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INFECTION CONTROL IN DENTAL LAB Revised by: C. Heston Created by: ANKIT PRABHAKAR GENESIS INSTITUTE OF DENTAL SCIENCES AND RESEARCH,FEROZEPUR PUNJAB CONTENTS 1 Introduction 2 Scope and objectives 3 Transmission of infection 4 Clinical and laboratory disinfection 5 CDC dental guidelines for sterilization of instruments INTRODUCTION Why do we need to know about infection control? •A study has found that 67% of materials sent from dental office to laboratories were contaminated with bacteria of varying degree of pathogenicity.` Scope of this presentation Occupational Risks Direct contact •Infected saliva or blood Airborne infection spatter • From microbial laden aerosols • During lab procedures •When using knives and other sharp items CHAIN OF INFECTION Pathogen Reservoir Susceptible host Direct contact Portal of entry Indirect contact GOALS/ ACTIONS Make dental lab safe Minimize potential Immunization Barrier techniques Aseptic techniques IC compliance Transmission of infection IMPRESSION IMPRESSION TRAYS ARTICULATOR Transmission of infection CASTS OCCLUSAL RIMS DENTAL PROSTHESIS SOURCES OF PATHOGENS Infection control precautions • Prevention of cross contamination should always be a prime consideration in the dental lab. • Appropriate personal protective equipment •Frequent hand hygiene •Organization of dental lab into separate receiving , production & shipping areas. BARRIER SYSTEMS Personal Protective equipment Hand washing Plain or antimicrobial soap Or an alcohol based hand rub Gloves Mask & protective eye wear Chin length face shield Labcoat Disinfection of impressions IMPRESSION COMPOUND Iodophors and sodium hypochlorite REVERSIBLE HYDROCOLLOID Iodophors and sodium hypochlorite IRREVERSIBLE HYDROCOLLOID Iodophors and sodium hypochlorite POLYETHER Iodophors and sodium hypochlorite ZOE IMPRESSION PASTE Glutaraldehydes, iodophors POLYSULFIDE Glutaraldehydes, iodophors SILICONE Glutaraldehydes, iodophors CHOICE OF DISINFECTANT METHODS OF DISINFECTION Methods of disinfection Spraying Uses less disinfectant Same disinfectant can be used again Immersion Preferable Exposure of all surfaces DENTAL LAB PROCEDURES INCOMING ITEMS OUTGOING ITEMS Rinse to remove blood & saliva Clean and disinfect Disinfect Rinse, dilute with mouthwash Again rinse to remove disinfectant Place in plastic bag Add the annotation on the form Label the plastic bag ORALLY SOILED PROSTHESIS Scrub with brush and antimicrobial soap. Place in plastic bag in ultrasonic cleaning solution. Removed Rinsed Dried Accomplished required work. DENTAL PROSTHESIS Do not exceed the recommended contact time to minimize corrosion. Do not store in disinfection before insertion. Store in diluted mouthwash until insertion. DISINFECTION OF CASTS Most difficult to disinfect without causing damage. In such cases, can be sprayed with an iodophor or chlorine product Rinsed, handled in aseptic manner Transfer to the production area. Dry properly, if shipping. LAB EQUIPMENT Polishing lathe requires special attention. Should be equipped with shield Should be equipped with ventilation to remove aerosols Air suction motor must be able to produce an air velocity of at least 200 feet/min A metal enclosure with hand holes is fixed to the front of the hood provides maximum containment Pumice has been shown to pose a potential contamination risk via aerosol or direct contact. It should be discarded after every use Rag-wheel and burs need to be sterilized between uses All unbarriered areas need to be disinfected. CDC DENTAL GUIDELINES Objectives - protect patients, practitioners & staff. All blood and saliva is infectious. Reviews scientific information & makes recommendations to protect the health of the population. Tracks disease trends & investigates disease outbreaks. RESPONSIBILITY Responsibility Practical code Universal precautions Standard precautions Procedure kept cross infection control Protect exposure from blood Blood as well as from body fluids also. GENERAL PREVENTION VACCINATION MEDICAL HISTORY •In order to identify pathological conditions, 30 25 20 15 10 5 0 •Drug induced conditions HIV HBV HCV Average Risk of Transmission after Percutaneous Exposure to Blood •Malformations & abnormalities SPECIFIC GUIDELINES These guidelines apply in the care of all patients. Disposal of wastes Cleaning and maintenance Personal hygiene SUMMARY Wearing protective personal equipments Adhering to Standard precautions Aseptic techniques PREVENTION OF DISEASE TRANSMISSION