Final Revision Flashcards
(107 cards)
1
Q
How can infections be transmitted in dental practice?
A
through immediate contact with blood, saliva and other secretions or through contaminated or inadequately disinfected or sterilized instruments
2
Q
What are the basic measures that need to be taken to be protected?
A
single use gloves mask protective gloves appropriate medical clothing surface covering single-use instruments instrument sterilization surface and flooring sterilization hand washing injury prevention vaccination immunization of dental personnel
3
Q
Hand Washing =
A
cornerstone of patient - doctor and staff protection circle against cross-contamination
- before and after in contact with the patient/instruments used
- independently of wearing gloves or not, during the operation
- after removing gloves, hands must be carefully washed since pores are present in latex allowing contaminated material to penetrate
4
Q
Solution to dry skin and dermatitis:
A
skin moisturizing lotions/creams
- used at the end of the day as they affect the material of the gloves creating micro holes
- as consequence, the gloves provide no protection whatsoever
5
Q
During dental work for hands you should use:
A
water and soap, followed by antimicrobial solution (with prolonged action)
-if injury you should wait until wound is healed. if this not possible use a double pair of suitable and tolerable gloves
6
Q
Use of antimicrobial solution with prolonged action:
A
- protects hands against development of microorganisms on the hand surface below the gloves
- it is ineffective if you don’t wash your hands prior to it
7
Q
Use of alcohol antiseptic solutions or gels:
A
destroy the germs on the hand surface, provided that adequate cleaning has been preceded
8
Q
When does a solution have a prolonged antiseptic action?
A
only if it contains an antiseptic agent
ex: chlorhexidine, quaternary ammonium compounds, octenidine, or triclosan
9
Q
When should dispensers be filled?
A
- when the container should be completely empty
- dispensers must be washed and dried prior to filling
- on hand cleaning and antiseptic products, microorganisms may occur when remaining in dispensers for a long time
10
Q
The gloves of medical and auxiliary staff should:
A
- be sterilized only if an operation is going to take place, particularly on HIV patients
- be used at any dental work for a single patient only and then they should be removed and discarded
- DO NOT wash the gloves or use them on another patient !!
- sterilizing examination gloves is not allowed as their integrity preservation is not guaranteed and any disinfection fluid, essential oil etc it may distort the cohesion of the glove material
- use DOUBLE GLOVES (DGT) with HIV patients for the protection of the surgeon -> difficult for them to get ripped
11
Q
Latex gloves can cause:
What is the solution to it?
A
- can cause anaphylactic rxn
- solution: use of hypoallergic gloves or vinyl/nitrile gloves
12
Q
In case of an injury, scratch or exudative injury the use of:
A
double pair gloves is recommended for extra protection
13
Q
Masks:
A
- to avoid splashes of blood or other biological fluids
- they must be able to withhold at least 95% of the microorganisms
- in case patient suffers from airborne disease (tuberculosis) the mask must be enhanced and fully adaptable to the wearer’s face
- must be able to withhold particles and microorganisms with a diameter up to 1μm at a percentage of 95% (aspirator N95, FFP3)
- if a mask gets wet it must be discarded and replaced
14
Q
In case goggles/ eye protectors are contaminated in b/w patients we must:
A
rinse with abundant water and disinfect them
15
Q
Suitable medical clothing:
A
- changed on daily basis and definitely as soon as they get stained
- cover a great part of the dentist’s body and arms
- if the operative procedure is expected to involve large amount of bleeding or pt is SEROPOSITIVE (person living with HBV/HCV/HIV), you should wear a specially designed single use clothing
- they must be washed in a machine washer at an appropriate Tm using a detergent and always separately from domestic and non-medical clothing
- these clothes should not be used outside dental practice
16
Q
Any surface/device/handles etc should:
A
- be covered with special rollers and plasticized paper sheets, cellulose film, aluminium foil, self-adhesive films, nylon cases, latex and vinyl cases etc
- be replaced after every contact and every patient
17
Q
Cleaning and sterilization of dental instruments:
A
- immediately after the completion of a dental work
- must be discarded in a special plastic container filled with appropriate disinfectant sol or enzyme sol with a proteolytic action
- they remain in sol for as long as the manufacturer recommends
- then they are transferred to machine washers where they undergo thorough mechanical cleaning using the appropriate detergents
18
Q
How should the instruments be cleaned if they have dental materials fixed to them? (process)
A
- with ultrasonic devices and appropriate solutions
- NOT with manual cleaning as injuries are highly to be caused
- then they are packaged in special bags or perforated cassettes and they are taken to the autoclaves to be sterilized
19
Q
Autoclaves:
A
- operate according to
1. the packaging of the instruments
2. to the default specifications set by the manufacturer - completion of cycle and sterilization process is confirmed through electronic instrument indications and changes in the color or shape of the indicators
- aforementioned times DO NOT INCLUDE preheating of the autoclave or air removal
- it will inform you if i needs a change
fresh: transparent, aging: dull - once you take our the instrument box from autoclave, the indicator will change color to let us know that sterilization has been completed
- steam sterilization
- removes microorganisms with high Tms and pressures
- ex: for surgical materials
20
Q
Single use instruments types:
A
obligatory single use and optionally single use instruments
21
Q
obligatory single use Vs optionally single use instruments
A
obligatory single use:
- used once and then are discarded
- ex: surgical suctions, needles, rubber cups, scalpes, fluoride trays etc
optionally single use:
-ex: napkin holders, impression trays, burrs, speed handpieces, stump formation in seropositive patients etc
22
Q
Sterilization of handpieces:
A
- before use
- after dental work completion, the external surfaces of the handpiece have come in contact with fluids and debris and residues of dental materials
- their internal tubes might got infected due to various hydrodynamic phenomena taking place when cavity forms subgingivally
- moist heat using saturated water vapours (autoclave)
23
Q
When can handpieces get infected by pathogens?
A
- opening up a coronal cavity during endo therapy
- forming stumps
- polishing gingival restorations
- polishing cervical areas of teeth after perio treatment
24
Q
Asepsis control:
A
- protection from any contact with the fluids existent in oral env
- chemical disinfection
- thermal sterilization
- disinfection using microwaves
- disinfection via irrigation
- single use handpieces
- moist heat using saturated water vapours (autoclave)
25
Sterilization of handpieces process:
- after dental work, operate them for a few sec over wash basin (container) while ejecting water and air
- then detached them from the tubes, connect them with the unit to be washed and brushed under water and dried with an absorbent paper
- after external cleaning the handpiece is reconnected to the tubes and operates for a few sec only with air so that water residues are removed from the interior of the tubes and the impellers
- then is lubricated and operated again only with air so that lubricant is properly distributed throughout the sensitive areas of the head
- then it is enclosed in a special pouch air tightly sealed with a self-adhesive tape or a thermosealer
- placed in autoclave
- the pouch should include: handpiece and sterilization indicator (special tape / vial with carbon grains) -> not necessary is the pouch includes the length of stay and vapor Tm w/in autoclave
- sterilized
- lubrication again sometimes with a different from previous time
26
Tm of autoclave operates at:
121 degrees for 20'
127 degrees for 13'
134 degrees for 3'
27
Sterilization of burrs process:
- meticulous cleaning or using paste-like mixture with saliva
- don't use rubber, goldsmith's brushes or old toothbrushes
- use ultrasonic devices (baths) with suitable fluids and addition of enzymes with proteolytic action
- after they are removed from bath, they are dried with absorbent paper and hot air
- then they are placed in appropriate device for sterilization depending on the material they are made of
28
Which burrs should not be placed in autoclave and why?
carbon steel b/c it will undergo oxidation
29
Problem with the sterilization of burrs device:
-dry heat ovens for sterilization; if their usage is prolonged it may damage the cutting edge of the burrs
-aldehydes and phenols may damage the integrity of rotating cutting instruments
-no technique can fully remove debris, thus result in successful sterilization
SO single use burrs are discarded after each patient
30
Use and care of sharp instruments and needles:
- shouldn't be recapped either with both hands or using any other technique when the point of the needle is directed towards the body
- techniques: 1 hand to recap OR mechanic device designed to hold the needle cap
31
Packaging and disposal of waste:
1. non-hazardous domestic waste
- only these are allowed to be packaged in a conventional way
2. potentially hazardous waste
3. hazardous waste
4. sharp and instruments
- from 2 to 4 are both packaged and disposed in plastic or metal containers lined with a high quality, thick, plastic bag of visible color
- single use or household gloves should be worn
- do not press on the waste bag
- on waste bag should bear an indication that it contains hazardous waste (even on the new bag)
- the fluids (ex: disinfectants) must be discarded in the drainage through a special funnel, not in the sinks or toilets and then the funnel is disinfected with an appropriate solution afterwards
32
Storing sharp instruments:
- special storage boxes
| - special freezer
33
Preparing impressions for the lab:
- after removing trays from the mouth, they must be cleaned and sterilized in an appropriate way with suitable solutions
- then tray is transferred to the wash basin and use of water is used to remove blood, saliva etc
- afterwards, spray/immerse the tray with disinfectant depending on the impression material used
- impressions must be packaged in a suitable plastic box so they can be safety transported to lab
34
Protection measures prior to beginning dental work:
- vaccination against hepatitis B (for free)
- take detailed medical history
- independently of the info you have collected from pt, you must consider their potentially contaminated and take the precautions advised for all pts
- instruments should be sterilized
- protect working surfaces
- disinfectant fluids and waste containers ready
- sterilize in autoclave or dry heat instruments in contact with tissues
35
*SOS*
When to wash hands:
```
Before food preparation or consumption
After touching raw food
After using the toilet
After cleaning/refilling personal hygiene items
Before and after patient care
After coughing, sneezing, rheum
After contact with animals and their faeces
After packing any kind of waste
Before and after contact with trauma
```
36
*SOS*
When to wash hands in dental office:
```
Before starting daily activity
Before putting on gloves !!
After removing the gloves !!
Immediately after an injury (or suspicion) !!
After secretarial work
After cleaning work !!
After disinfection / sterilization work !!
After completing daily activity
```
37
*SOS*
How to wash hands in dental office:
Wet your hands with lightly warm water
Apply a dose of hand cleanser
Rub your palms, wrists, opisthenar, fingers and between the fingers for 15-20 sec
Clean the areas around and under nails
Rinse the detergent thoroughly
Dry your hands !!! (critical for your safety)
-not necessary to wash with a strong antiseptic, even a normal soap is fine
```
Places on hands where is most crucial to wash:
below nails
opisthenars
finger tips
b/w fingers
palms
above hands
```
38
*SOS*
Methods of hand drying:
1. Paper:
- More superior than electric air dryers
- Most effective
- Should be used by hospitals and clinics
- Safe technique
- Financially difficult
- Not environmentally friendly
2. Air
- electric hand driers pose health risk
- jet air dryer: thousand virus particles, warm air dryer: hundred virus particles, paper towel: ten virus particles
3. Rolling towel
4. Towel
- not scrubbing them, but tapping them b/c it can cause irritation in a few weeks
39
Are electric air dryers the right solution?
- a warm air dryer and electric hand dryer increase the average numbers of bacteria on the hands after use, whereas paper towel reduces them
- jet air dryer has potential to spread contamination to users and washroom environment than warm air dryers
- energy consuming
- there's a conical inside that helps trap moisture and doesn't spread
40
Warm/Hot air dryers Vs Cloth roller towels:
Warm/Hot air dryers:
- not recommended for use
- slow and noisy
- their hygiene performance is questionable
Cloth roller towels:
- not recommended
- they can become common-use towels at the end of the roll
- can be a source of pathogen transfer to clean hands
41
*SOS*
The transmission of bacteria is more likely to occur through _ skin surfaces:
wet
42
Single use paper towels is the optimal choice b/c:
```
Offer protection against disease
Preferred among washroom users
Endorsed by experts
Sustainable, economic and energy efficient
Cause less contamination to the washroom environment
Dry hands effectively
Easy to install and maintain
Remove bacteria effectively
They are superior to electric air dryers
THE BEST but, expensive
```
43
*SOS*
Body covers:
```
Mask
Gloves
Medical shirt
Glasses
Headgear
```
44
*SOS*
Glove types:
Latex
Vinyl
Nitryl
Nylon
45
Which dental assistant knows how to sterile instruments?
a certified one
46
Which is responsible for dental assistant's performance?
the dentist needs to know how to monitor the dental assistant's performance
47
Polymerics:
ex: composites, resins
- very hard
- stick everywhere
- light cure
- flowable composite only in syringes
48
Autoclave OR Dry storage is better?
Autoclave
49
What do you sterilize and what do you disinfect?
sterilize: instruments
disinfect: surfaces (ex: benches,chairs)
50
Yellow color of gloves inside:
due to humidity -> micro penetration
is NOT sweating
51
*SOS*
WHERE ELSE DO WE HAVE CAVITATION?
ultrasonic (15', on and off for high Tm and 40 degrees is the max)
52
In office we don't use:
- chlorines or aldehydes
| - we want an aldehyde free office
53
Allergies caused by:
latex gloves
| silicon impression materials
54
*SOS*
Critical items:
come in contact with what?
how risky are they?
which technique is used to clean them?
- contact with sterile tissue, circulatory system, internal organs - infection risk
- injury risk for the patient
- cleaning, disinfection & sterilization
55
*SOS*
Semicritical items:
come in contact with what?
how risky are they?
which technique is used to clean them?
- contact with mucous membranes and perforated skin
- injury risk for the patient
- cleaning & disinfection
56
*SOS*
Non-critical items:
come in contact with what?
how risky are they?
which technique is used to clean them?
- contact with perforated skin
- no injury risk for the patient
- cleaning & optional disinfection
57
*SOS*
Sterilization =
which tools do you sterilize?
process in which the removal of any pathogenic microorganism is achieved, on the outside and on the inside of any tool undergoing this procedure for a relatively long time
Tools that penetrate or come into contact with
soft tissues, bone but also with hard dental tissues
in the sense of stump or cavity preparation
58
*SOS*
Dental clinical asepsis protocol BEFORE surgical procedure (surfaces):
- Cleaning and disinfection of ALL non covered surfaces
- Coverage of different surfaces - neck pillow, seat controls, headlight handles, air water syringe, suction switches, handle sockets, peripheral device controls
- Medical glove change
- Tool placing
59
*SOS*
Dental clinical asepsis protocol DURING surgical procedure (surfaces):
- Restriction of microorganism diffusion from patients’ mouth (minimize them)
- Avoidance of nervous movement
- Diligent (=inappropriate) needle coverage -> decup them with a specific system
- Avoidance of cabinet material making
- Disinfection of packages when put back into place
- No usage of septic gloves during health record keeping
60
*SOS*
Dental clinical asepsis protocol AFTER surgical procedure (surfaces):
- Wearing gloves, safety glasses and a mask removes the tools
- Tool placing in a disinfectant or enzyme solution
- Disposal of one-use supplies
- Collection of tools and immersion in appropriate solutions
- Handle functioning for 30”, cleaning and sterilization
- Disposal of surface covers: the blue staff are lightly sticky to be removed easily
- Disinfection of surfaces
- Cleaning of safety glasses
- Disposal of gloves and clothing
- Diligent hand washing
61
*SOS*
Sole responsibility of the dental assistant:
- Patient settlement
- Necessary tool development
- Necessary material development
- Retention of surgical suction
- Preparation of neutral layers, cements etc
- Material activation in the form of a capsule
- Transfer of amalgam / polymers into the cavity
- Photopolymerization device retention
- Necessary tool and material supply
- Disposal of septic screens, saliva ejectors etc
- Tool immersion in cleaning / disinfectant solution (do not insert a handpiece into immersion)
- X-ray imaging
- Patient’s card update
- Imprinted material preparation
- Imprint rinsing
- Surface cleaning with alcohol base compounds (spray 1.5' and then dry with paper towel) / covering change
- Care of tool sterilization cleaning cycle
- Assessment/Census of stock supplies
62
*SOS*
Organic pollutants during dental practice:
```
Saliva
Sputum
Blood
Pus
Serum
Gingival sulcus liquid
Gastric fluids
Various by case
```
63
*SOS*
Field of work control:
```
1.Unit preparation
Workbench
Projector
Seat
Sputum container
Cutting tool area
Air syringe
Waste container
```
2. Receipt - Tool development:
- Tool set: starter, amalgam, resin composite
- Disposable trays
- Necessities development
3.Dentist preparation
4.Clinical procedure
5.Delivery of tools
6.Unit cleaning
-Sharps disposal
needles
wedges
artificial matrix bands
broken tools
64
Which bonding agents attack gloves?
alcohol
| ethanol
65
Betatine disadv:
staining
66
Oxidizes disadv:
can affect the pluming of the office
67
Light curing lamp:
- sterilize it w/o the orange protection
- alcohol or autoclave
- no aldehyde, no oxidizing releasing agent
68
Vacuum:
- clean it after each patient
| - after each afternoon disinfect it, otherwise you will have a bad smell the next morning
69
*SOS*
Tools with cutting edges:
anesthesia needles, endodontic fibers and expanders, nodules, scalpel blades, connectors, lateral condensing tools, welders, wedges, artificial walls, broken glass, bone spikes, periodontal scrapers, dental screws, probes, microorganism hooks and anything that could penetrate the scarf skin or skin
70
*SOS*
Injury Protection Safety measures:
Bioguard long sleeve shirt
Good quality mask
Good quality gloves, suitable for any kind of work
Eye protectors
Closed textile, leather or synthetic footwear
71
*SOS*
Injury protection from sharp instruments:
Immediate coverage or destruction of the needle after anesthesia
Avoidance of repositioning the needle in the hood with both hands
Avoidance of bending or unscrewing the needle by hand
Disposal of needles in special, durable and non-visitable containers
Avoidance of searching for sharps in dumping sites
Blade removal with the help of a needle holder
Selective compression of artificial walls
Burr removal from the handles
Avoidance of manual tool cleaning
Usage of heavy-duty gloves when cleaning tools
Careful application of 4-hand dentistry: better than 2 hands
Frustration and rush restraint
Control of the “confidence” factor
Acceptance of safety glasses
72
*SOS*
Post Exposure Prophylaxis instructions:
1. Immediate care in the area of the injury
2. Fill out the report form and consult a qualified medical service
3. Follow the applicable standing instructions
α) Use any information
β) Search for information regarding HBV, HCV, HIV
4. Evaluate your serological status including screening for anti-HCV and ALT 4-6 months after exposure
5. Evaluate your serological status for HIV antigen and anti-HIV
6. Receive HAART treatment (=highly active antiretroviral therapy) no later than the first 72 hours
73
Light cure devices with fiber glass tips sterilization:
- immersion inside strong antiseptic solutions
| - autoclave devices to sterilize the rods
74
*SOS*!!
Sonication:
what CANNOT be sonicated?
- sonicate separately the different types of rotating instruments, grouping them according to their performing and structural characteristics
- uses sound waves
- from the moment it vibrates, it is the same as the ultrasonic we use for scaling
- a dental clinic must have it with a tube so that it flows into the sink, you wont have to carry it
- ex: for endodontic files
- during sonication, cycles of pressure form millions of microscopic vacuum bubbles in the solution (which remove dirt and dust)
- these bubbles collapse into cavitation solution which causes powerful waves of vibration that release an enormous energy force in the cavitation field, which disrupts molecular interactions such as interaction b/w molecules of water, separates clumps of particles and facilitates cleaning
- The majority of dental instruments can be sonicated (burrs, files, reamers, hand tools, metallic trays, glass slabs etc) EXCEPT high speed contra angle handpieces
75
Which are the most affected rotating instruments?
- Diamond burrs are the less affected rotating instruments followed by the TuCa burrs.
- Steel burrs are the most affected rotating instruments, corroded and difficultly cleaned
- steel vs stainless steel are totally different from each other
76
How to clean the burrs:
Low concentration enzymatic solutions as well as nοn ionic ones are the most appropriate for burrs cleaning, prior to sterilization.
Deionised water, low in chlorine has to be used in order to avoid spots formation and tarnishing of the metallic instruments.
77
Non ionic solutions:
- excellent cleansing agents
- non corrosive
- remove the majority of the debris clogged on every part of the burrs
78
How can enzymatic solutions become efficient?
longer immersion and sonication time
79
Quantify the amount of Total Volatile Compounds emitted from commonly used dental substances:
```
disinfectants
bonding agents
acrylic substances
controlled dental micro-environment
evaluation of environmental parameters
```
80
Ventilation systems should:
- exhaust outdoors
| - must be maintained and cleaned professionally (as well as air conditioning units)
81
How to minimize the amount of aerosol splatter contaminating surfaces?
use of personal barriers such as face mask, protective eye wear, dental uniform and gloves in conjunction with preoperative mouth-rinse with 0.12% or 0.20 % chlorhexidine, high vacuum surgical suction and rubber dams
82
How are the Dental Unit Water Lines affected by microbial contamination?
The quality of the water provided from the Public water lines
Constructions and new connections
Suck back during the operational procedures
83
Dental Unit Waterlines and Biofilm:
Microbial biofilms form in small bore tubing of dental units
Biofilms serve as a microbial reservoir
Primary source of microorganisms is municipal water supply
84
The multiplication of pathogenic Μ/Ο inside the dental office is easier because of:
The immobility of the water for many hours
The favourable temperature in the area
Biofilm formation inside the long and narrow tubing
Continuous suck back of pathogenic Μ/Ο
85
Sterile Irrigating Solutions:
Use sterile saline or sterile water as a coolant/irrigator when performing surgical procedures
Use devices designed for the delivery of sterile irrigating fluids
86
System for preventing and remediating biofilms in dental equipment :
A system having a fluid source and a pasteurizer coupled with a disinfectant unit in flow communication with the fluid source for use in disinfecting dental or other water lines.
The combination of pasteurizer and disinfectant unit is adapted to receive water from the fluid source.
A fluid delivery unit is provided in flow communication with the pasteurizer and disinfectant unit combination. The disinfectant unit has a means for supplying hydrogen and oxygen and a means for generating hydrogen peroxide in flow communication with the means for supplying hydrogen and oxygen.
87
what the general dental practitioner needs to do to reduce the problem in his dental unit:
- Flushing of the water lines for 2 minutes every morning before treating the first patient
- Flushing of the water lines for 30 seconds between each two patients
- The use of independent water system
- The use of disinfectants such as H2O2 and NaClO
- Avoidance the use of warm water in the DUWLs as the water should be kept below 20° C
- Draining of the DUWLs at the end of each day
- Making sure that the anti-retraction valve in the handpiece is functional by regular maintenance.
88
Ultrasonic cleaner:
- for micro instruments, NOT handpieces !!
- for sterilization of burs
- clean them with water before placing them in to remove any large debris
- never place instruments or cassettes directly on the bottom of the cleaner as it would damage the unit
- place the lid on the cleaner to avoid aerosols
- never reach into it with bare hands or while its running
- never add or remove instruments during the cycle
- once completed take it out from the cleaner and place it in sink with warm flow of water for faster drying
- then package them after drying
- then place them in autoclave for sterilization
89
*SOS*
Disinfection Vs Sterilization Vs Dry heat:
Disinfection:
-removes some microorganisms
Sterilization:
- removes all microorganisms
- can sterilize anything
- accomplished in HOT AIR OVENS
- it is longer than in steam sterilizers due to lack of moisture
Dry heat:
- doesn't sterilize everything
- death of microorganisms occurs here by oxidation (the slow process of coagulating the protein of the cell)
90
What is SCM?
=microscopic magnification to check debris on burs, files etc
91
Wrapping of instruments:
1. self-sealed: 2 types: thermosealing device and manual
2. dry heat: green only
-so that they are not spilled out
92
*SOS*
Autoclave types: N Vs S Vs B types:
N type:
- most commonly used
- only water placed, closed door and switch it on
- fully automatic front loading autoclave with a capacity of 15 L
- with dry cycle autoclave and micro processor controlled
- wrapped/unwrapped, non porous, solid instrument can be sterilized
- diagnostic automatic alarm for any malfunctioning
- 2 storage tanks for fresh and used water
- chamber size 230 mm x 360 mm
- net weight: 50 kg
- digital display for pressure and Tm
- silicon gasket prevents any leakage of air
- can be used at 121 or 134 degrees during sterilization
- no negative pressure
- comparing with nothing is very good
S type:
-removes large quantity of air
B type:
- fully automatic front loading with a capacity of 18L
- double air suction
- no air inside
- 1 vacuum to absorb large quantity of air
- excellent
- tries to find more bubbles
- 2 cycles
93
Focus targets of injury protection protocols:
```
The Dentist
The dental office personnel
The janitors
The public
The disposals’ collectors
The scavengers
```
94
Causes of injuries:
```
Needle sharp edge
Dental cavity spoon
Dental explorer
Debridement instruments
Perioscale instruments
Contaminated Debridement instruments
Clean perioscale instrument
Hollenbeck amalgam trimmer
Ultrasonic scaler tip
Water spray emmited from handpieces
Matrix bands
Matrix band retainers
Perio ligament cutter
Diamond separation discs
Various diamond burrs
```
95
Needle recapping or removal technique:
```
Tweezer technique
Tablet technique
Single hand/ Amputee technique
Stand technique
Card style stand technique
Other techniques (shield,etc)
Cut off techniques
Vaporization technique
```
96
What to do if an needle injury occurs?
1. stay calm
2. wash with water and soap the area
3. apply antiseptic and band-aid
4. contact your supervisor
5. visit your hospital emergency department as soon as possible for blood testing, counselling etc
6. staff can access the EAP
7. dispose of the needle/syringe safely
97
Manual decontamination under certain circumstances:
```
Use of thick utility groves
No use of Latex gloves
Use a long handle brush
Avoid agile movements
Avoid hard (έντονων) movements
Use goggles
Limited use on specific instruments
```
98
Manual cleaning of instruments DISADV:
High risk for acupuncture or ocular spills accidents
Moderate cleaning results
Contamination of the surrounding area
Time consuming procedure
Large quantity of tap water consumption
Improper for hosed (metallic surgical tip) instruments
High cost procedure
99
Trauma Protection Protocols:
Immediate capping or destruction of the needle
Avoid to replace the needle cap with both hands
Avoid to unscrew or to bend the needle with bare hands
Use the specifically designed sharps containers
Do not search for missing items inside the sharps’ bins.
Remove scalpels using suture tweezers or specifically designed devices
Gentle placement and removal of the metallic matrix bands
Remove all burrs from the handpieces when not operating
No manual cleaning /decontaminating of the hand instruments.
Use heavy duty gloves when cleaning and decontaminating instruments.
Perform carefully 4 hands dentistry.
Do not be in a hurry or upset
Moderate the “self confidence “ factor
Always wear appropriate goggles
100
Post Exposure Protocol:
```
Remove gloves immediately
Do NOT squeeze the bleeding area
Wash trauma carefully with water and antiseptic soap
Use paper towels to dry your hands.
Use an alcohol based disinfectant
Cover the trauma with a sterile band
Recover the patients medical history
Immediate contact/visit a proper hospital unit
```
101
Which of the following types of gloves should be utilized to provide the best protection during the cleaning of dental operatories?
A. Vinyl
B. Cotton
C. Utility
D. Latex
C. Utility
Utility gloves are thicker than latex and vinyl gloves
These have larger cuffs and are designed to handle wastes more easily
Utility gloves have greater tear strength and are more water resistant
102
Autoclaving technique is depending on:
1. Dry heat.
2. Steam heat (under pressure)
3. Chemicals
2. Steam heat (under pressure)
103
*SOS*
CIRCLE OF DENTAL TOOL TRANSPORTATION:
SEPTIC COLLECTION – STORAGE
Dry Storage
Immersion
CLEANING
Ultrasounds
Washing Machines
LUBRICATION/OXIDES REMOVAL
PACKAGING
STERILIZATION
STORAGE
104
*SOS*
IMMERSION:
It facilitates the cleaning process to prevent dried blood, excretions and the adherence of scrapings
105
*SOS*
THERMO DISINFECTORS:
Tm?
HEATED WATER UP TO 93oC
( disinfection which relies on moist heat to kill bacteria and viruses by exposure to a specific temperature for a set amount of time)
106
Boiling Water:
Boiling water can never be trusted for absolute sterilization procedures because its maximum temperature is 100o C (at sea level). As indicated previously, spores can resist this temperature
Exposure to boiling water kills all pathogenic microorganisms in 10 minutes, but not bacterial spores or hepatitis viruses
107
STERILIZATION THROUGH DRY HEAT (in comparison to autoclave)
PROS
Low cost
Challenge of minor problems
Minimum preparation required
Ability to record the sterilization cycle
Ability of confirming the sterilization process
```
CONS
Time consuming sterilization
Moderate heat penetration
Poor heat distribution
Destruction of many heat sensors and mixed tools
Tool color changing
Handle sterilization inability
```
