What is the placement order of PPE?
- Wash hands
What um is protected by the mask filtration?
> 3um is protected
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/False. Resident Bacteria can be shed with exfoliation?
What is transient bacteria?
bacteria on skin from contact
how may transient bacteria be taken off your 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
- store packages
- clinical use
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?
- or materials that can't be under high temp
what is the temp, pressure, and time for steam under pressure?
- temp-120c 250 f
- time 15min or 30 for heavy load
what are the advantages for steam under pressure?
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?
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
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?
- immersion disinfection
- immersion sterilants
what are the classifications of inanimate objects?
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
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
what must be done with an noncritical object after used during a patient appointment?
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?
what are the contradictions to supine position?
- requests (elderly)
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
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?
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
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?
what are the characteristics of spatter?
- shorter air suspension than aerosols because they are heavier
- visible especially when they land
what are some ways spatter can be created?
- air water spray
how is TB transmitted?
- not good standard precautions
- droplet nuclei through mask
- direct inoculation
how is hep A tansmitted?
- waterborne/food borne
how is hep B transmitted?
- blood transfusion
- sexual exposure
- perinatal transmission- in utero and birth
how is hep B transmitted?
- percutaneous-blood, needles
- 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)
- 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?
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?
- manipulation of gingival tissue
- involving PA region of the tooth
- perforation of the oral mucosa