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Dental Health & safety

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Direct contact
What is the most common route of contamination?
droplet infection
What is the term for acquiring an infection through mucosal tissues?
The use of gloves, hand washing, masks, rubber dams, and patient mouth rinses.
Wht infection-control measures help prevent disease transmission from the dental team to the patient?
The purpose of the Bloodborne Pathogens Standard is to protect healthcare employees.
What is the purpose of the BBP?
at least annually
How often should an exposure-control plan be reviewed and updated?
all body substances, regardless of whether or not they contain blood.
What does the term Standard Precautions include?
The date of the session, name of the presenter, the topic, and names of all attendees.
What information must be included in the employee training record?
The employee must sign and informed consent if he or she does not want the hepatitis B vaccine.
What must an employee do if her or she does not want the hepatitis B vaccine?
An alcohol-based hand rub is the most effective hand product for use on clean hands.
What is the most effective hand product on the markedt for use on clean hands?
They can harbor pathogents.
Why should long or artificial nails and rings be avoided when working in a dental office?
Masks, gloves, protective eyewear, and protective clothing are examples of personal protective equipment.
What are four examples of PPE?
The anticipated risk of exposure
What determines the type of PPE to be worn?
Face shields and eyeglasses with side and bottom shields
What are the two types of protective eyewear?
Gloves
What may be the most critical PPE?
procedures that involve cutting of bone or significant amounts of blood or saliva, such as oral surgery or periodontal treatment.
When should sterile gloves be worn?
When treatment room is cleaned and disinfected, while contaminated instruments are being cleaned or handled, and when surfaces are being cleaned and disinfected.
When should utility gloves be worn?
Overgloves
What type of glove should be worn to open drawers during a dental procedure?
Non-immunologic response
What type of response is irritant dermatitis?
IV sensitivity
What is the most common of latex allergy?
Anaphylaxis
What is the most serious type of latex allergy?
Vinyl or nitrile gloves
What type of gloves should be used for a latex-sensitive patient?
surface barriers, patient bibs, and gloves
What are three examples of contaminated waste?
Paper towels, paper mixing pads, and empty food containers
What are three examples of general waste?
Regulated waste
What is another term for infectious waste?
Infectious or regulated waste
Which type of waste much be identified with the biohazard label?
Never store food or drink in refrigerators that contain potentially contaminated items.
What is the BBP rule regarding refrigerators in dental offices?
Do not advise patients to close their lips tightly around the tip of the saliva ejector to evacuate oral fluids.
What is the CDC guidline for using sliva ejectors?
TB infection occurs when a susceptible person inhales bacteria, which then travel to the lungs.
How does tuberculosis infection occur?
The CDC does not make a recommendation on the use of pre-procedural mouth rinses.
What is the CDC recommendation on the use of pre-procedural mouth rinses?
The CDC has not made a recommendation because the effect on dental healthcare professionals from the use of lasers in dentistry has not been adequately evaluated.
Did the CDC make a recommendation on the effects of exposure to laser plumes on dental healthcare professionals? why or why not?
virulence
The link in the chain of infection that refers to the strength of the organism is
latent
A patient who had chickenpox as a child is now suffering from shingles (herpes zoster). This is an example of what type of infection?
splash or splatter
Using moisturizers to maintain healthy skin helps to prevent which type of disease transmission?
airborne transmission
Aerosolized saliva, blood, or microorganisms created by use of the high-speed hand piece, air water syringe, and ultrasonic scaler can contribute to which mode of disease transmission?
inherited immunity
Which type of immunity is present at birth?
Dental office to community
Leaving the dental office wearing contaminated attire and then hugging another person is an example of what type of disease transmission?
OSHA's bloodborne pathogens (BBP) standard.
OSHA requries that every dental office and clinic protect its employees from potentially infectious material. The source for guidelines is
thumb and in between the fingers
Areas of the hand that are frequently missed when washing with anitmicrobial soap and water are the
60%-95%
Waterless antiseptic products that contain alcohol are most effective at what concentration?
Protective clothing, mask, protective eyewear, wash and dry hands, put on gloves
In what order should personal protective equipment be put on?
Microbiology is important to the dental assistant for understanding infection-control protocol.
Why is microbiology important to the dental assistant?
Louis Pasteur is known as the Father of Microbiology
Who is referred to as the Father of Microbiology?
Josheph Lister
Who recognized that airborne microorganisms were responsible for postsurgical infections?
Louis pasteur
Who was responsible for discovering the rabies vaccine?
Cocci, bacilli, and spirochetes
What are the three primary shapes of bacteria?
Gram's stain
What is the staining process for separating bacteria?
Aerobes
What is the term for bacteria that require oxygen to grow?
a spore
What is the most resistant form of bacterial life?
Prions contain only protein and no nucleic acids (DNA or RNA).
How are prions different from other microorganisms?
HBV, HCV, and HDV
Which types of hepatitis are spread by exposure to blood?
HIV is spread by sexual contact with an infected person and by direct contact with infected blood also from infected mothers to their unborn children.
How is HIV spread?
West Nile virus affects a person's nervous system, causing inflammation of the brain and spinal cord.
What tissues are affected by the West Nile virus?
Infected birds
How is the H5N1 influenza virus spread?
The bacterium M. tuberculosis
What microorganism is used as the benchmark for the effectiveness of a surface disinfectant?
Tetanus
What disease is also known as lockjaw?
is a painless ulcerating sore known as a chancre
What is a sign of the first stage of syphilis?
global disease outbreak
What is a pandemic?
Aristotle
Who introduced the earliest beleif that life was spontaneously generated from nonliving matter?
viruses
Which microorganism is known as the perfect parasite because of its ability to live inside cells of the host and produce 10,000 offspring in as quickly as 7 hours?
Safranin dye
Gram's stain technique requires the sequential use of a crystal violet dye, iodine solution, alcohol solution, and
cocci
Bacteria with a spherical shape are called
spore
What type of microorganism is the most resistant form of life?
immunization
What is the main preventive measure a dental care worker can take to avoid contracting the virus hepatitis B?
performed through the skin
What does the term percutaneous mean?
mononucleosis
What does Epstein-Barr virus cause?
T-cells
What does HIV affect once it enters the body?
Chancre
The first stage of syphilis is the presentation of a painless, ulcerating sore known as a
Surface barriers
Is a fluid impervious material that is used to cover surfaces that are likely to become contaminated?
Transfer surfaces
Are surfaces that are not directly touched but often are touched by contaminated instruments?
Splash, splatter, droplet surfaces
Are surfaces that do not contact the members of the dental team or the contaminated instruments or supplies?
precleaning
is the removal of bioburden before disinfection?
disinfectant
A chemical to reduce or lower the number of microorganisms is a ?
Residual activity
Is the action that continues long after initial application?
Bioburden
Blood, saliva, and other body fluids are considered?
Broad spectrum
agent is capable of killing a wide range of microbes is labeled?
Idophor
An EPA registered intermediate level hopistal disinfectant is an?
Synthetic phenol compound
is an EPA registered intermediate level hospital disinfectant with broad-spectrum disinfecting action?
Glutaraldehyde
is classified as a high level disinfectant/sterilant
Chlorine dioxide
is an effective rapid acting envioronmental surface disinfectant or chemical sterilant?
Intermediate level disinfectant
destroys m. tuberculosis, viruses, fungi, and vegetative bacteria and is used for disinfecting dental operatory surfaces?
Low level disinfectant
destroys certain viruses and fungi and can be used for general housecleaning purposes (walls, floors).
to prevent patient to patient transmission of microorganisms.
Why must surfaces in dental treatment rooms be disinfected or protected with barriers?
To prevent cross-contamination
What is the purpose of surface barriers?
OSHA
Which regulatory agency requires the use of surface disinfection?
to remove the bioburden
Why must surfaces be precleaned?
on skin
Where are antiseptics used?
EPA
Which angency regulates disinfectants?
Glutaraldehyde
Which disinfectant is recommended for heat resistant items?
sterilization
A process that kills all microorganisms is ?
Transport
Cleaning
Packaging
Sterilization
Storage
Delivery
Quality
Seven steps for instrument processing?
High level disinfection
Process that kills some but not all bacterial endospores and inactivates mycobacterium tuberculosis.
Critical Instruments
Used to penetrate soft tissue or bone.
Greatest risk of transmitting infection and should be sterilized with the use of heat. ex: forceps, scalpels, bone chisels, scalers, and burs.
Semicritical Instruments
Touch mucous membranes or nonintact skin. Have lower risk of diseasse transmision.
most items are heat-tolerant, should also be sterilized. If item will be damaged by heat it should undergo high-level disinfection
Noncritical Instruments
Pose the least risk of transmission of infection.
Should be cleaned and processed using an EPA registered intermediate-level or low-level disinfectant after each use. ex: PID, the lead apron, curing light.
Workflow pattern
dirty,to clean, sterile, to storage!! Processing intsruments should proceed in a single loop.
Ultrasonic cleaner
Is a device that loosens and removes debris with the use of sound waves traveling through a liquid?
5-15 min, instrument have to be rinsed when comes out.
Autoclave
Is a piece of equipment that is used for sterilizing by means of moist heat under pressure?
Flash sterilization
May be used only on instruments that are placed in the chamber unwrapped, uses moisture so if dry when go in wont rust.
Chemical vapor sterilizer
Is a piece of equipment that is used for sterilizating by means of hot formaldehyde vapors under pressure? Have to be dry or will rust./ smell really bad
Dry heat sterilizer
A piece of equipment used for sterilization by means of heated air is the? less common/ can put wet instruments wont rust/ can use closed items Two types of dry-heat sterilizers: static air and forced air.
Static air sterilizers
Very common to a oven, 1 to 2 hrs/ time consuming!!
Biologic indicators
are vials or strips, also known as spore tests, that contain harmless bacterial spores and are used to determine whether a sterilizer is working? (must know)
Biologic monitor
Verifies sterilization by confirming that all spore-forming microorganisms have been destroyed?
(spore testing) rec. once a week
Process indicators
Chemical & outside of the instrument package? (external) ex: autoclave tape and color change marks on package. Also known as single parameter indicators.
Process integrators
Inside instrument packages? (internal)
Multi-parameter indicator
Tape, strips, and tabs with heat-sensitive chemicals that change color when exposed to a certain temp. are ex of a ?
Handpiece Sterilization Techniques
Only steam sterilization and chemical vapor sterilizers are recommended.
Should be packaged in bags, wraps, or pack to protect them form contamination before use.
Never run handpiece hot out of the sterilizer, and avoid rapid-cool-down, such as running handpiece under cold water. Extreme cold changes stresses the metal.(Really important)!!
Hand scrubbing
The least desirable method of cleaning instruments?
Flash sterilization
Quick easy 6-17 min advantages
Steam autoclave sterilization
Temp is maintained for set time 3-30 min
Dry-heat
Time 1-2hrs
Temp 320F-375F (160) to (190) c
Chemical Vapor sterilization
Pressure which should measure 20psi
Temp 270f (131)c
Time 20-40
Processing area requirements
Should be centrally located in the office to allow easy access.
Should be dedicated only to instrument processing. Should be physically seperated from the operatories and the dental lab. Should not be a part of a common walkway. The area should not have a door or window that opens the outside because dust. U shaped area.
vital signs
determine a patients health status.
Temperature, pulse, respiration, blood pressure.
normal
120/80
must be referred to the doc.
140/90
Emotional factors
stress, fear
Physical factors
illness, drinking or eating, exercise
Temperature
97.6 to 99 F average range of an adult.
Normally higher in infants and children thatn in adults.
Pulse
Rhythmic expansion of an artery each time the heart beats.
Radial artery:
inner surface of wrist
Brachial artery:
inner fold of the upper arm
Carotid artery:
alongside the larynx
Pulse characteristiscs
Rate:number of beats
Rhythm:pattern of beats
Volume:force of beats
Readings:
adults resting:60 to 100 beats per min.
Child:70 to 120 beats per min.
Irregularity
arrhythmia: an irregularity in the force or rhythm of the heartbeat.
Respiration
The process of inhaling and exhaling, or breathing.
Characteristics of respiration
Rate:total number of breaths per min.
Rhythm: breathing pattern
Depth: amount of air inhaled and exhaled
Readings:
Adults: 10 to 20 breaths per min.
Children and teenagers: 18 to 30 breaths per min.
Blood pressure
Reflects the amount of work the heart has to do to pump blood throughout the body. 120/80 S/D
Two pressures of the heart:
Systolic: reflects the amount of pressure it takes for the left ventricle of the heart to compress or push oxygenated blood out into the blood vessels.
Diastolic: The heart muscle at rest when it is allowing the heart to take in blood to be oxygenated before the next contraction.
Korotkoff sounds
Are sounds produced in artery when blood rushes back in after having to be cut off blood pressure cuff.
S-
D-
S- when hear
D- sounds disappear
Recognizing a medical emergency
Signs & symptoms report dissy, jaw hurts watch them walk, skin, resp, weight.
Physical changes
Unconsciousness, altered consciouness, respiratory distress, convulsions, and chest pain. We are in charge of the patient till ems or others show up! recognise signs and treat whats happening.
Syncope(fainting)-
Reduced blood flow to the brain causes the patient to lose consciousness. may be due to stress and apprehension, fear, the sight of blood or instruments.
Postural hypotension
(drop in blood pressure)-
Due to lack of sufficient blood flow to the brain that occurs immediately after a sudden change in positioning. when seated up or down.
Angina pectoris-
patient feels severe chest pain, heart muscle is deprived of adequate oxygen, angina pain usually lasts 3 to 8 min. Pain is relieved quickly by the administration of a commonly prescribed drug. Nitroglycerin. placed under tongue.
Signs of fainting-
Warm, flush, pale, vision blury, rapid heart beat.
Acute myocardial infarction
(heart attack)-
Muscles of the heart are damaged because sufficient oxygen cannot reach them.
Stroke-
interruption of blood flow to the brain.
Last long enough to damage the brain and cause loss of brain function.
Predisposing diseases:
Arteriosclerosis
Heart disease
Uncontrolled high blood pressure which can lead to stroke.
Hyperventilation
Increase in the frequency or depth (or both) of respiration.
Results in the consumption of too much oxygen by the patient. use paper bag to help breather. signs finger turn cold.
Bronchial asthma
Attacks of sudden onset during which the patients airway narrows, causing difficulty in breathing, caughing and a wheezing sound. Causes: allergic reaction, severe emotional stress, and respiratory infection.
Localized allergic reactions
slow to develop.
Mild symptoms such a itching, erythema, and hives.
Anaphylaxis
life-threatening allergic reaction.
Develops very quickly.
Happens very fast and can cause death.
Epilepsy
neurologic disorder characterized by recurrent episodes of seizures
pretit mal seizure
brief lapse of consciousness that may last only a few seconds
A grand mal seizure
involves temporary loss of consciousness accompanied by uncontrollable muscular contractions and relaxation.
Phase 1: aura
Phase 2: loss of consciousness
Phase 3: muscle contractions
Phase 4: sleep/recovery
Diabetes mellitus very common
metabolic disorder resulting from disturbances in normal insulin levels. They are best treated in the morning.
Hyperglycemia
(more sugar) abnormal increase in the glucose (sugar) level in the blood resulting in: Diabetic ketoacidosis, Diabetic coma. always ask when was the last time they took there insulin?
Hypoglycemia
(less sugar) abnormal decrease in the glucose level in the blood cause by: missing a meal, an overdose of insulin. Always ask when did you eat last?
Signs and symptoms of hyperglycemia:
Excessive urination, excessive thirst, dry mouth, and dry skin, acetone breath (fruity smell) blurred vision and headache, rapid pulse, lower blood pressure, and loss of consciousness. Record info let dentis know. More blood sugar in blood level.
Signs and symptoms of hypoglycemia:
Mood changes, hunger, perspiration, increased anxiety, possible unconsciouness. low blood sugar, they need sugar like orange juice 4oz at a time. wait 5 min inbetween.