Safety
standard precautions
Standard of care applying to all patients to protect healthcare providers and their patients from pathogens
spread by body fluids.
Prepare a comprehensive patient history and make necessary referrals.
Ask the patient to rinse with an antimicrobial mouthrinse to reduce the numbers of oral microorganisms.
Provide protective eyewear.
Avoid elective procedures for a patient who is suffering from a communicable condition, such as a respiratory infection, or who has an open lesion on or about the lips or oral tissues.
patient factors
ergonomic factors for gloves
Fit hand well, no interference with motion
▪ Tactile sense not decreased
▪ No tight pull over palm or between thumb and index f
Sterilization is achieved by action of heat transfer (inactivate/coagulate cellular proteins/enzymes); pressure
serves only to attain high temperature (air is forced out).
▶▶ Sterilization depends on the penetrating ability of steam
Steam Under Pressure (autoclave)
chemical vapor sterilization
A combination of alcohols, formaldehyde, ketone, water, and acetone heated under pressure produces a gas that is effective as a sterilizing agent
patient factors, clinic preparation, factors for the dental team, treatment factors, posttreatment
5 standard precautions
when should you change masks
With each new patient
Every hour
when wet
criteria for selecting gloves
safety and ergonomic factors
advantages of steam under pressure
- All microorganisms, spores, and viruses are destroyed quickly and efficiently.
- Wide variety of materials may be treated;
- most economical method of sterilization.
Corrosion- and rust-free operation for carbon steel instruments.
Ability to sterilize in a relatively short total cycle.
Ease of operation and care of the equipment.
advantages of chemical vapor sterilization
Syringe Needles Use a safe recapping and disposal methods (Chapter 36) to prevent accidental penetration or self-inoculation.
Removable Oral Prostheses Gloves are worn to receive a prosthesis from a patient. Place the prosthesis in a disposable cup or plastic resealable zipper bag and cover with a disinfectant. Use a fresh solution of 0.05% iodophor in water, or a 1:5 dilution of 5% sodium hypochlorite. Place the cup or bag alone in an ultrasonic cleaner, making sure it does not tip and spill.
Treatment Factors
when should you wash hands
Before and after each patient
After barehanded touching of inanimate objects likely to be contaminated by blood or saliva
Before leaving the dental operatory or the dental laboratory
When visibly soiled
Before regloving after removing gloves that are torn, cut, or punctured
Before donning sterile surgeon's gloves for surgical procedures
safety factors for gloves
▪ Effective barrier
▪ Impermeable
▪ Strength and Durability
▪ Impervious
▪ Nonirritating or Harmful to Skin
▪ Length
disadvantages to steam under pressure
If precautions are not taken, carbon steel instruments may corrode
disadvantages of chemical vapor sterilization
Chemical vapor sterilization cannot be used for materials or objects that can be altered by the chemicals that make the vapor or that cannot withstand the high temperature.
Adequate ventilation is needed; cannot be used in a small room.
Slight odor, which is rarely objectionable
how long should you run water lines for?
2 minutes at the beginning of the day and 30 seconds before and after use
wash wound with soap and water/rinse
flush nose/eyes/mouth/skin
complete incident report
follow posted procedures
obtain medical evaluation
ask patient to be accompanies for testing
if not baseline testing is done
6 week follow up
counseling
procedure following exposure
what agents would break down gloves
Alcohol based products
washing gloves (they are disposable for a reason)
Vaseline (petroleum jelly)
achieve sterilization by oxidation of molecules, resulting in death of the organism.
▶▶ Sterilization is achieved by heat conducted from the exterior surface to the interior of the object; the penetration time varies among materials.
dry heat
Corrosion- and rust-free operation for carbon steel instruments.
Ability to sterilize in a relatively short total cycle.
Ease of operation and care of the equipment.
advantages of chemical vapor sterilization
Use heavy puncture-resistant gloves to handle contaminated, unsterile instruments.
Follow routines to disinfect, clean, and prepare the instruments for sterilization.
Contaminated waste is secured in disposable plastic bags and infectious waste in a container with a secure lid. Disinfect safety eyewear for patient and dental team members.
Posttreatment
Report signs and symptoms (hepatitis/HIV)
Obtain medical evaluation (for fever/rash)
Pursue counseling
follow up after exposure
_________ cleaning of instruments is a dangerous, difficult, and time-consuming procedure.
Manual
disadvantages of dry heat
- Long exposure time required; penetration slow and uneven.- High temperature critical to certain materials.
Chemical vapor sterilization cannot be used for materials or objects that can be altered by the chemicals that make the vapor or that cannot withstand the high temperature.
Adequate ventilation is needed; cannot be used in a small room.
Slight odor, which is rarely objectionable
disadvantages of chemical vapor sterilization