Infection Prevention in Dentistry

Question 1

List some body substances in dentistry that may contain blood borne viruses

Answer 1

1. Blood
2. Unfixed tissue
3. CSF
4. Saliva

Question 2

List some body substances NOT in dentistry that may contain other pathogens

Answer 2

1. Faeces
2. Urine
3. Vomit
4. Sputum

Question 3

Give some standard precautions we use dentistry

Answer 3

1. Hand hygiene
2. Protection- gowns, masks, gloves, eyewear
3. Safe/ efficient working environment

Question 4

list some things we wear on clinic for protection?

Answer 4

1. Gown
2. Eye wear
3. Mask
4. Gloves

Question 5

List the stages of cleaning/ sterilisation of instruments and equipment

Answer 5

1. Pre sterilisation
2. Sterilisation
3. Storage

Question 6

How can we pre sterilise instruments and equipments

Answer 6

1. Hand cleaning
2. Ultrasonic
3. Bath
4. Enzyme
5. Cleaners
6. Instruments washing machin

Question 7

What is the aim of pre sterilisation?

Answer 7

To remove all organic matte

Question 8

How do we sterilise instruments and equipments

Answer 8

Autoclaving

Question 9

How do we store sterilised instruments and equipments

Answer 9

Dry covered conditions

Question 10

Which method of sterilisation is most favoured and why:

1. Boiling
2. Disinfectant
3. Autoclaving

Answer 10

Autoclaving

As Boiling can be inadequate and Disinfectants are inadequate

Question 11

What settings does a dental autoclave usually have?

Answer 11

1. 134-138 Degrees for 3 minutes

2. 115-118 degrees for 30 minutes

Question 12

Name the document that states how your autoclave should work

Answer 12

HTM 01-05

Question 13

Give examples of transmissible spongiform encephalopathies that can be transmitted in dentistry

Answer 13

1. Mad cow disease
2. CJD, VCJD, Gerstmann-straussler-scheinker Syndrome
3. Prion disease

Question 14

What are the problems associated with trying to sterilise surfaces from prions

Answer 14

They are impervious to:

1. Heat
2. Steam
3. Chemical disinfection

Question 15

Where can prions be found in dentistry

Answer 15

1. Nervous tissue
2. Tonsils
3. Other lymphoid tissue
4. Dental pulp (?)

Question 16

When is chemical disinfection used to sterilise equipment?

Answer 16

When that equipment can’t be autoclaved

Question 17

Name some surface disinfectants

Answer 17

1. Alcohols
2. Aldehydes
3. Halogens
4. Oxidising agents
5. Phenols
6. Quaternary ammonium compounds

Question 18

In the Leeds teaching hospital what do we use to decontaminate surfaces?

Answer 18

Chlorine releasing agents (diluted bleach)

Question 19

Describe the qualities of bacterial based surface disinfectants

Answer 19

1. Bactericidal
2. Fungicidal
3. Virucidal

Question 20

Describe the qualities of aldehyde based surface disinfectants

Answer 20

COSHH

Sporcidal

Question 21

Describe the qualities of halogen based surface disinfectants

Answer 21

Corrosive and not active against spores

Question 22

Describe the qualities of oxidising agent based based surface disinfectants

Answer 22

Corrosive at high concentrations

Question 23

Describe the qualities of phenol based surface disinfectants

Answer 23

COSHH and not active against spores

Question 24

Describe the qualities of Quaternary ammonium compound based surface disinfectants

Answer 24

Limited efficiency

No activity for virus or spores

Question 25

How can blood Bourne viruses spread in dentistry

Answer 25

1. Sharps injury 2. Mucocutaneous exposure 3. Contaminated instruments

Question 26

What is the risk of developing HBV after a percutaneous sharps injury

Answer 26

30%

Question 27

What is the risk of developing HCV after a percutaneous sharps injury

Answer 27

3%

Question 28

What is the risk of developing HIV after a percutaneous sharps injury

Answer 28

0.3%

Question 29

List 3 factors that affect the risk of transmission of blood borne viruses

Answer 29

1. Prevalence of infection in the population served 2. The infection state of the source patient 3. Risk of exposure

Question 30

Define exposure prone procedures

Answer 30

Invasive procedures where there is a risk that injury to the worker may result in the exposure of the patients open tissues to the blood of the worker

Question 31

List features of exposure prone procedures

Answer 31

1. Hands inside cavities 2. May not be able to see hands/fingers 3. Exposed to sharp instruments/ tissues

Question 32

What should the viral load of hep B for an uninfected person be?

Answer 32

Below 200 IU/ML

Question 33

How do we treat exposure to HIV?

Answer 33

Combination of post exposure prophylaxis drugs

Question 34

What are the ethical guidelines regarding treating people with a blood borne virus

Answer 34

It is unethical for a dentist to refuse to treat a patient solely on the grounds that the person has a blood borne virus

Question 35

Name some water Borne organisms that can cause disease

Answer 35

1. Pseudomonas aeruginosa 2, Atypical mycobacteria 3. Legionella sp

Question 36

Who is at threat from water Borne organisms

Answer 36

Immunocompromised patients or those with chronic lung diseases