what um is NOT protected with the mask filtration?
< 3um is not protected
what is the size of tuberculosis?
.5 to 1 um
What is Resident Bacteria?
Stable normal Flora of the skin
True/False. Resident Bacteria can be altered by new pathogens or washing of the hands?
True
True/False. Resident Bacteria can be shed with exfoliation?
True
What is transient bacteria?
bacteria on skin from contact
how may transient bacteria be taken off your hands?
washing hands
What are the indications for a routine handwash?
before and after lunch
before and after bathroom
before and after gloving
if gloves become torn
if hands become contaminated
When do you perform an antiseptic handwash?
AM and PM
When do you perform an Antiseptic hand rub?
within the same patient appointment
what are the four objectives of infection control?
prevent transmission of infectious agent
reduce level of pathogenic organisms
eliminate cross contamination
application of standard precautions
what is process for instrument processing?
instrument cleaning
rinse and dry
package
seal
sterilize
store packages
clinical use
repeat
what is the purpose (2) for instrument packaging?
prevent contamination of sterilized instruments
maintain sterile environment when storing instruments
what are the three types of sterilization?
moist heat-steam under pressure
dry heat
chemical vapor
What things can not be used with steam under pressure?
oils
waxes
powders
or materials that can't be under high temp
what is the temp, pressure, and time for steam under pressure?
temp-120c 250 f
pressure-15lbs
time 15min or 30 for heavy load
what are the advantages for steam under pressure?
inexpensive
quick
economical
what are the disadvantages for steam under pressure?
corrosive to some instruments
How does Dry heat sterilize?
sterilizes thru oxidation (outside to inside)
what can you sterilize with dry heat?
oils
powders
burs
what is the temp and time for dry heat?
temp-160c 320f
time 2hrs
temp170c 340f
time 1 hr
what are the advantages for dry heat sterilization?
used for things that can't be autoclaved
no corrosion
great for sharp instruments
what are the disadvantages for dry heat sterilization?
long time
maintain high temp
How does chemical vapor sterilization work?
combo of alcohols, formaldehyde, ketone, water and acetone heated under pressure produces gas that is an effective sterilizing agent
what is the temp pressure and time for chemical vapor sterilization?
temp 127-132c 260-270f
pressure 20-40lbs
time 20 min
what are the advantages to chemical vapor sterilization?
corrosion free
short time
easy to operate
what are the disadvantages for chemical vapor sterilization?
needs good ventilation
odors
What are the categories for chemical disinfectants?
high level
intermediate level
low level
what does a high level disinfectant do?
inactivates spores and all forms of bacteria fungi and viruses
what does an intermediate level disinfectant do?
kills all microorganisms but not spores
what does a low level disinfectant do?
inactivates vegetative bacteria and certain lipid type viruses
What are the types of chemical disinfectants?
surface
immersion disinfection
immersion sterilants
what are the classifications of inanimate objects?
critical
semicritical
noncritical
what is a critical object and give and example.
penetrates soft tissue
needles curettes and probes
what do you do with a critical object after using it during an appointment?
dispose or sterilize
what is a semi critical object and give an example.
doesn't penetrate mucus membrane just touches it
mirror
what must be done with semicritical objects after used during a patient appointment?
sterilize or high level disinfection
what is a noncritical object and give an example.
doesn't touch the mucus membrane
light
what must be done with an noncritical object after used during a patient appointment?
intermediate disinfection
what is the water line maintenance pre appointment in the AM and the maintenance before and after each patient?
AM-2 minutes
Between patients-30 seconds
What are the 2 objectives for the pre-procedural rinse?
number of bacteria on gingival or mucosal surface is reduced
substantivity of .12% chlorhexide provides lower bacterial count for >60 minutes
What is the procedure following an occupational accident exposure?
wash wound immediately with soap and water
flush nose, mouth, eyes or skin with clear water, saline or sterile irrigant
report to designated official
complete incident report as required
follow clinic procedures
post exposure policies must follow guidelines given by the United States public health services
What are six rules for patient introductions?
always introduce yourself to the patient
Always call by Mr. Mrs or Miss
Lady's name proceeds gentlemen
Older person before younger (when of the same sex)
Patient name before dental personnel
Elderly never by 1st name unless requested
what are the four chair positions?
upright
semi-upright
supine
trendelenberg
what are the contradictions to supine position?
cardiovascular
respiratory
vertigo
pregnancy
requests (elderly)
Define ergonomics
practice that makes work safe, decreases strain and fatigue, eliminating hazards, improve work process affecting health and well being of clinician and patient
what is NWP?
neutral working position
what are the 5 things to consider when thinking about relationship to patient and equipment?
clinician chair-next to pt chair, thighs parallel to floor
height of patient chair- at clinicians elbow
dental light-easy to reach 45degrees max and straight on for man
clinician- clock positions
bracket table-level or below shoulders
what are the 4 clock positions and what areas are they used for?
8 to 9- anterior surfaces toward
9- posterior surfaces toward
10-11-posterior surfaces away
12- anterior surfaces away
what are the four uses of the mouth mirror?
indirect vision
illumination
transillumination
retraction
what are the precautions for using the air/water syringe?
alert patient
avoid sharp blasts
avoid air into pockets
avoid deflecting saliva
avoid patient throat
what angle must the probe be inserted at?
parallel to long axis of the tooth
where is the perio probe inserted at?
distal line angle
what kind of strokes are used when probing?
walking strokes
how many measurements are taken when probing and from where?
6 measurements
3 buccal and 3 lingual
Can pockets be seen on radiographs?
no, must be probed
define universal precautions
infection control in which all human blood and certain body fluids are treated as if known to be infectious for HIV, HBV, and other blood borne pathogens
define standard precautions
infection control to protect dental health care personnel and patients from pathogens spread thru blood or other body fluids (except sweat)
what are the modes of disease transmission?
direct contact
indirect contact
airborne
what are the 7 factors influencing infection development?
presence of infectious agent
number of organism
duration of exposure
virulence of the organism
immune status of host
general physical health of the host
nutritional status of the host
what are the characteristics of aerosols?
less than 50 um but usually less than 5 um
solid or liquid
visible or invisible
long air suspension
less than 5um can go deep into lungs
what are areosols created by?
breathing
coughing
sneezing
what are the characteristics of spatter?
>50um
shorter air suspension than aerosols because they are heavier
visible especially when they land
what are some ways spatter can be created?
handpieces
ultrasonics
air water spray
how is TB transmitted?
inhalation
aerosols
not good standard precautions
droplet nuclei through mask
airborne
ingestion
direct inoculation
how is hep A tansmitted?
fecal/oral
waterborne/food borne
blood
how is hep B transmitted?
percutaneous
blood transfusion
sexual exposure
perinatal transmission- in utero and birth
how is hep B transmitted?
percutaneous-blood, needles
saliva
nonpercutaneous- sexual and perinatal
What is HHV1 (Herpes Labialis)?
cold sore or fever blister
get a prodrome-burning stinging before lesion
what is HHV1 (herpes whitlow)?
occurs on fingers- enters thru skin abrasions
saliva, direct contact, nail biting
what is HHV3 (varicella)?
chicken pox
highly contagious
direct or indirect contact
what is HHV3 (zoster)
shingles
latent in dorsal root ganglia
localized or unilateral
intraoral lesions when 2nd branch of trigeminal nerve is involved
when can you legally defer a patients treatment?
with active TB
when can you postpone treatment to another day?
with herpes lesion
what are the (6) features of a health history?
logical sequence
quick identification
space for patients comments
space for interviewers notes
size consistent with other ecordes
other languages
what are the two types of exams for health histories?
questionnaire
interview
what type of patients are required to take prophylatic antibiotics?
required for patients at risk for infective endocarditis for soft tissue instrumentation, that may create a bacteremia.
what are some health indications for profphylatic antibiotic?
prosthetic cardiac valves
previous endocarditis
congenital heart disease
for prophlatic antibiotic patients what procedures do they need to take antibiotics for?