scaler, as well as the air-water syringe. Can contain blood, saliva, or debris

Intact skin

acts as a natural protective barrier

Nonintact skin

in which a cut, scrape, or needle stick injury has occurred provides a means of entrance for the pathogens

What will help minimize splashes and aerosols?

use of dental dams and high-velocity air evacuation

Parenteral Transmission

through the skin; cuts or punctures. Needle stick injuries, human bites, abrasions, or any break in the skin

Blood-borne pathogens

carried in the blood and body fluids of infected individuals and can be transmitted to others.

Blood-borne transmission occurs through what types of contacts?

Direct and Inderect with blood and other body fluids

What are common blood borne microorganisms dental offices have concern for?

HCV,HBV, and HIV

Immunity

allows the body to resist disease and prevents foreign bodies from causing infection

inherited immunity

when immunity is present at birth

acquired immunity

immunity developed throughout a persons lifetime
may occur naturally or artificially

when does natural acquired immunity occur

when a person has previously contracted a disease and recovered

active immunity

when the body was fighting the invading pathogen, it formed antibodies that provide future resistance against that particular pathogens.
the body of the host is actively involved in the process

passive immunity

occurs during pregnancy when the fetus receives antibodies from the mothers placenta. antibodies are acquired from an outside source

what does it mean when the human body has not been exposed to a disease?

that it has not developed antibodies and is completely defenseless against the disease

How can antibodies be introduced into the body artificially?

by immunization or vaccination

What are types of disease transmission in the dental office?

Patient to dental team
Dental team to patient
patient to patient
dental office to community (includes dental teams family)
community to dental office to patient

What is the most common route of direct contact?

Patient to dental team
If the dental team member has cuts, abrasions, or breaks in the skin around the fingernails, microorganisms may gain entrance

Dental team to patient

can result if the dental team member has lesions on the hands, or if the hands are cut while in the patients mouth, permitting the transfer of microorganisms

What are infection controls that can help prevent team to patient transmission?

gloves, mask, hand washing, and immunization

Patient to patient transmission

occurs in the medical fields mostly.
contamination from instruments used on one patient would need to be transferred to another patient

Infection control measures used to prevent patient to patient transmission are:

instrument sterilization, surface barriers, handswashing, gloves, and use of sterile instruments

Dental office to community

contaminated impressions may be sent to the dental lab, or contaminated equipment may be sent out to repair.
or through clothing or hair

Community to dental office

microorganisms enters the water that supplies the dental unit.
may form biofilm

What kind of agency is the CDC? And what role does it play?

The CDC is not a regulatory agency. Its role is to issue specific recommendations that are based on sound scientific evidence for health-related matters

When were the CDC Guidelines released?

In December 2003, the CDC released its Guidelines for Infection Control in Dental Healthcare settings-2003

What is the most important infection control law in dentistry?

OSHA's BBP Standard is the most important infection control law in dentistry

What is OSHA's BBP Standard designed for?

to protect employees against occupational exposure to blood-borne, disease causing organisms, such as HBV, HCV, and HIV

Exposure Control Plan

each dental office must have a written exposure control plan that clearly describes how that office complies BBP Standard. This exposure control plan must be reviewed and updated at least annually. A copy must be made available to all employees.

Standard Universal Precautions

refereed to in the OSHAs BBP Standard. Universal precautions is based on the concept that all human blood and body fluids (including saliva) are to be treated as if known to be infected with a blood-borne disease such as HBV,HCV, or HIV

standard Precaution

integrate and expand elements of Universal Precautions into a standard of care that is designed to protect healthcare providers from pathogens that can be spread by blood or any other body fluid, excretion, or secretion

Standard Precautions apply to contact with the following:

blood
all body fluids, secretions, and excretions, except sweat, regardless of whether or not they contain blood
nonintact skin
mucous membranes

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