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
touching or contact with the patient's blood or other body fluids
Touching or contact with contaminated surface or instrument
An infection that occurs through mucosal surfaces of the eyes, nose or mouth
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
acts as a natural protective barrier
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
through the skin; cuts or punctures. Needle stick injuries, human bites, abrasions, or any break in the skin
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
allows the body to resist disease and prevents foreign bodies from causing infection
when immunity is present at birth
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
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
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
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