m





m

| Both patients and dental health care
personnel (DHCP) can be exposed to
pathogens.
| Contact with blood, oral and respiratory
secretion, and contaminated equipment
occurs.
| Proper procedures can prevent transmission
of infections among patients and DHCP.
m
 r he removal of harmful substances such as
chemicals, harmful bacteria, or other organisms, from
exposed individuals, rooms, and furnishings in buildings or in
the outside environment.
m  
 r he process of the spread of a disease
agent through a population



 r
easures practiced by health care personnel
in health care facilities to prevent the spread of infectious
agents

 

   r pecialized clothing or
equipment worn by a worker for protection from a hazard.
 1. an organism that harbors or nourishes another
organism (the parasite).
2. the recipient of an organ or other tissue derived from
another organism (the donor).
| Bloodrborne pathogen.

|Nonrbloodrborne pathogen.
Y
icrobes that may be present in human
blood and other potentially infectious
materials (OPI
) and cause human diseases.

Y ë


0 Hepatitis C (HCV)
0 Human immunodeficiency virus (HIV; AID)
0 Hepatitis B (HBV)
0 Cerebrospinal fluid (around brain and spinal
cord)
0 ynovial fluid (around knee joint)
0 Pleural fluid (around lungs)
0 Amniotic fluid (around unborn baby)
0 Pericardial fluid (around heart)
0 Peritoneal fluid (in abdominal area)
0 Wound drainage
ð emen (male sexual fluid)
ð Vaginal & cervical secretions
(female sexual fluids)
ð aliva (fluids in mouth)
ð Blood contaminated fluids
ð Pathogenrinfected organs & tissue
(invasion of diseasercausing germs into body
parts)
| uxposure to blood, infectious body fluids/tissue/organs and
contaminated fluids
| most common:
|Needle sticks
|Injury by sharps
|uxposure to mucous membranes (e.g., eyes, nose, mouth)
|uxposure to nonrintact (broken) skin

|exual contact
|haring contaminated needles and/or syringes
|Infected mother to unborn child
|Wound exudates (drainage with pus
ë espiratory
ë Cough
ë neeze

ë Fecalroral
ë Feces contaminate food, environment, or
hands

ë Vectorrborne
ë ransmitted by insects
 | DirectContact | Indirect Contact
| Host comes into | Disease is carried from
contact with reservoir reservoir to host

| Kissing,
skinrtorskin | Contaminated
contact, sexual surfaces.
intercourse

| Contactwith soil or
vegetation
£arge droplets within ~1 meter (3 feet)
transmit infection via:
- Coughing, sneezing, talking
-
edical procedures
uxamples:
Y Diphtheria
Y Pertussis (Whooping Cough)
Y
eningococcal meningitis
Very small particles of evaporated
droplets or dust with infectious agent
may«
- emain in air for a long time
- ravel farther than droplets
- Become aerosolized during procedures
uxamples:
Y uberculosis
Y
easles (ubella)
Y  
ð Inflammation of the liver, caused by a virus, other toxic
substance ² here are several types
ð Hepatitis A ² caused by a virus and is transmitted from
infected feces to the mouth and by raw shellfish from
contaminated water ² his occurs primarily in poor
sanitary conditions
ð Hepatitis B ² caused by the HBV virus and is transmitted
through contact with infected body fluids ² he virus can
survive on surfaces and dried blood for at least a week ²
his is why surfaces contaminated with body fluids must be
cleaned and disinfected ² Hepatitis B is the only form of
hepatitis that currently has a vaccination
ð Hepatitis C infection is a chronic infection,
rarely causes death ² 80% have no signs or
symptoms
ð Hepatitis D ² virus is an incomplete NA
virus that requires Hepatitis B to replicate;
found in people with HBV
Y   :
ð Fever, nausea, vomiting, loss of appetite, diarrhea, muscle
and joint pain, jaundice (yellowing of the skin, mucous
membrane or eyes caused by the inability of the liver to
process the bilirubin * break down producer of
heamoglobin*), fatigue, stomach pain and darkened urine
Y `  
ð ood personal hygiene especially hand washing
ð afe sex practices
ð Use of tandard Precautions by health workers
ð Blood product screening
ð Hepatitis B vaccine
| 
  

ð HBV Vaccination series shall be offered, at no cost,

to all employees whose jobs involve the risk of
directly contacting blood or other potentially
infectious materials
ð Vaccinations shall be given according to
recommendations for standard medical practice
ð Vaccinations needs to be made available after the
employee has received training and within 10 days
of initial assignment
ð umployee can decline vaccination and later change
his/her mind. If an employee declines vaccination,
they need to sign a declination form
|  m
ð Acquired Immunodeficiency yndrome ² is caused by the
Human Immunodeficiency Virus (HIV) ² an individual may be
infected for several years before symptoms of the disease
develop ² it is estimated from 2% to 9% of the population is
infected ² HIV can eventually lead to AID or death ²
reatments may be effective in prolonging life but there is no
cure ² he chance of contracting HIV in the workplace is
estimated at 0.4 % r he virus is transmitted by contact with
body fluids ² Contact with infected blood and/or body fluids
|   
ð Weakness, fever, sore throat, nausea, night sweats, skin rash,
headaches, diarrhea, weight loss, swollen lymph glands and
white coating on tongue
|  m  ` 
ð isk reduction education
ð afe sex practices
ð Use of standard precautions by health care workers
ð afe disposal of sharps
ð Blood product screening
ð Avoidance of breast feeding by HIV positive
mothers
| 
 ð Ú

ð 100 r 103
|    ð 0.3%

    ð Ú

 ! ð 100 r 106
ð 3%
| " ð Ú

ð 102 r 108
ð 30%
|Commonly involve: Percutaneous
(through skin) injury, splashes to
eyes/nose/mouth, contact with broken
skin

|Whatare the steps to take after an

exposure?
teps:
1. First aid, if needed
2. Wash/flush involved site
3. Notify supervisor; identify source person when
possible
4. Complete an injury form*
5. Followrup care/evaluation & counseling*
rr lab testing, appropriate prophylaxis/
treatment, information on laws/regulations;
options written; recordkeeping of event

* At the direction of healthcare site·s policy/ procedure

|hortclean finger nails.
|No jewels.
|Hand wash before and after each
patient.
|No food or drink in clinical area .
|Vaccination .

|Personal protection6
|Wet hands with clean (not hot) water
|Apply soap

|ub hands together for about 20

seconds
|inse with clean water

|Dry with disposable towel or air dry

|Use towel to turn off faucet

|uffective if hands not visibly soiled
|
ore costly than soap & water

ethod
|Apply appropriate (3ml) amount to
palms
|ub hands together, covering all
surfaces until dry
|loves.
|
ask.
|own.
|Protection eye wear.
|Face shield.
|Protects the skin and mucous
membranes from exposure to
infectious materials in spray or
spatter.
|hould be remove when leaving
treatment area.
|Wear a surgical mask and eye
protection with solid side shields or a
face shields to protect mucous
membranes of eyes, nose and mouth.
|Change masks between patients.
|Clean reusable face protection between
patients ; if visibly soiled , clean and
disinfect.
|Wear gowns, lab coats, or
uniform that cover skin and
personal clothing likely become
soiled with blood ,saliva or
infectious materials.

|Change if visibly soiled .

|emove all barriers before
leaving the work area.
|
inimize the risk of doctors acquiring
infection from patients.
| Prevent the transmitted of microbial flora
from doctors to patients.
| educe contamination of the hands of
doctors by microbial flora that can
transmitted from one patient to another .
| Are not a substitute for hand washing.
|Wear gloves when contact with
blood , saliva and mucous
membrane is possible.
|emove gloves after patient
care.
|Wear anew pair of gloves for
each patient.
Do not wash ,disinfect or emove gloves that torn,
sterilize gloves for reuse . cut or punctured.
|Criticalinst.
|semircritical inst.
|Nonrcritical inst.
|Penetrate mucous membrane or
contact bone, bloodstream ,or other
normally sterile tissues ( on mouth) .
|Heat sterilize between uses or use
sterile singler use, disposable devices .
|uxample :
r urgical inst.
r calpel blade .
r Periodontal scalars.
r urgical dental burs.
|Contact mucous membrane but
not penetrate soft tissue .
|Heat sterilize or highrlevel
disinfect.
|uxamples :
r Dental mouth mirror .
r Amalgam condenser.
r Dental hand pieces.
|Contact intact skin.
|Clean and disinfect using a low to
intermediate level disinfectant.
|uxample:
r xrray heads .
r Face bows .
r Pulse ox meter.
r Blood pressure cuff.
|Use designated processing area to
control quality and ensure safety.

|Divided processing area into work areas:

1. receiving, cleaning and
decontamination.
2. Preparation and packaging.
3. terilization.
4. torage.
|Ultrasoniccleaner .
|Instrument washer

|Washerr disinfector 6
|oak until ready to clean.
|Wear heavyrduty utility
gloves, masks, eye wear and
protective clothing.
|Critical and semircritical items that will
be stored should be wrapped or placed
in continuers before heat sterilization .
|Hinged inst. Opened and unlocked .
|Place a chemical indicator inside the
pack .
|Wear heavyrduty , puncturerresistant
utility gloves .
| is freeing of an article from
all living organisms and there
spores.
    
r uither : dry heat or moist heat.
  
  liquid
    all plastic instruments.
m   
  
r uither gases or fluid .
r Fluid : formaldehyde ,
gluteraldehyde .
r as : ethylene oxide .
Õ m
   
r Hot air oven 170 ¶c for one hour .
 
 
r Using spirit or alcohol .
r Burning used when no way for sterilization.
 

 
r For removal of waste products and
disposable materials.
m   
r for metallic inst.
|Õ
 
r Best way.
r principle steam under pressure .
â ravity displacement
â Prervacuum
r pressure 1 pound ( 121·c for 15min )
0 Partial removal of micrororganisms.
0  
Õ   temp. below 100·c .
  
  hepafilter
 
m  
  
r Alcohol .
r Halogens .
r H2O2 .
|Only for heatrsensitive critical and semir
critical devices.
|Powerful ,toxic chemicals raise safety
concern.
|Heat tolerant or disposable alternative
are available .
| Use date or eventrrelated shelfrlife practice .
| uxamine wrapped items carefully prior to
use.
| When packaging of sterile items is damaged ,
rerclean , rerwarp and rersterilize.
| tore clean items in dry ,closed or covered
containment.
|
echanical :
â measure time , temperature , pressure
|Biological.: ( spores tests)
â use biological spores to assess the
sterilization process directly
|Chemicals:
â Change in color when physical
parameter is reached .