Dental Office Infection Control
Cross-contamination: Occurs from patient to patient via medical staff or the instruments used. The chain of infection is influenced by key factors that determine the spread of disease through contact between the infectious agent and a susceptible host. Opportunistic Pathogens: Pathology results when the body’s defenses are reduced. Antiseptic: Chemical disinfection of the skin, mucosa, or other tissues using an antiseptic. Antiseptics inactivate substances that inhibit bacterial growth. Disinfection: The process of destroying pathogens, but not necessarily spores and viruses. Bactericide: A substance capable of destroying bacteria. Infection: The invasion of a body by an external agent that can produce disease.
Dental Office Environment: All personnel in the dental office are exposed to infectious diseases due to potential contamination between patients. This contamination can occur because the patient’s mouth harbors germs, and transmission channels exist through organic secretions like saliva and blood. Transmission can be direct, through contact, or indirect, through contaminated or poorly disinfected instruments, skin, or mucous membranes. Microorganisms involved include bacteria, fungi, and viruses.
Control Measures in the Dental Office
Control in the Dental Office: Aims to minimize the risk of infection for both patients and professionals. Protection measures include: personal hygiene, barrier protection (e.g., gloves, masks), and immunization (hepatitis B, tetanus, flu), as well as adherence to vaccination schedules.
Hygiene and Sterilization Techniques
Hygiene Technique: The process of instrument hygiene includes: soaking and disinfecting, cleaning, drying and lubrication, packing, and sterilization. Disinfectants are classified by level. High-level disinfectants inactivate vegetative forms of bacteria, fungi, spores, viruses, etc. Low-level disinfectants, such as sodium hypochlorite (10%), inactivate vegetative forms of bacteria and fungi.
Commonly Used Disinfectants
Commonly Used Disinfectants: Sodium hypochlorite is used to disinfect non-critical surfaces and metallic materials, as well as root canals in endodontics. Glutaraldehyde is a high-potency disinfectant used in spray form. Chlorhexidine is used for disinfecting skin and mucous membranes or for scrubbing surfaces and hands. Phenol compounds were among the first antiseptics. Quaternary ammonium compounds act as fungicides and bactericides. Ethyl alcohol at 70% or 96% is a less preferred disinfectant.
Material Classification and Sterilization
Material Classification: Critical items have direct contact with oral tissues and blood and must be sterilized. Semi-critical items are those that do not penetrate oral tissues but still require high-level disinfection. Non-critical items enter the mouth but are disinfected in the dental office.
Sterilization Methods
Sterilization: A procedure that destroys all life on an object. This can be achieved through physical methods such as dry heat ovens, hot air sterilizers, moist heat autoclaves, or chemiclaves. Chemical methods, such as ethylene oxide, are used in hospital settings, and 2% glutaraldehyde has a sterilizing effect.
Sterilization Process Control
Control of Sterilization Process: Ensures that the goal of eliminating microorganisms has been achieved. Physical controls monitor pressure, time, and temperature. Chemical controls check for color change at specific temperatures. Biological controls use bacterial spores in a capsule, incubating them for 48 hours to measure color change. If no color change occurs, sterilization was successful; a color change indicates incorrect sterilization.