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unit 1&2

Pathways for Cross Contamination

patient to dental team, dental team to patient, patient to patient, dental office to community, community to patient

patient --> dental team

direct contact (saliva/blood) into openings,droplet infection(spray/splatter) into eye,nose,mouth etc, indirect contact(poke with used needle)

dental team --> patient

not following procedures (ex. no gloves with cuts on hands)
direct, indirect, droplet

patient --> patient

indirect contact (not sterilized equiptment)

dental office --> community

indirect contact (waste management, disinfection of appliances,laundry, handwashing

community --> patient

direct contact (water)
water source should be separate, should disinfect waterlines, water contain antimicrobial agent, filtering the water

Route of Microbial Transmission

1) pathogen 2) source (person w/infection) 3) Mode (how it is transmitted-door handle, saliva etc) 4) Entry (opening to body) 5) Susceptible Host (may not be vaccinated)

universal precautions

Treat all blood,saliva, and OPIM as infected

standard precations

treat all blood,saliva, OPIM, mucous membranes, non intact skin as infected

reccomendations vs. regulations

reccomendations are not law (made by individuals and groups with no authority) and regualtions are laws (have authority-state/local)


center for disease control and prevention
infection control in dentistry often follows this
not law


American Dental Association-supports the CDC
infection control reccomendations
not law


Organization for Safety and Asepsis Procedures
infection control education in dentistry
not law


Association for the Advancement of Medical Instrumentation
develop sterilization methods and standards
not law


Food and Drug Administration -law
regulates and labels medical devices (gloves, masks, sterilizers etc) for safety


Environmental Protection Agency- law
control waste and regulate sterilizer


Occupational Safety and Health Administration- law
protects employees, bloodborne pathogen standard

Bloodborne Pathogen Standard

OSHA- most important infection control law in dentistry to protect workers

Steps to Compliance to Bloodborne standard

1. review standard 2. written exposure plan 3. training of employees 4. Provide employees with everything needed(vaccinations,clean PPE,procedures,postexposure care,biohazard communication) 5. Maintain records

Written Exposure Plan components

1. exposure determination 2. schedule of implementation(inform,vaccinations,postexposure,records,PPE) 3. Evaluation of exposure incidnets-plan to evaluate exposure 4.Prevention of sharps injuries (devices and methods)

OSHA training

-accessible copy and explanation of bloodborne pathogen standard, exposure plans-inform about bloodborne pathogens,transmission,exposure plan, infection control, PPE,vaccinations,signs and labels-evaluations and answered questions


lab coat,gloves,masks,eyewear,sheild

barrier techniques

prevent contact w/microorganisms escaping from their sources

gloves-protection value

prevent direct contact w/microorganisms in patients mouth and contaminated surfaces and chemicals
protect patient from microorganisms on dental team hands

uses/types of gloves

patient care gloves-disposable gloves-latex,nitral,vinyl
overgloves-"food handlers gloves"
sterile gloves-for surgical procedures
utility gloves-not disposable-for cleaning and sterilizing

limitation of gloves

little protection from sharps

Reactions to gloves

irritant contact dermatitis-dry,red,itchy,cracked(not allergy)
allergic contact dermatitis-typeIV hypersentitivity,limited to areas of contact-itchy,red,vesicles,dry,sores
latex allergy-type I hypersensitivity

Preventing/managing latex allergies

avoid contact,latex free environment,include on patient medical history records,education about latex reactions

protective value of handwashing

resident flora-microorganisms that normally live on the skin and are temporarily reduced when handwash
transient flora-not normally on skin,pick up anywhere, removed during handwash
disease prevention procedure

steps of handwashing

1.remove jewelry 2.scrub hands,nails,forearms with soap 3.rinse with cool water 4.repeat 5.dry hands starting at fingertips

handwashing agents

plain soap-buy at store, used at home,bar or liquid
antimicrobial soap-prevents/removes microbes
alcohol based hand rub-hand sanitizer, can't use when visibly soild, but most effective

protective value of masks

protect mucous membranes of nose/mouth of dental team from spray/splatter of patient contaminated fluids
may protect patient from infectious of dental team

uses/types of masks

use during any procedure,changed with every patient,different levels of filtering

limitations of masks

not perfect seal around the edges,when becomes wet the air can flow more

protective value of eyewear

protect againts infections in spray/splatter/aerosols,physical damage to the eyes from propelled objects/chemicals, patients may wear also

uses/types of eyewear

wear whenever doing procedures,must fit properly and have side sheilds,sterilized between patients

protective value of protective clothing

protects the body(arms/chest) against infectious materials, helps from spreading to home,keeps from spreading from home to patients

types/uses of protective clothing

outer layer of clothing protecting uniform(lab coat)
wear whenever doing procedures to prevent contamination, change if visibly soiled,don't wear to lunch or out of op, can't take home

placing/removing barriers

putting on-protective clothing, eyewear, mask, gloves
removing-disposable gown,gloves,eyewear, mask

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